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Sustained Endemicity of Burkholderia cepacia Complex in a Pediatric Institution, Associated With Contaminated Ultrasound Gel

Published online by Cambridge University Press:  21 June 2016

Michelle Jacobson ,
Rick Wray ,
Danuta Kovach ,
Deborah Henry ,
David Speert  and
Anne Matlow
Michelle Jacobson
Affiliation:
Department of Pediatrics, The Hospital for Sick Children, Torronto
Rick Wray
Affiliation:
Department of Pediatrics, The Hospital for Sick Children, Torronto
Danuta Kovach
Affiliation:
Department of Pediatric Laboratory Medicine, University of Toronto, Toronto
Deborah Henry
Affiliation:
Department of Pediatrics, University of British Columbia, Vancouver
David Speert
Affiliation:
Department of Pediatrics, University of British Columbia, Vancouver Division of Infectious and Immunological Diseases, Department of Pediatrics, Children's and Women's Health Centre of British Columbia, Vancouver
Anne Matlow*
Affiliation:
Department of Pediatrics, The Hospital for Sick Children, Torronto Department of Pediatric Laboratory Medicine, University of Toronto, Toronto Departments of Pediatrics and Laboratory Medicine and Pathobiology, University of Toronto, Toronto
*
Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada (anne.matlowd@sickkids.ca)
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Abstract

Objective.

To determine whether contaminated ultrasound gel is the source of intermittent outbreaks of nosocomial infection due to Burkholderia cepacia complex in patients without cystic fibrosis since 1992.

Design.

A prospective clinical and in vitro study of all in-use bottles of ultrasound gel, as well as a retrospective analysis of archived bacterial strains, were performed. Handling of gel for clinical purposes throughout the hospital was evaluated. Gel and archived clinical isolates of B. cepacia complex were speciated to genomovar level and characterized by pulsed-field gel electrophoresis, and the pulsed-field gel electrophoresis patterns were compared.

Setting.

The Hospital for Sick Children, a 300-bed, tertiary care, pediatric academic health sciences center in Toronto, Canada.

Patients.

All patients without cystic fibrosis from whom B. cepacia complex was recovered at the Hospital for Sick Children since 1992.

Results.

No standardized protocol for storage or handling of ultrasound gel was found. Gel from 39% of bottles grew either B. cepacia (genomovar I) or Burkholderia stabilis (genomovar IV). These isolates had pulsed-field gel electrophoresis patterns identical to 2 of the 7 clinical pulsed-field gel electrophoresis types that are responsible for 88% of clinical isolates.

Conclusions.

Contaminated ultrasound gel contributed to nosocomial infection due to B. cepacia complex in this institution over the course of 10 years. Suggested guidelines for the handling of ultrasound gel are provided.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 4 , April 2006 , pp. 362 - 366
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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