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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...

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Autores principales: Häfliger, Emmanuel, Atkinson, Andrew, Marschall, Jonas
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
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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.
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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
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