Report of two events of nosocomial outbreak and pseudo-outbreak due to contamination with Achromobacter spp

• Published in: Revista argentina de microbiología Vol. 54; no. 3; pp. 175 - 180
• Main Authors: Clara, Liliana, Staneloni, María Ines, Salazar, Estela, Greco, Graciela, Visus, Mariangeles, Lizzi, Alicia, Alexander, Valeria, Gutkind, Gabriel, Radice, Marcela, Papalia, Mariana
• Format: Journal Article
• Language: English
• Published: Argentina Elsevier España, S.L.U 01.07.2022
• Subjects: Achromobacter genogroup 20; Achromobacter genogrupo 20; Achromobacter insuavis; Antibiotic stewardship; Brote; Clorhexidine contamination; Contaminación con clorhexidina; Cuidado de heridas; Genotipificación; Genotyping; Outbreaks; Pseudo-bacteremia; Pseudo-outbreaks; Seudobacteriemia; Seudobrote; Uso apropiado de antibióticos; Wound care; Clorhexidine contamination; Achromobacter insuavis; Brote; Outbreaks; Achromobacter genogroup 20; Pseudo-outbreaks; Contaminación con clorhexidina; Seudobrote; Wound care; Genotipificación; Genotyping; Uso apropiado de antibióticos; Pseudo-bacteremia; Cuidado de heridas; Antibiotic stewardship; Achromobacter genogrupo 20; Seudobacteriemia
• ISSN: 0325-7541
• DOI: 10.1016/j.ram.2021.10.004

•Description of two events of nosocomial Achromobacter spp. outbreak and pseudo-outbreak.•Contamination of sodium citrate blood collection tubes with Achromobacter insuavis.•Chlorhexidine soap contaminated with Achromobacter spp. caused infections.•Molecular approaches were critical to achieve the accurate species identification.•The multidisciplinary work was essential to elucidate the epidemiological situation. Achromobacter spp. are increasingly recognized as emerging pathogens in immunocompromised patients or suffering cystic fibrosis, but unusual in immunocompetent hosts or individuals that underwent surgery. In this study we describe two simultaneous events attributable to two different Achromobacter spp. contaminated sources. One event was related to an episode of pseudo-bacteremia due to sodium citrate blood collection tubes contaminated with Achromobacter insuavis and the other to Achromobacter genogroup 20 infection and colonization caused by an intrinsically contaminated chlorhexidine soap solution. Both threatened the appropriate use of antimicrobials. Molecular approaches were critical to achieving the accurate species identification and to assess the clonal relationship, strengthening the need for dedicated, multidisciplinary and collaborative work of microbiologists, specialists in infectious diseases, epidemiologists and nurses in the control of infections to clarify these epidemiological situations. Achromobacter spp. son reconocidas con mayor frecuencia como patógenos emergentes en pacientes con fibrosis quística e inmunodeprimidos, pero son inusuales en hospedadores inmunocompetentes o quirúrgicos. En este estudio describimos 2 eventos simultáneos atribuibles a 2 fuentes contaminadas con Achromobacter spp. Uno correspondió a un episodio de seudobacteriemia por tubos de citrato de sodio contaminados con Achromobacter insuavis y el otro a infecciones y colonizaciones debidas al uso de solución jabonosa de clorhexidina intrínsecamente contaminada con Achromobacter genogrupo 20. Ambos episodios pusieron en peligro el uso apropiado de antimicrobianos. Los enfoques moleculares fueron fundamentales para lograr la identificación precisa de las especies y evaluar la relación clonal de los aislamientos, lo que refuerza la necesidad del trabajo perseverante y multidisciplinario de microbiólogos, especialistas en enfermedades infecciosas, epidemiólogos y enfermeras en el control de infecciones para el esclarecimiento de estas situaciones epidemiológicas.