title: A napkin-associated outbreak of Burkholderia cenocepacia bacteraemia in haemodialysis patients.
abstract: This article reports a catheter-related outbreak of bacteraemia involving 38 patients in two haemodialysis units in Verona. Burkholderia cepacia complex strains were isolated from human blood and from an individually wrapped disinfection napkin that was contained in a commercially available, sterile dressing kit used to handle central venous catheters. Micro-organisms isolated from blood cultures and from the napkin were identified by standard procedures and confirmed as B. cenocepacia (genomovar III) by molecular analysis. Using pulsed-field gel electrophoresis analysis, the clinical isolates were indistinguishable or closely related to the B. cenocepacia isolated from the napkin. In conclusion, this study found that a contaminated commercial napkin soaked in quaternary ammonium, even when quality certified, was the source of infection.
authors.affiliation: Dipartimento di Patologia, Sezione di Microbiologia, Università di Verona, Verona, Italy. giuliana.locascio@azosp.vr.it
authors.forename: G
authors.initials: G
authors.lastname: Lo Cascio
authors.forename: M G
authors.initials: MG
authors.lastname: Bonora
authors.forename: A
authors.initials: A
authors.lastname: Zorzi
authors.forename: E
authors.initials: E
authors.lastname: Mortani
authors.forename: N
authors.initials: N
authors.lastname: Tessitore
authors.forename: C
authors.initials: C
authors.lastname: Loschiavo
authors.forename: A
authors.initials: A
authors.lastname: Lupo
authors.forename: M
authors.initials: M
authors.lastname: Solbiati
authors.forename: R
authors.initials: R
authors.lastname: Fontana
mesh_terms: D016470:Bacteremia / Q000097:blood / Q000453:epidemiology / Q000382:microbiology*; D001458:Bandages / Q000382:microbiology; D019121:Burkholderia Infections / Q000453:epidemiology / Q000382:microbiology*; D042602:Burkholderia cepacia complex / Q000235:genetics / Q000302:isolation & purification*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D004196:Disease Outbreaks; D004202:Disinfectants / Q000494:pharmacology; D004203:Disinfection / Q000379:methods; D016521:Electrophoresis, Gel, Pulsed-Field / Q000379:methods; D004866:Equipment Contamination; D006801:Humans; D007558:Italy / Q000453:epidemiology; D000644:Quaternary Ammonium Compounds / Q000037:antagonists & inhibitors / Q000494:pharmacology*; D006435:Renal Dialysis
chemical_list: D004202:Disinfectants; D000644:Quaternary Ammonium Compounds