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Burkholderia stabilis outbreak associated with contaminated commercially-available washing gloves, Switzerland, May 2015 to August 2016
- Rami Sommerstein1,2 , Urs Führer2,3 , Elia Lo Priore1 , Carlo Casanova4 , Dominik M Meinel5,6 , Helena MB Seth-Smith5,6 , Andreas Kronenberg1,4 , on behalf of Anresis10 , Daniel Koch7 , Laurence Senn8 , Andreas F Widmer9 , Adrian Egli2,5,6 , Jonas Marschall1,2 , on behalf of Swissnoso10
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View Affiliations Hide AffiliationsAffiliations: 1 Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland 2 These authors contributed equally to the manuscript 3 Infectious Diseases Department, Biel Hospital, Biel, Switzerland 4 Institute for Infectious Diseases, University of Bern, Bern, Switzerland 5 Division of Clinical Microbiology, University Hospital Basel, Basel, Switzerland 6 Applied Microbiology Research Unit, Department of Biomedicine, University of Basel, Basel, Switzerland 7 Federal Office of Public Health, Bern, Switzerland 8 Service of Hospital Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland 9 Department of Infectious Diseases, University Hospital Basel, Basel, Switzerland 10 The members of the group are listed at the end of the paperRami Sommersteinrami.sommerstein insel.ch
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Citation style for this article: Sommerstein Rami, Führer Urs, Lo Priore Elia, Casanova Carlo, Meinel Dominik M, Seth-Smith Helena MB, Kronenberg Andreas, on behalf of Anresis, Koch Daniel, Senn Laurence, Widmer Andreas F, Egli Adrian, Marschall Jonas, on behalf of Swissnoso. Burkholderia stabilis outbreak associated with contaminated commercially-available washing gloves, Switzerland, May 2015 to August 2016. Euro Surveill. 2017;22(49):pii=17-00213. https://doi.org/10.2807/1560-7917.ES.2017.22.49.17-00213 Received: 21 Mar 2017; Accepted: 19 Jul 2017
Abstract
We describe an outbreak of Burkholderia stabilis associated with contaminated washing gloves, a commercially available Class I medical device. Triggered by an increase in Burkholderia cepacia complex (BCC) bacteremias and the detection of BCC in unopened packages of washing gloves, an ad hoc national outbreak committee comprising representatives of a public health organisation, a regulatory agency, and an expert association convened and commissioned an outbreak investigation. The investigation included retrospective case finding across Switzerland and whole genome sequencing (WGS) of isolates from cases and gloves. The investigation revealed that BCC were detected in clinical samples of 46 cases aged 17 to 91 years (33% females) from nine institutions between May 2015 and August 2016. Twenty-two isolates from case patients and 16 from washing gloves underwent WGS. All available outbreak isolates clustered within a span of < 19 differing alleles, while 13 unrelated clinical isolates differed by > 1,500 alleles. This BCC outbreak was rapidly identified, communicated, investigated and halted by an ad hoc collaboration of multiple stakeholders. WGS served as useful tool for confirming the source of the outbreak. This outbreak also highlights current regulatory limitations regarding Class I medical devices and the usefulness of a nationally coordinated outbreak response.
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