AN OUTBREAK OF PSEUDOBACTERAEMIA CAUSED BY BURKHOLDERIA-PICKETTII - THE CRITICAL ROLE OF AN EPIDEMIOLOGIC LINK

A protracted outbreak of pseudobacteraemia caused by Burkholderia pick ettii is reported. Initial investigation did not reveal the source of the outbreak. Subsequently, careful examination of patient records pro vided an insight to the probable source, which was further confirmed b y a case control study. It was found that 48% of cases had either hepa tobiliary diseases or haematological malignancies, whereas only 15% of the controls had similar problems. Furthermore, a coagulation study w as performed on all of the cases on the day the blood culture was take n, but was performed on only 17% of the controls. With the establishme nt of this epidemiological link, a breakdown in aseptic blood culture technique was suspected. B. pickettii was isolated from citrated bottl es used in the wards and from the citrate solution stocked in the haem atology laboratory. The clonality of these strains was established by the pulsed-field gel electrophoresis (PFGE) and the arbitrary primed-p olymerase chain reaction (AP-PCR). The phlebotomists were notified of the findings of the outbreak investigation, and the importance of stri ct adherence to the aseptic blood culture technique was re-emphasized.