Characterizing uncommon Burkholderia cepacia complex isolates from an outbreak in a haemodialysis unit.
An outbreak of bacteraemia in a haemodialysis unit where 65 episodes of infection involved 35 outpatients is reported. Burkholderia cepacia complex was the agent most frequently recovered from blood. Thirty-three environmental and clinical isolates of B. cepacia complex were characterized by whole-cell protein electrophoresis and recA-RFLP profile. Fourteen isolates were genomovar I and 16 isolates were not classifiable by their recA-RFLP pattern. Ribotyping, random amplification of polymorphic DNA (RAPD) and integron profile were used to explore the clonality of the isolates, and revealed multiple strain genotypes. Four ribotypes and RAPD types and three integron patterns were identified. The water supply was identified as the source of the outbreak, and inappropriate cleaning and a leak in the reverse osmosis tubing connection were the probable causes of contamination. B. cepacia complex was still recovered from blood of patients even after apparently adequate measures were taken and water quality standards were met, suggesting that higher standards for water quality should be adopted in haemodialysis units. The genomovars recovered here were distinct from those commonly reported for cystic fibrosis isolates.
Souza
Andrea V
AV
Centro de Pesquisa Experimental, Instituto de Ensino e Pesquisa Albert Einstein - Av. Albert Einstein 627, 05651-901, São Paulo, SP, Brazil 2Infection Control Service, Hospital da Beneficência Portuguesa de São Paulo, São Paulo, Brazil 3Infection Control Service, Hospital Israelita Albert Einstein, São Paulo, Brazil 4Laboratorium voor Microbiologie, Faculteit Wetenschappen, Universiteit Gent, Gent, Belgium.
Moreira
Cláudia R
CR
Centro de Pesquisa Experimental, Instituto de Ensino e Pesquisa Albert Einstein - Av. Albert Einstein 627, 05651-901, São Paulo, SP, Brazil 2Infection Control Service, Hospital da Beneficência Portuguesa de São Paulo, São Paulo, Brazil 3Infection Control Service, Hospital Israelita Albert Einstein, São Paulo, Brazil 4Laboratorium voor Microbiologie, Faculteit Wetenschappen, Universiteit Gent, Gent, Belgium.
Pasternak
Jacyr
J
Centro de Pesquisa Experimental, Instituto de Ensino e Pesquisa Albert Einstein - Av. Albert Einstein 627, 05651-901, São Paulo, SP, Brazil 2Infection Control Service, Hospital da Beneficência Portuguesa de São Paulo, São Paulo, Brazil 3Infection Control Service, Hospital Israelita Albert Einstein, São Paulo, Brazil 4Laboratorium voor Microbiologie, Faculteit Wetenschappen, Universiteit Gent, Gent, Belgium.
Hirata
Maria de Lurdes
ML
Centro de Pesquisa Experimental, Instituto de Ensino e Pesquisa Albert Einstein - Av. Albert Einstein 627, 05651-901, São Paulo, SP, Brazil 2Infection Control Service, Hospital da Beneficência Portuguesa de São Paulo, São Paulo, Brazil 3Infection Control Service, Hospital Israelita Albert Einstein, São Paulo, Brazil 4Laboratorium voor Microbiologie, Faculteit Wetenschappen, Universiteit Gent, Gent, Belgium.
Saltini
Denise Alves
DA
Centro de Pesquisa Experimental, Instituto de Ensino e Pesquisa Albert Einstein - Av. Albert Einstein 627, 05651-901, São Paulo, SP, Brazil 2Infection Control Service, Hospital da Beneficência Portuguesa de São Paulo, São Paulo, Brazil 3Infection Control Service, Hospital Israelita Albert Einstein, São Paulo, Brazil 4Laboratorium voor Microbiologie, Faculteit Wetenschappen, Universiteit Gent, Gent, Belgium.
Caetano
Viviane Cristina
VC
Centro de Pesquisa Experimental, Instituto de Ensino e Pesquisa Albert Einstein - Av. Albert Einstein 627, 05651-901, São Paulo, SP, Brazil 2Infection Control Service, Hospital da Beneficência Portuguesa de São Paulo, São Paulo, Brazil 3Infection Control Service, Hospital Israelita Albert Einstein, São Paulo, Brazil 4Laboratorium voor Microbiologie, Faculteit Wetenschappen, Universiteit Gent, Gent, Belgium.
Ciosak
Suely
S
Centro de Pesquisa Experimental, Instituto de Ensino e Pesquisa Albert Einstein - Av. Albert Einstein 627, 05651-901, São Paulo, SP, Brazil 2Infection Control Service, Hospital da Beneficência Portuguesa de São Paulo, São Paulo, Brazil 3Infection Control Service, Hospital Israelita Albert Einstein, São Paulo, Brazil 4Laboratorium voor Microbiologie, Faculteit Wetenschappen, Universiteit Gent, Gent, Belgium.
Azevedo
Fátima M
FM
Centro de Pesquisa Experimental, Instituto de Ensino e Pesquisa Albert Einstein - Av. Albert Einstein 627, 05651-901, São Paulo, SP, Brazil 2Infection Control Service, Hospital da Beneficência Portuguesa de São Paulo, São Paulo, Brazil 3Infection Control Service, Hospital Israelita Albert Einstein, São Paulo, Brazil 4Laboratorium voor Microbiologie, Faculteit Wetenschappen, Universiteit Gent, Gent, Belgium.
Severino
Patricia
P
Centro de Pesquisa Experimental, Instituto de Ensino e Pesquisa Albert Einstein - Av. Albert Einstein 627, 05651-901, São Paulo, SP, Brazil 2Infection Control Service, Hospital da Beneficência Portuguesa de São Paulo, São Paulo, Brazil 3Infection Control Service, Hospital Israelita Albert Einstein, São Paulo, Brazil 4Laboratorium voor Microbiologie, Faculteit Wetenschappen, Universiteit Gent, Gent, Belgium.
Vandamme
Peter
P
Centro de Pesquisa Experimental, Instituto de Ensino e Pesquisa Albert Einstein - Av. Albert Einstein 627, 05651-901, São Paulo, SP, Brazil 2Infection Control Service, Hospital da Beneficência Portuguesa de São Paulo, São Paulo, Brazil 3Infection Control Service, Hospital Israelita Albert Einstein, São Paulo, Brazil 4Laboratorium voor Microbiologie, Faculteit Wetenschappen, Universiteit Gent, Gent, Belgium.
Magalhães
Vanda D
VD
Centro de Pesquisa Experimental, Instituto de Ensino e Pesquisa Albert Einstein - Av. Albert Einstein 627, 05651-901, São Paulo, SP, Brazil 2Infection Control Service, Hospital da Beneficência Portuguesa de São Paulo, São Paulo, Brazil 3Infection Control Service, Hospital Israelita Albert Einstein, São Paulo, Brazil 4Laboratorium voor Microbiologie, Faculteit Wetenschappen, Universiteit Gent, Gent, Belgium.
D019121:Burkholderia Infections / Q000453:epidemiology*; D016956:Burkholderia cepacia / Q000145:classification / Q000235:genetics*; D003428:Cross Infection / Q000453:epidemiology*; D004196:Disease Outbreaks; D006436:Hemodialysis Units, Hospital; D006801:Humans; D032023:Integrons; D019105:Random Amplified Polymorphic DNA Technique; D021521:Ribotyping; D014871:Water Microbiology