Wednesday, May 10, 2017

B Cepacia Outbreak at Nursing Homes Traced to Contaminated Medical Products

Researchers have traced an outbreak of Burkholderia cepacia  also called B. cepacia, at skilled nursing facilities (SNFs) spanning five states to contaminated saline flushes. B. cepacia poses little medical risk to healthy people, but poses serious risk to the elderly, young children, cancer patients, pregnant women, and people with chronic health problems like weakened immune systems or chronic lung diseases.  B. cepacia bacteria are often resistant to common antibiotics, and the mortality rate for already compromised patients, for example, those with lung diseases like Cystic Fibrosis, is particularly high. 

The outbreak was discovered on Sept. 22, 2016, when four B. cepacia bloodstream infections were found in patients receiving IV therapy at a Maryland skilled nursing facility. Officials notified colleagues across state lines, and clusters of B. cepacia infection were discovered in other SNFs.  Investigators abstracted patient records and visited SNFs affected by the outbreak in two states in the hope of finding the source. The investigators found that all the infected patients were staying at SNFs supplied by a certain pharmacy that on Sept. 1 began distributing saline flushes from a specific manufacturer. They then focused on SNFs using flushes from that manufacturer.

The investigators found 162 cases of B. cepacia infection at 59 facilities in five states. Epidemiologic and laboratory evidence indicates the contamination of saline flushes produced by the manufacturer was the source of the outbreak, but  investigation and surveillance for more cases of B. cepacia are ongoing.
This is not the only recent outbreak of B. cepacia linked to contaminated medical products. A 2016 multistate B. cepacia outbreak was traced to syringes of liquid docusate, a stool softener. 

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