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B. cepacia Contaminated Solutions — SCE Infectious Diseases MCQ

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ModerateHealthcare-Associated InfectionsB. cepacia Contaminated SolutionsSCE Infectious Diseases

A 55-year-old man develops a hospital-acquired bloodstream infection with a Gram-negative rod identified as Burkholderia cepacia. He does NOT have cystic fibrosis. He is on the ICU and has a central line. What is the most likely source?

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Correct answer: E — Contaminated IV medications, disinfectants, or nebuliser solutions — B. cepacia is an environmental contaminant that survives in aqueous solutions and disinfectants

Non-CF B. cepacia complex infections in hospital settings are almost always from contaminated aqueous solutions: IV medications, chlorhexidine/antiseptic solutions, nebuliser fluids, or contaminated water supplies. B. cepacia is intrinsically resistant to many disinfectants and can survive/multiply in aqueous environments that kill other organisms. Outbreaks have been linked to contaminated Chlorhexidine, mouthwash, and Ultrasound gel. Investigation requires environmental sampling of all aqueous solutions the patient has been exposed to. Treatment: Co-trimoxazole is first-line.

Reference: UKHSA 2024 – B. cepacia non-CF; NICE NG139 – HAI; BSAC 2023