title: [An outbreak of Burkholderia cepacia bacteremia in a hemodialysis unit, Cadiz, 2014].
abstract: BACKGROUND
  In January 2014 a possible outbreak of Burkholderia cepacia bacteremia occurred in a hemodialysis center situated in La Linea de la Concepción (Cadiz). An investigation was begun to confirm the outbreak, identify the source, and implement control measures.
  
  
  METHODS
  A descriptive analysis was performed to describe the characteristics of the patients affected with Burkholderia cepacia bacteremia from November 2013 to February 2014. Environmental samples were taken. A molecular typing study was performed using pulsed field gel electrophoresis (SpeI PFGE) and MLST analysis in order to determine the genetic similarity between the isolates.
  
  
  RESULTS
  The bacterium was isolated from blood cultures of 7 patients during the study period. Three of the samples (2 of which were also cases) were endoluminal fluid from catheter locks, and 4 chlorhexidine bottle samples. The patients were coincident in 2 of the 6 work shifts. The mean age of the cases was 67 years of whom 57% were women. Human samples and an environmental sample was analyzed and found to be genetically identical (ST653 clone).
  
  
  CONCLUSIONS
  The analysis confirmed the outbreak of Burkholderia cepacia, with 7 cases among the patients of the hemodialysis center. The outbreak was due to the same strain, probably a common source and secondary transmission from person to person.
authors.affiliation: Servicio de Epidemiología, Área de Gestión Sanitaria Campo de Gibraltar, Sistema Andaluz de Salud, Algeciras, España. Electronic address: cmontanno@gmail.com.
authors.forename: Carmen
authors.initials: C
authors.lastname: Montaño-Remacha
authors.affiliation: Servicio de Medicina Preventiva, Área de Gestión Sanitaria Campo de Gibraltar, Sistema Andaluz de Salud, La Línea de la Concepción, España.
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Márquez-Cruz
authors.affiliation: Servicio de Nefrología, Área de Gestión Sanitaria Campo de Gibraltar, Sistema Andaluz de Salud, Algeciras, España.
authors.forename: Pilar
authors.initials: P
authors.lastname: Hidalgo-Guzmán
authors.affiliation: Servicio de Microbiología, Área de Gestión Sanitaria Campo de Gibraltar, Sistema Andaluz de Salud, La Línea de la Concepción, España.
authors.forename: Antonio
authors.initials: A
authors.lastname: Sánchez-Porto
authors.affiliation: Servicio de Enfermedades Infecciosas, Área de Gestión Sanitaria Campo de Gibraltar, Sistema Andaluz de Salud, La Línea de la Concepción, España.
authors.forename: Francisco de Paula
authors.initials: Fde P
authors.lastname: Téllez-Pérez
mesh_terms: D000368:Aged; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D015373:Bacterial Typing Techniques; D019121:Burkholderia Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission; D016956:Burkholderia cepacia / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission; D004269:DNA, Bacterial / Q000032:analysis; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006757:Hospital Units; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008875:Middle Aged; D058885:Multilocus Sequence Typing; D006435:Renal Dialysis; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
chemical_list: D004269:DNA, Bacterial
keywords: Bacteremia; Bacteriemia; Brotes de enfermedades; Burkholderia cepacia; Cross infection; Disease outbreaks; Diálisis renal; Infección hospitalaria; Renal dialysis