C. Kaitwatcharachai et al., An outbreak of Burkholderia cepacia bacteremia in hemodialysis patients: An epidemiologic and molecular study, AM J KIDNEY, 36(1), 2000, pp. 199-204
The risk of blood stream infections increases in patients undergoing chroni
c hemodialysis, Outbreaks of infection are usually caused by contamination
of the water supply, water treatment, distribution system, or dialyzer repr
ocessing. We report an outbreak of subclavian catheter-related Burkholderia
cepacia bacteremia in nine patients undergoing hemodialysis. Using randoml
y amplified polymorphic DNA (RAPD) analysis, the bacterial isolates were cl
onally identical to Burkholderia cepacia isolated from residue of the dilut
ed chlorhexidine-cetrimide solution used to disinfect the transfer forceps.
These forceps were used to pick up cotton balls and gauze for dressing the
subclavian catheter. Antibiotic therapy failed to cure the infections, and
all patients required catheter removal, Pathology showed numerous bacilli
embedded in the biofilm on the inner surface of the removed catheters. In c
onclusion, our study showed that contaminated chlorhexidine-cetrimide solut
ion was the source of a bacteremic outbreak in nine patients who developed
catheter-related Burkholderia cepacia infection. (C) 2000 by the National K
idney Foundation, Inc.