Outbreak of Burkholderia cepacia complex infection associated with intrinsically contaminated commercial 0.5% chlorhexidine solution
Issued Date
2025-12-01
Resource Type
ISSN
01956701
eISSN
15322939
Scopus ID
2-s2.0-105019651646
Pubmed ID
41077356
Journal Title
Journal of Hospital Infection
Volume
166
Start Page
28
End Page
32
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Hospital Infection Vol.166 (2025) , 28-32
Suggested Citation
Dilokkunanant T., Malathum K., Chotiprasitsakul D., Santanirand P., Muntajit T., Techasaensiri C. Outbreak of Burkholderia cepacia complex infection associated with intrinsically contaminated commercial 0.5% chlorhexidine solution. Journal of Hospital Infection Vol.166 (2025) , 28-32. 32. doi:10.1016/j.jhin.2025.09.019 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/112854
Title
Outbreak of Burkholderia cepacia complex infection associated with intrinsically contaminated commercial 0.5% chlorhexidine solution
Author's Affiliation
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Burkholderia cepacia complex (BCC) is an aerobic Gram-negative bacillus commonly isolated from aqueous environments. In May 2024, we identified two cases who developed BCC infections within one month following fronto-orbital advancement (FOA) procedures in the paediatric surgery ward. Aim: To identify the source, intervene in the ongoing infections, and implement control measures. Methods: The cases were defined as individuals with laboratory-confirmed BCC isolated from December 2023 to May 2024. We reviewed medical records, interviewed healthcare workers, and verified compliance with infection control guidelines. Additionally, we aseptically collected environmental samples for microbiological analysis. Findings: Two initial cases of BCC infection were identified following FOA procedures, and one additional case occurred after wound dressing. All three cases were associated with the use of 0.5% aqueous chlorhexidine gluconate (CHG) solution. These cases exhibited similar antimicrobial susceptibility patterns. Subsequent investigation detected BCC in 10 samples of the 0.5% aqueous CHG solution. Both clinical and environmental BCC isolates were subjected to multi-locus sequence typing (MLST) analysis to determine their clonal relationship. The analysis revealed that all isolates shared an identical sequence type, consistent with Burkholderia cenocepacia. The outbreak was successfully controlled following the withdrawal of the product and re-education of staff. Conclusion: The monitoring of hospital-acquired infections by a multi-disciplinary team played a critical role in the prevention and rapid control of the outbreaks. Additionally, stricter government regulations are needed to prevent the contamination of disinfectants during manufacturing.