title: Polyclonal outbreak of bacteremia caused by Burkholderia cepacia complex and the presumptive role of ultrasound gel.
abstract: A nosocomial polyclonal outbreak associated to bacteremia caused by different Burkholderia cepacia complex (BCC) species and clones is reported. Molecular characterization identified Burkholderia stabilis, Burkholderia contaminans, and Burkholderia ambifaria among BCC isolates obtained from patients in neonatal and adult intensive care units. BCC was also isolated from an intrinsically contaminated ultrasound gel, which constituted the presumptive BCC source. Prior BCC outbreak related to contaminated ultrasound gels have been described in the setting of transrectal prostate biopsy. Outbreak caused strains and/or clones of BCC have been reported, probably because BCC are commonly found in the natural environment; most BCC species are biofilm producers, and different species may contaminate an environmental source. The finding of multiple species or clones during the analysis of nosocomial BCC cases might not be enough to reject an outbreak from a common source.
authors: Division of Infectious Diseases, Sanatorio Británico, Rosario, Argentina; Division of Infectious Diseases, School of Medicine, Universidad Nacional de Rosario, Rosario, Argentina. Electronic address: esteban.nannini@sanbritanico.com.ar.
authors: Esteban C
authors: EC
authors: Nannini
authors: Department of Microbiology, Sanatorio Británico, Rosario, Argentina.
authors: Adriana
authors: A
authors: Ponessa
authors: Division of Infectious Diseases, Sanatorio Británico, Rosario, Argentina.
authors: Rosa
authors: R
authors: Muratori
authors: Instituto de Biología Molecular y Celular de Rosario - CONICET, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Argentina.
authors: Patricia
authors: P
authors: Marchiaro
authors: Instituto de Biología Molecular y Celular de Rosario - CONICET, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Argentina.
authors: Viviana
authors: V
authors: Ballerini
authors: Division of Infectious Diseases, Sanatorio Británico, Rosario, Argentina.
authors: Luis
authors: L
authors: Flynn
authors: Instituto de Biología Molecular y Celular de Rosario - CONICET, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Argentina.
authors: Adriana S
authors: AS
authors: Limansky
mesh_terms: D000328:Adult; D016470:Bacteremia / Q000175:diagnosis / Q000382:microbiology*; D019121:Burkholderia Infections / Q000175:diagnosis / Q000382:microbiology*; D042602:Burkholderia cepacia complex / Q000145:classification / Q000302:isolation & purification*; D003428:Cross Infection / Q000175:diagnosis / Q000382:microbiology*; D004196:Disease Outbreaks; D005782:Gels / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D007362:Intensive Care Units; D014463:Ultrasonography / Q000009:adverse effects* / Q000451:nursing
chemical_list: D005782:Gels
keywords: Bacteremia; Burkholderia cepacia complex; Outbreak; Polyclonal