Antibiotic-Resistant Bacteria Cause Multistate Outbreak

A multistate outbreak of Burkholderia cepacia infections might be linked to contaminated liquid docusate products in one of the states.

The Centers for Disease Control and Prevention (CDC) is conducting investigations regarding the outbreak in conjunction with the US Food and Drug Administration as well as state and local health departments and health facilities. The majority of the cases have been observed to be ventilated patients being treated in Intensive Care Units (ICU) who do not suffer from cystic fibrosis.

This is not the first outbreak caused by these bacteria. In 2004, several ICU patients in a Texas hospital were infected with B. cepacia; the infections were linked to exposure to contaminated sublingual probes. That same year a voluntary recall of over-the-counter nasal spray was issued due to contamination with the bacteria. The most recent outbreak was in 2005, when a multi-state outbreak of B. cepacia was linked to contaminated mouthwash. The patients developed several complications, including pneumonia.

According to the CDC, B. cepacia is a complex of gram-negative bacteria found in soil and water. Those at highest risk of developing severe complications from these generally antibiotic-resistant bacteria, are immunocompromised individuals, specifically those with chronic lung diseases, such as cystic fibrosis. Severity of B. cepacia infection varies among patients. While some patients are asymptomatic, others may develop serious respiratory infections.

B. cepacia can be transmitted through contact with an infected individual, contact with contaminated surfaces, through exposure to the bacteria’s natural environment, or through treatment with contaminated medicines or devices. Maintaining proper hand hygiene can reduce the risk of infection with B. cepacia.

The CDC advises against the use of liquid docusate products in patients with critical conditions, on ventilators, or who are immunosuppressed, until further information regarding the outbreak is known. Healthcare and laboratory personnel are urged to disclose all cases of B. cepacia infections in patients who do not have cystic fibrosis, to infection prevention staff, who should report the cases to state or local health authorities.