Cargando…
Systematic review of healthcare-associated Burkholderia cepacia complex outbreaks: presentation, causes and outbreak control
BACKGROUND: Over the past decades, the Burkholderia cepacia complex (BCC) has been linked to multiple healthcare-associated outbreaks. No systematic analysis of these outbreaks has been carried out to date. The aim of this study was to conduct a systematic review of reports on nosocomial BCC outbrea...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8335909/ https://www.ncbi.nlm.nih.gov/pubmed/34368718 http://dx.doi.org/10.1016/j.infpip.2020.100082 |
_version_ | 1783733220644225024 |
---|---|
author | Häfliger, Emmanuel Atkinson, Andrew Marschall, Jonas |
author_facet | Häfliger, Emmanuel Atkinson, Andrew Marschall, Jonas |
author_sort | Häfliger, Emmanuel |
collection | PubMed |
description | BACKGROUND: Over the past decades, the Burkholderia cepacia complex (BCC) has been linked to multiple healthcare-associated outbreaks. No systematic analysis of these outbreaks has been carried out to date. The aim of this study was to conduct a systematic review of reports on nosocomial BCC outbreaks. METHODS: Published studies from 1971 until 9/12/2019 presenting nosocomial BCC outbreaks were identified using Embase, Pubmed and abstracts from professional meetings. RESULTS: We identified a total of 111 outbreak reports. Thirty-two percent of the affected institutions were academic hospitals and 43.8% community hospitals. The average outbreak duration was 198.6 ± 604.4 days. A total of 240 deaths (10% of the 2390 case patients) were reported but only 28 (1.2% of the 2390 case patients and 11.7% of the 240 deaths) were directly attributable to BCC. The source could be identified in 73.9% of the outbreaks; 53.2% were caused by contaminated medical solutions and medications, 12% were due to a contaminated disinfectant. In 28.2% of the outbreaks intrinsic product contamination was reported. Multidrug resistance was noted in 26.1% of the BCC strains. PFGE was the most frequently used typing method (43.2%) in the context of outbreak work-up. CONCLUSION: Medical products are the most frequent source of BCC outbreaks, representing over half of the identified sources, with 12% of the outbreaks caused by disinfectant products. Intrinsic product contamination was detected frequently, suggesting a need for stricter regulation. While BCC-related mortality was low, our systematic review revealed significant heterogeneity in both investigations and reporting of BCC outbreaks. |
format | Online Article Text |
id | pubmed-8335909 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-83359092021-08-05 Systematic review of healthcare-associated Burkholderia cepacia complex outbreaks: presentation, causes and outbreak control Häfliger, Emmanuel Atkinson, Andrew Marschall, Jonas Infect Prev Pract Original Research Article BACKGROUND: Over the past decades, the Burkholderia cepacia complex (BCC) has been linked to multiple healthcare-associated outbreaks. No systematic analysis of these outbreaks has been carried out to date. The aim of this study was to conduct a systematic review of reports on nosocomial BCC outbreaks. METHODS: Published studies from 1971 until 9/12/2019 presenting nosocomial BCC outbreaks were identified using Embase, Pubmed and abstracts from professional meetings. RESULTS: We identified a total of 111 outbreak reports. Thirty-two percent of the affected institutions were academic hospitals and 43.8% community hospitals. The average outbreak duration was 198.6 ± 604.4 days. A total of 240 deaths (10% of the 2390 case patients) were reported but only 28 (1.2% of the 2390 case patients and 11.7% of the 240 deaths) were directly attributable to BCC. The source could be identified in 73.9% of the outbreaks; 53.2% were caused by contaminated medical solutions and medications, 12% were due to a contaminated disinfectant. In 28.2% of the outbreaks intrinsic product contamination was reported. Multidrug resistance was noted in 26.1% of the BCC strains. PFGE was the most frequently used typing method (43.2%) in the context of outbreak work-up. CONCLUSION: Medical products are the most frequent source of BCC outbreaks, representing over half of the identified sources, with 12% of the outbreaks caused by disinfectant products. Intrinsic product contamination was detected frequently, suggesting a need for stricter regulation. While BCC-related mortality was low, our systematic review revealed significant heterogeneity in both investigations and reporting of BCC outbreaks. Elsevier 2020-08-13 /pmc/articles/PMC8335909/ /pubmed/34368718 http://dx.doi.org/10.1016/j.infpip.2020.100082 Text en © 2020 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Research Article Häfliger, Emmanuel Atkinson, Andrew Marschall, Jonas Systematic review of healthcare-associated Burkholderia cepacia complex outbreaks: presentation, causes and outbreak control |
title | Systematic review of healthcare-associated Burkholderia cepacia complex outbreaks: presentation, causes and outbreak control |
title_full | Systematic review of healthcare-associated Burkholderia cepacia complex outbreaks: presentation, causes and outbreak control |
title_fullStr | Systematic review of healthcare-associated Burkholderia cepacia complex outbreaks: presentation, causes and outbreak control |
title_full_unstemmed | Systematic review of healthcare-associated Burkholderia cepacia complex outbreaks: presentation, causes and outbreak control |
title_short | Systematic review of healthcare-associated Burkholderia cepacia complex outbreaks: presentation, causes and outbreak control |
title_sort | systematic review of healthcare-associated burkholderia cepacia complex outbreaks: presentation, causes and outbreak control |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8335909/ https://www.ncbi.nlm.nih.gov/pubmed/34368718 http://dx.doi.org/10.1016/j.infpip.2020.100082 |
work_keys_str_mv | AT hafligeremmanuel systematicreviewofhealthcareassociatedburkholderiacepaciacomplexoutbreakspresentationcausesandoutbreakcontrol AT atkinsonandrew systematicreviewofhealthcareassociatedburkholderiacepaciacomplexoutbreakspresentationcausesandoutbreakcontrol AT marschalljonas systematicreviewofhealthcareassociatedburkholderiacepaciacomplexoutbreakspresentationcausesandoutbreakcontrol |