Outbreak of Burkholderia cepacia complex infections associated with contaminated octenidine mouthwash solution, Germany, August to September 2018

Euro Surveill. 2018 Oct;23(42):1800540. doi: 10.2807/1560-7917.ES.2018.23.42.1800540.

Abstract

Three German patients developed nosocomial pneumonia after cardiac surgery and had Burkholderia cepacia complex detected in respiratory specimens. Two patients died of septic multi-organ failure. Whole-genome sequencing detected genetically identical B. cepacia complex strains in patient samples, from a batch of octenidine mouthwash solution, which had been used for nursing care, as well as in samples obtained from the manufacturer during production. Contamination of medical products during manufacturing may lead to international outbreaks.

Keywords: Burkholderia cepacia; Hygiene; Infection prevention; Outbreak investigation; Whole-genome sequencing.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents, Local
  • Bronchoalveolar Lavage Fluid / microbiology
  • Burkholderia Infections / diagnosis*
  • Burkholderia Infections / mortality
  • Burkholderia cepacia complex / genetics
  • Burkholderia cepacia complex / isolation & purification*
  • Cross Infection / microbiology*
  • Drug Contamination*
  • Healthcare-Associated Pneumonia / diagnosis*
  • Healthcare-Associated Pneumonia / microbiology
  • Healthcare-Associated Pneumonia / mortality
  • Humans
  • Imines
  • Male
  • Mouth / microbiology
  • Mouthwashes*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / microbiology*
  • Postoperative Complications / mortality
  • Pyridines / administration & dosage
  • Pyridines / adverse effects*
  • Thoracic Surgery
  • Whole Genome Sequencing

Substances

  • Anti-Infective Agents, Local
  • Imines
  • Mouthwashes
  • Pyridines
  • octenidine