Successful cessation of transmitting healthcare-associated infections due to Burkholderia cepacia complex in a neonatal intensive care unit in a Japanese children's hospital

<p>Abstract</p> <p>Background</p> <p><it>Burkholderia cepacia </it>strains have been known to possess the capability to cause serious infections especially in neonatal intensive care units (NICUs), and their multi-drug resistances become a severe threat in hospital settings. The aim of this investigation was to evaluate the <it>B. cepacia </it>complex infections in the NICU in Nagano Children's Hospital, Azumino 399-8288, Japan, and to report the intervention leading to the successful cessation of the outbreak.</p> <p>Methodology</p> <p>The incidence of isolation and antimicrobial susceptibilities of nosocomial <it>Burkholderia cepacia </it>complex strains during a four-year period were retrospectively examined by clinical microbiological records, and by pulsed-field gel electrophoresis analyses along with the bacteriological verification of disinfectant device itself and procedures for its maintenance routinely used in the NICU.</p> <p>Results</p> <p>During the period surveyed between 2007 and 2009, only an isolate per respective year of <it>B. cepacia </it>complex was recovered from each neonate in the NICU. However, in 2010, the successive 6 <it>B. cepacia </it>complex isolates were recovered from different hospitalized neonates. Among them, an isolate was originated from peripheral blood of a neonate, apparently giving rise to systemic infection. In addition, the hospitalized neonate with bacteremia due to <it>B. cepacia </it>complex also exhibited positive cultures from repeated catheterized urine samples together with tracheal aspirate secretions. However other 5 isolates were considered as the transients or contaminants having little to do with infections. Moreover, the 5 isolates between July and October in 2010 revealed completely the same electrophoresis patterns by means of pulsed-field gel electrophoresis analyses, strongly indicating that they were infected through the same medical practices, or by transmission of the same contaminant.</p> <p>Conclusions</p> <p>A small outbreak due to <it>B. cepacia </it>complex was brought about in the NICU in 2010, which appeared to be associated with the same genomovar of <it>B. cepacia </it>complex. The source or the rout of infection was unknown in spite of the repeated epidemiological investigation. It is noteworthy that no outbreak due to <it>B. cepacia </it>complex was noted in the NICU after extensive surveillance intervention.</p