title: An outbreak of Burkholderia cepacia lower respiratory tract infection associated with contaminated albuterol nebulization solution.
abstract: An outbreak of Burkholderia cepacia lower respiratory tract colonization and infection occurred in the adult intensive-care units in various geographic locations throughout our hospital. Forty-four patients became colonized or infected over an 11-month period, whereas B cepacia had been isolated from only 13 patients in the preceding 48 months. Environmental cultures revealed the source to be extrinsically contaminated albuterol nebulization solution. Polymerase chain reaction-ribotyping confirmed the genetic relatedness of the B cepacia patient isolates and the contaminated albuterol. After extensive infection control training for the respiratory therapy staff, including attention to nebulization technique, washing and drying the nebulizer cup, and good handwashing, there have not been any new cases.
authors.affiliation: Cooper Hospital/University Medical Center, Division of Infectious Diseases, Camden, NJ 08103, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Reboli
authors.forename: R
authors.initials: R
authors.lastname: Koshinski
authors.forename: K
authors.initials: K
authors.lastname: Arias
authors.forename: K
authors.initials: K
authors.lastname: Marks-Austin
authors.forename: D
authors.initials: D
authors.lastname: Stieritz
authors.forename: T L
authors.initials: TL
authors.lastname: Stull
mesh_terms: D000328:Adult; D000420:Albuterol; D019121:Burkholderia Infections / Q000209:etiology*; D016956:Burkholderia cepacia; D003428:Cross Infection / Q000209:etiology*; D004196:Disease Outbreaks; D004340:Drug Contamination; D006801:Humans; D017053:Infection Control; D007362:Intensive Care Units; D009330:Nebulizers and Vaporizers; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000209:etiology*; D012189:Retrospective Studies
chemical_list: D000420:Albuterol