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Burkholderia cepacia Infections Associated With Intrinsically Contaminated Ultrasound Gel: The Role of Microbial Degradation of Parabens

Published online by Cambridge University Press:  02 January 2015

Jim Hutchinson ,
Wendy Runge ,
Mike Mulvey ,
Gail Norris ,
Marion Yetman ,
Nelly Valkova ,
Richard Villemur  and
Francois Lepine
Jim Hutchinson*
Affiliation:
Healthcare Corporation of St. John's, Newfoundland, Canada Memorial University of Newfoundland, St. John's, Newfoundland, Canada
Wendy Runge
Affiliation:
Calgary Regional Health Authority, Calgary, Alberta, Canada
Mike Mulvey
Affiliation:
National Microbiology Laboratory, Health Canada, Winnipeg, Manitoba, Canada
Gail Norris
Affiliation:
Healthcare Corporation of St. John's, Newfoundland, Canada
Marion Yetman
Affiliation:
Healthcare Corporation of St. John's, Newfoundland, Canada
Nelly Valkova
Affiliation:
Institut National de la Recherche Scientifique (INRS)-Institut Armand-Frappier, Laval, Quebec, Canada
Richard Villemur
Affiliation:
Institut National de la Recherche Scientifique (INRS)-Institut Armand-Frappier, Laval, Quebec, Canada
Francois Lepine
Affiliation:
Institut National de la Recherche Scientifique (INRS)-Institut Armand-Frappier, Laval, Quebec, Canada
*
Department of Microbiology, Health Sciences Center, 300 Prince Philip Drive, St. John's, Newfoundland, CanadaA1B 3V6
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Abstract

Objective:

To describe an outbreak of serious nosocomial Burkholderia cepacia infections occurring after transrectal prostate biopsy associated with ultrasound gel intrinsically contaminated with paraben-degrading microorganisms.

Methods:

A retrospective chart review prompted by a blood culture isolate of B, cepacia. Identification of microorganisms in ultrasound gel in two Canadian centers and characterization by pulsed-field gel electrophoresis and assays for paraben degradation.

Setting:

Two Canadian university-affiliated, tertiary-care centers in Newfoundland and Alberta.

Results:

Six serious B. cepacia infections were identified at the two centers. Isolates of B. cepacia recovered from the blood of patients from both centers and the ultrasound gel used during the procedures were identical, confirming intrinsic contamination. Strains of Enterobacter cloacae isolated from ultrasound gel at the two centers were also identical. The ability to degrade parabens was proven for both B. cepacia and E. cloacae strains recovered from the ultrasound gel.

Conclusions:

Ultrasound gel is a potential source of infection. Contamination occurs at the time of manufacture, with organisms that degrade parabens, which are commonly used as stabilizing agents. There are far-reaching implications for the infection control community.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 4 , April 2004 , pp. 291 - 296
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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