Monday, July 11, 2016

Multistate Outbreak of Burkholderia cepacia Infections

The Centers for Disease Control and Prevention (CDC) is collaborating with the Food and Drug Administration (FDA), multiple state and local health departments, and numerous healthcare facilities to investigate a multi-state outbreak of Burkholderia cepacia infections. These infections have occurred primarily in ventilated patients without cystic fibrosis and who are being treated in intensive care units. 

Preliminary information indicates that a contaminated liquid docusate product might be related to cases in one state. Until more information is available, the CDC recommends that facilities not use any liquid docusate products for patients who are critically ill, ventilated, or immunosuppressed. Institutions with non-cystic fibrosis patients in whom there are B. cepacia infections should sequester all liquid docusate products.

Healthcare providers and laboratories should be on alert for B. cepacia cases occurring among non-cystic fibrosis patients and should inform infection prevention staff when these infections occur. Cases should be reported to state or local public health authorities. 

To date, 47 B. cepacia complex cases have been confirmed by molecular typing to match one of two outbreak strain types identified from healthcare facilities in five states. Reports of possible cases from additional states are currently being investigated. The CDC has confirmed that two samples of unused oral liquid docusate product received from one of the affected hospitals have tested positive for B. cepacia complex. Further testing is being conducted to determine if bacteria from these samples match the outbreak strains. 

The FDA is currently testing multiple liquid docusate products that are epidemiologically linked to reported B. cepacia complex cases. To date, the CDC has confirmed one product as having B. cepacia complex growth; however, because of epidemiologic links, the CDC is concerned about potential contamination of multiple liquid docusate products, pending FDA’s ongoing investigation of shared ingredients in the products in question.

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