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Global burden, point sources, and outbreak management of healthcare-associated Burkholderia cepacia infections: An integrative review

Published online by Cambridge University Press:  22 May 2020

Ramon Z. Shaban Open the ORCID record for Ramon Z. Shaban [Opens in a new window] ,
Cristina Sotomayor-Castillo Open the ORCID record for Cristina Sotomayor-Castillo [Opens in a new window] ,
Shizar Nahidi Open the ORCID record for Shizar Nahidi [Opens in a new window] ,
Cecilia Li Open the ORCID record for Cecilia Li [Opens in a new window] ,
Deborough Macbeth Open the ORCID record for Deborough Macbeth [Opens in a new window] ,
Brett G. Mitchell Open the ORCID record for Brett G. Mitchell [Opens in a new window]  and
Philip L. Russo Open the ORCID record for Philip L. Russo [Opens in a new window]
Ramon Z. Shaban*
Affiliation:
Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, New South Wales, Australia Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, New South Wales, Australia Department of Infectious Diseases and Sexual Health, Westmead Hospital and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, New South Wales, Australia
Cristina Sotomayor-Castillo
Affiliation:
Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, New South Wales, Australia Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, New South Wales, Australia
Shizar Nahidi
Affiliation:
Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, New South Wales, Australia Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, New South Wales, Australia
Cecilia Li
Affiliation:
Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, New South Wales, Australia Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, New South Wales, Australia
Deborough Macbeth
Affiliation:
Infection Control Department, Infectious Diseases and Immunology, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
Brett G. Mitchell
Affiliation:
School of Nursing and Midwifery, Newcastle University, Callaghan, New South Wales, Australia School of Nursing, Avondale University College, Wahroonga, New South Wales, Australia
Philip L. Russo
Affiliation:
Department of Nursing Research, Cabrini Institute, Malvern, Victoria, Australia Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
*
Author for correspondence: Ramon Z. Shaban, E-mail: ramon.shaban@sydney.edu.au
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Abstract

Objective:

To examine the global burden, associated point sources, and successful prevention and control measures for documented outbreaks of Burkholderia cepacia healthcare-associated infections (HAIs).

Design:

Integrative review.

Methods:

A review of all outbreaks of Burkholderia cepacia HAIs published in the peer-reviewed literature between January 1970 and October 2019 was conducted to identify the global burden, associated point sources, and successful prevention and control measures using the Guidelines for Outbreak Reports and Intervention Studies of Nosocomial Infections (ORION).

Results:

In total, we reviewed 125 documented outbreaks of Burkholderia cepacia–related HAIs worldwide. The reported B. cepacia HAIs for this period involved 3,287 patients. The point sources were identified in most outbreaks of B. cepacia HAIs (n = 93; 74.4%); they included medication vials, disinfectants, and antiseptics. Moreover, 95 of the outbreak reports (76%) described effective prevention and control measures, but only 33 reports indicated the use of a combination of environment-, patient- and staff-related measures. None of the outbreak reports used the ORION guidelines.

Conclusions:

Outbreaks of Burkholderia cepacia HAIs are an ongoing challenge. They are often associated with immunocompromised patients who acquire the infection from exposure to contaminated medications, products, and equipment. These outbreaks are not infrequent, and a range of infection prevention and control measures have been effective in arresting spread. The use of ORION guidelines for outbreak reporting would improve the quality of information and data to generate evidence for translation into practice.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 41 , Issue 7 , July 2020 , pp. 777 - 783
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Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

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