Surto policlonal de infecção de corrente sanguínea causada pelo complexo Burkholderia cepacia em unidades de hospital-dia de hematologia e transplante de medula óssea

Aim: The objective was to describe an outbreak of bloodstream infections by Burkholderia cepacia complex (Bcc) in bone marrow transplant and hematology outpatients. Methods: On February 15, 2008 a Bcc outbreak was suspected. 24 cases were identified. Demographic and clinical data were evaluated. Environment and healthcare workers' (HCW) hands were cultured. Species were determined and typed. Reinforcement of hand hygiene, central venous catheter (CVC) care, infusion therapy, and maintenance of laminar flow cabinet were undertaken. 16 different HCWs had cared for the CVCs. Multi-dose heparin and saline were prepared on counter common to both units. Findings: 14 patients had B. multivorans (one patient had also B. cenopacia), six non-multivorans Bcc and one did not belong to Bcc. Clone A B. multivorans occurred in 12 patients (from Hematology); in 10 their CVC had been used on February 11/12. Environmental and HCW cultures were negative. All patients were treated with meropenem, and ceftazidime lock-therapy. Eight patients (30%) were hospitalized. No deaths occurred. After control measures (multidose vial for single patient; CVC lock with ceftazidime; cleaning of laminar flow cabinet; hand hygiene improvement; use of cabinet to store prepared medication), no new cases occurred. Conclusions: This polyclonal outbreak may be explained by a common source containing multiple species of Bcc, maybe the laminar flow cabinet common to both units. There may have been contamination by B. multivorans (clone A) of multi-dose vials.O objetivo foi descrever um surto de infecções da corrente sanguínea por complexo B. cepacia (Bcc) nos ambulatórios de hematologia e transplante de medula óssea. Métodos: Em 15/02/2008, um surto de Bcc foi suspeitado. 24 casos foram identificados. Os dados demográficos e clínicos foram avaliados. Mãos de profissionais da saúde e ambiente foram cultivadas. Espécies foram determinadas e tipadas. Reforço da higiene das mãos, cuidados com cateteres, terapia de infusão e manutenção da câmara de fluxo laminar foram realizadas. 16 profissionais de saúde (PS) diferentes manipularam os cateteres. Heparina multidoses e soro eram preparadas em um balcão comum a ambas as unidades. Resultados: 14 pacientes tiveram B. multivorans (um paciente teve também B. cenopacia), 6 Bcc não-multivorans e um teve um agente não pertencente a Bcc. Clone A de B. multivorans ocorreu em 12 pacientes (da Hematologia), em 10 o cateter havia sido utilizado nos dias 11 ou 12 de fevereiro. Culturas ambientais e de PS foram negativos. Todos os pacientes foram tratados com meropenem e selo de ceftazidima. Oito pacientes (30%) foram hospitalizados. Não ocorreram mortes. Após as medidas de controle, nenhum novo caso ocorreu. Conclusões: Este surto policlonal pode ser explicado por uma fonte comum contendo várias espécies de Bcc, talvez a câmara de fluxo laminar comum a ambas as unidades. Pode ter havido contaminação por B. multivorans (clone A) de frascos multi-dose

The changing epidemiology of Acinetobacter spp. producing MA. carbapenemases causing bloodstream infections in Brazil: a BrasNet report

Made available in DSpace on 2019-09-12T16:53:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2015Merieux Research Grants - Institut MerieuxWe evaluated the epidemiology of Acinetobacter spp. recovered from patients diagnosed with bloodstream infections in 9 tertiary hospitals located in all Brazilian geographic regions between April and August 2014. Although OXA-23-producing Acinetobacter baumannii clones were disseminated in most hospitals, it was observed for the first time the spread of OXA-72 among clonally related A. baumannii isolated from distinct hospitals. Interestingly, Acinetobacter pittii was the most frequent species found in a Northern region hospital. Contrasting with the multisusceptible profile displayed by A. pittii isolates, the tetracyclines and polymyxins were the only antimicrobials active against all A. baumannii isolates. (C) 2015 Elsevier Inc. All rights reserved.[Vasconcelos, Ana Tereza R.] Lab Nacl Comp Cient LNCC MCTI, Petropolis, RJ, Brazil[Barth, Afonso L.; Zavascki, Alexandre P.] Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, Lab Pesquisa Resistencia Bacteriana LABRESIS, Porto Alegre, RS, Brazil[Gales, Ana C.; Furtado, Guilherme H. C.; da Silva, Juliana O.; Correa, Luci; Cayo, Rodrigo; Martins, Willames M. B. S.] Univ Fed Sao Paulo UNIFESP, Disciplina Infectol, Dept Med, Sao Paulo, SP, Brazil[Levin, Anna S.; Rossi, Flavia; Silva, Mariama T.; Oliveira, Maura S.; Dalben, Mirian F.; Santos, Sania A.] Univ Sao Paulo, Inst Med Trop USP LIM 54, Dept Patol LIM 03, Hosp Clin,Fac Med, Sao Paulo, SP, Brazil[Lucarevschi, Bianca R.; Moreira, Marina] Universidade de Taubaté (Unitau) , Dept Med[Cabral, Blenda G.; Brasiliense, Danielle M.; Carneiro, Irna Carla R. S.; Lima, Karla V. B.; da Conceicao, Marilia L.] Fundacao Santa Casa Misericordia Para UFPA, Belem, Para, Brazil[Cabral, Blenda G.; Brasiliense, Danielle M.; Carneiro, Irna Carla R. S.; Lima, Karla V. B.; da Conceicao, Marilia L.] Inst Evandro Chagas SVS MS, Belem, Para, Brazil[Ribeiro, Julival; Guzman, Ricardo D.] Hosp Base, Brasilia, DF, Brazil[Correa, Luci; Martino, Marines D. V.] Hosp Israelita Albert Einstein HIAE, Sao Paulo, SP, Brazil[Correa, Luci; Martino, Marines D. V.] Fac Ciencias Med Santa Casa Sao Paulo, Sao Paulo, SP, Brazil[Britto, Maria H.; de Freitas, Manse R.; Morais, Rosangela] Univ Fed Rio Grande Norte UFRN, Ctr Patol Clin, Natal, RN, Brazi