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2022-03-09Zeitschriftenartikel
Combined Clinical, Epidemiological, and Genome-Based Analysis Identified a Nationwide Outbreak of Burkholderia cepacia Complex Infections Caused by Contaminated Mouthwash Solutions
dc.contributor.authorBender, Jennifer K.
dc.contributor.authorHaller, Sebastian
dc.contributor.authorPfeifer, Yvonne
dc.contributor.authorHogardt, Michael
dc.contributor.authorHunfeld, Klaus-Peter
dc.contributor.authorThürmer, Andrea
dc.contributor.authorZanuzdana, Arina
dc.contributor.authorWerner, Markus
dc.contributor.authorKunz, Bernd
dc.contributor.authorEisenberger, David
dc.contributor.authorPfennigwerth, Niels
dc.contributor.authorKempf, Volkhard A. J.
dc.contributor.authorWerner, Guido
dc.contributor.authorEckmanns, Tim
dc.date.accessioned2022-07-08T11:58:45Z
dc.date.available2022-07-08T11:58:45Z
dc.date.issued2022-03-09none
dc.identifier.other10.1093/ofid/ofac114
dc.identifier.urihttp://edoc.rki.de/176904/9917
dc.description.abstractBackground: In September 2018, Burkholderia cepacia complex (BCC) infections in 3 patients associated with exposure to a mouthwash solution (MWS) were reported to the Robert Koch Institute (RKI). As the product was still on the market and the scale of the outbreak was unclear, a nation-wide investigation was initiated. Methods: We aimed to investigate BCC infections/colonizations associated with MWS. Hospitals, laboratories, and public health services were informed that BCC isolates should be sent to the RKI. These isolates were typed by pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing (WGS) including development of an ad hoc core genome MLST (cgMLST) scheme. Results: In total, 36 patients from 6 hospitals met the case definition, the last patient in November 2018. Twenty-nine isolates from 26 of these patients were available for typing. WGS analysis revealed 2 distinct cgMLST clusters. Cluster 1 (Burkholderia arboris) contained isolates from patients and MWS obtained from 4 hospitals and isolates provided by the manufacturer. Patient and MWS isolates from another hospital were assigned to cluster 2 (B. cepacia). Conclusions: The combined clinical, epidemiological, and microbiological investigation, including whole-genome analysis, allowed for uncovering a supraregional BCC outbreak in health care settings. Strains of B. arboris and B. cepacia were identified as contaminating species of MWS bottles and subsequent colonization and putative infection of patients in several hospitals. Despite a recall of the product by the manufacturer in August 2018, the outbreak lasted until December 2018. Reporting of contaminated medical products and recalls should be optimized to protect patients.eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.rights(CC BY 3.0 DE) Namensnennung 3.0 Deutschlandger
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/de/
dc.subjectBurkholderia arboriseng
dc.subjectoutbreakeng
dc.subjectclonal transfereng
dc.subjectmouthwash solutioneng
dc.subjectmedical deviceeng
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleCombined Clinical, Epidemiological, and Genome-Based Analysis Identified a Nationwide Outbreak of Burkholderia cepacia Complex Infections Caused by Contaminated Mouthwash Solutionsnone
dc.typearticle
dc.identifier.urnurn:nbn:de:0257-176904/9917-2
dc.type.versionpublishedVersionnone
local.edoc.container-titleOpen Forum Infectious Diseasesnone
local.edoc.container-issn2328-8957none
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://academic.oup.com/ofid/article/9/5/ofac114/6544879none
local.edoc.container-publisher-nameOxford University Pressnone
local.edoc.container-volume9none
local.edoc.container-issue5none
local.edoc.container-year2022none
dc.description.versionPeer Reviewednone

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