POLYCLONAL OUTBREAK OF BLOODSTREAM INFECTIONS CAUSED BY Burkholderia cepacia COMPLEX IN HEMATOLOGY AND BONE MARROW TRANSPLANT OUTPATIENT UNITS

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorBOSZCZOWSKI, Icaro
dc.contributor.authorPRADO, Gladys Villas Boas do
dc.contributor.authorDALBEN, Mirian F.
dc.contributor.authorTELLES, Roberto C. P.
dc.contributor.authorFREIRE, Maristela Pinheiro
dc.contributor.authorGUIMARAES, Thais
dc.contributor.authorOLIVEIRA, Maura S.
dc.contributor.authorROSA, Juliana F.
dc.contributor.authorSOARES, Robson E.
dc.contributor.authorLLACER, Pedro Enrique Dorlhiac
dc.contributor.authorDULLEY, Frederico Luiz
dc.contributor.authorCOSTA, Silvia F.
dc.contributor.authorLEVIN, Anna S.
dc.date.accessioned2014-07-03T20:29:27Z
dc.date.available2014-07-03T20:29:27Z
dc.date.issued2014
dc.description.abstractAim: The objective was to describe an outbreak of bloodstream infections by Burkholderia cepacia complex (Bcc) in bone marrow transplant and hematology outpatients. Methods: On February 15, 2008 a Bcc outbreak was suspected. 24 cases were identified. Demographic and clinical data were evaluated. Environment and healthcare workers' (HCW) hands were cultured. Species were determined and typed. Reinforcement of hand hygiene, central venous catheter (CVC) care, infusion therapy, and maintenance of laminar flow cabinet were undertaken. 16 different HCWs had cared for the CVCs. Multi-dose heparin and saline were prepared on counter common to both units. Findings: 14 patients had B. multivorans (one patient had also B. cenopacia), six non-multivorans Bcc and one did not belong to Bcc. Clone A B. multivorans occurred in 12 patients (from Hematology); in 10 their CVC had been used on February 11/12. Environmental and HCW cultures were negative. All patients were treated with meropenem, and ceftazidime lock-therapy. Eight patients (30%) were hospitalized. No deaths occurred. After control measures (multidose vial for single patient; CVC lock with ceftazidime; cleaning of laminar flow cabinet; hand hygiene improvement; use of cabinet to store prepared medication), no new cases occurred. Conclusions: This polyclonal outbreak may be explained by a common source containing multiple species of Bcc, maybe the laminar flow cabinet common to both units. There may have been contamination by B. multivorans (clone A) of multi-dose vials.
dc.description.abstractO objetivo foi descrever um surto de infecções da corrente sanguínea por complexo B. cepacia (Bcc) nos ambulatórios de hematologia e transplante de medula óssea. Métodos: Em 15/02/2008, um surto de Bcc foi suspeitado. 24 casos foram identificados. Os dados demográficos e clínicos foram avaliados. Mãos de profissionais da saúde e ambiente foram cultivadas. Espécies foram determinadas e tipadas. Reforço da higiene das mãos, cuidados com cateteres, terapia de infusão e manutenção da câmara de fluxo laminar foram realizadas. 16 profissionais de saúde (PS) diferentes manipularam os cateteres. Heparina multidoses e soro eram preparadas em um balcão comum a ambas as unidades. Resultados: 14 pacientes tiveram B. multivorans (um paciente teve também B. cenopacia), 6 Bcc não-multivorans e um teve um agente não pertencente a Bcc. Clone A de B. multivorans ocorreu em 12 pacientes (da Hematologia), em 10 o cateter havia sido utilizado nos dias 11 ou 12 de fevereiro. Culturas ambientais e de PS foram negativos. Todos os pacientes foram tratados com meropenem e selo de ceftazidima. Oito pacientes (30%) foram hospitalizados. Não ocorreram mortes. Após as medidas de controle, nenhum novo caso ocorreu. Conclusões: Este surto policlonal pode ser explicado por uma fonte comum contendo várias espécies de Bcc, talvez a câmara de fluxo laminar comum a ambas as unidades. Pode ter havido contaminação por B. multivorans (clone A) de frascos multi-dose.
dc.description.indexMEDLINE
dc.description.sponsorshipHospital das Clinicas, University of Sao Paulo (FMUSP-HC), Brazil
dc.description.sponsorshipFundacao de Auxilio a Pesquisa do Estado de Sao Paulo [FAPESP 2010/09714-8]
dc.identifier.citationREVISTA DO INSTITUTO DE MEDICINA TROPICAL DE SAO PAULO, v.56, n.1, p.71-76, 2014
dc.identifier.doi10.1590/S0036-46652014000100011
dc.identifier.eissn1678-9946
dc.identifier.issn0036-4665
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/5600
dc.language.isoeng
dc.publisherInstituto de Medicina Tropical
dc.relation.ispartofRevista do Instituto de Medicina Tropical de São Paulo
dc.rightsopenAccess
dc.rights.holderCopyright Instituto de Medicina Tropical
dc.subjectBurkholderia cepacia complex
dc.subjectBloodstream infection
dc.subjectNosocomial infection
dc.subjectHematology
dc.subjectBone marrow transplant
dc.subject.otherIDENTIFICATION
dc.subject.otherBACTEREMIA
dc.subject.wosTropical Medicine
dc.titlePOLYCLONAL OUTBREAK OF BLOODSTREAM INFECTIONS CAUSED BY Burkholderia cepacia COMPLEX IN HEMATOLOGY AND BONE MARROW TRANSPLANT OUTPATIENT UNITS
dc.title.alternativeSurto policlonal de infecção de corrente sanguínea causada pelo complexo Burkholderia cepacia em unidades de hospital-dia de hematologia e transplante de medula óssea
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.author.externalTELLES, Roberto C. P.:University of Sao Paulo, Sao Paulo, BRAZIL
hcfmusp.author.externalSOARES, Robson E.:University of Sao Paulo, Sao Paulo, BRAZIL; Pontifícia Universidade Católica de São Paulo, BRAZIL
hcfmusp.citation.scopus6
hcfmusp.contributor.author-fmusphcICARO BOSZCZOWSKI
hcfmusp.contributor.author-fmusphcGLADYS VILLAS BOAS DO PRADO MELO
hcfmusp.contributor.author-fmusphcMIRIAN DE FREITAS DAL BEN CORRADI
hcfmusp.contributor.author-fmusphcMARISTELA PINHEIRO FREIRE
hcfmusp.contributor.author-fmusphcTHAIS GUIMARAES
hcfmusp.contributor.author-fmusphcMAURA SALAROLI DE OLIVEIRA
hcfmusp.contributor.author-fmusphcJULIANA FERRAZ ROSA
hcfmusp.contributor.author-fmusphcPEDRO ENRIQUE DORLHIAC LLACER
hcfmusp.contributor.author-fmusphcFREDERICO LUIZ DULLEY
hcfmusp.contributor.author-fmusphcSILVIA FIGUEIREDO COSTA
hcfmusp.contributor.author-fmusphcANNA SARA SHAFFERMAN LEVIN
hcfmusp.description.beginpage71
hcfmusp.description.endpage76
hcfmusp.description.issue1
hcfmusp.description.volume56
hcfmusp.origemWOS
hcfmusp.origem.pubmed24553612
hcfmusp.origem.scieloSCIELO:S0036-46652014000100071
hcfmusp.origem.scopus2-s2.0-84894046508
hcfmusp.origem.wosWOS:000331932400011
hcfmusp.publisher.citySÃO PAULO
hcfmusp.publisher.countryBRAZIL
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hcfmusp.remissive.sponsorshipFMUSP-HC
hcfmusp.scopus.lastupdate2024-05-10
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