title: Molecular epidemiological investigation using a randomly amplified polymorphic DNA assay of Burkholderia cepacia isolates from nosocomial outbreaks.
abstract: We experienced two Burkholderia cepacia outbreaks over a 1-year period. During this period, 28 B. cepacia isolates were obtained from clinical specimens, and 2 were obtained from environmental specimens (i.e., from a nebulizer solution and a nebulizer tube). These 30 isolates were subjected to the PCR-based randomly amplified polymorphic DNA (RAPD) assay as well as to pulsed-field gel electrophoresis (PFGE). In the first outbreak, in which eight patients hospitalized in the Trauma and Critical Care Center were involved, the RAPD assay revealed that all 20 isolates obtained from clinical specimens and the 2 isolates from environmental specimens had identical DNA profiles. These RAPD data enabled us to pinpoint a possible source and to take countermeasures to prevent further spread of the epidemic-causing strain. In the second outbreak, two consecutive B. cepacia infection/colonization cases were seen in the surgery ward. The RAPD profiles of four isolates obtained were again identical, but they were distinct from those seen in the first outbreak, clearly indicating that the second outbreak was not related to the first. Thus, our experience demonstrated that the RAPD assay is a useful and reliable tool for epidemiological studies of B. cepacia isolates from nosocomial outbreaks. Since the RAPD assay could provide discriminatory potential and reproducibility comparable to those of the widely used PFGE assay with less complexity and in a shorter time, the introduction of the RAPD assay into hospital microbiology laboratories as a routine technique may help prevent nosocomial outbreaks.
authors.affiliation: Department of Clinical Laboratory, Kyorin University School of Medicine, Tokyo 181-8611, Kyorin University School of Health Sciences, Tokyo 192-8508, USA. ur9twtnb@asahi-net.or.jp
authors.forename: M
authors.initials: M
authors.lastname: Okazaki
authors.forename: T
authors.initials: T
authors.lastname: Watanabe
authors.forename: K
authors.initials: K
authors.lastname: Morita
authors.forename: Y
authors.initials: Y
authors.lastname: Higurashi
authors.forename: K
authors.initials: K
authors.lastname: Araki
authors.forename: N
authors.initials: N
authors.lastname: Shukuya
authors.forename: S
authors.initials: S
authors.lastname: Baba
authors.forename: N
authors.initials: N
authors.lastname: Watanabe
authors.forename: T
authors.initials: T
authors.lastname: Egami
authors.forename: N
authors.initials: N
authors.lastname: Furuya
authors.forename: M
authors.initials: M
authors.lastname: Kanamori
authors.forename: S
authors.initials: S
authors.lastname: Shimazaki
authors.forename: H
authors.initials: H
authors.lastname: Uchimura
mesh_terms: D015373:Bacterial Typing Techniques; D019121:Burkholderia Infections / Q000453:epidemiology* / Q000382:microbiology; D016956:Burkholderia cepacia / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004269:DNA, Bacterial / Q000235:genetics; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005838:Genotype; D006760:Hospitalization; D006801:Humans; D017720:Molecular Epidemiology; D009330:Nebulizers and Vaporizers / Q000382:microbiology; D010641:Phenotype; D016133:Polymerase Chain Reaction; D019105:Random Amplified Polymorphic DNA Technique; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology; D013183:Sputum / Q000382:microbiology; D014193:Trauma Centers
chemical_list: D004269:DNA, Bacterial