Management of an Epidemic Outbreak of Burkholderia Cepacia in A Hospital in The North of Italy

Abstract

Background: Burkholderia Cepacia(B. Cepacia) is a gram-negative bacterium responsible both for colonization and for awide range of infections and clinical complications that significantly increasemorbidity and mortality. B. Cepacia is able to survive and replicate into antiseptic solutionsand invasive medicaldevices, thus representing potential reservoirs for hospital infections. Aim: Between April and August 2019 in the north of Italy, in two hospitals belonging to the same social healthdistrict (AULSS 8 Berica- West District), five cases of B. Cepaciasepsis were reported. This paper describes the epidemiological and microbiological investigation of the causalpathogen, the controlmeasures adopted to contain the epidemic and the results obtained. Methods: The Infection Control Committee (ICC) assessed relevant demographic characteristics and potential riskfactors of infected patients and collected environmental and equipment samples. Phenotypic and genotypic identification was carried out using microbiological methods of culture and MALDI-TOF technique. Findings: The B. Cepaciasepsis involved four oncological patientsand one cardiological patient who underwent aninvasive procedure under ultrasound guidance from April to August 2019 at one of the hospitals involved. The analyses highlighted the positivity for B. Cepacia in the ultrasound gel used for the eco-guidedprocedures. All samples were found to be sensitive to Meropenem. Conclusion: The infection controlmeasures put into effect permittedan effective management of the outbreakandhelped to reducethe risk of subsequent cases. The outbreak has revealed the need to draw up internal operating procedures that regulate punctually the grafting of invasive devices.