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Burkholderia lata Infections from Intrinsically Contaminated Chlorhexidine Mouthwash, Australia, 2016

Lex E X Leong, Diana Lagana, Glen P Carter

    Emerging Infectious Diseases
    |October 19, 2018
    PubMed

    Insights

    A contamination in chlorhexidine mouthwash led to Burkholderia lata infections in intensive care patients. Efflux pump genes may explain how the bacteria survived the disinfectant.

    Area of Science:

    • Clinical Microbiology
    • Infectious Diseases
    • Genomics

    Background:

    • Burkholderia lata is an opportunistic pathogen that can cause infections, particularly in immunocompromised individuals.
    • Healthcare-associated infections (HAIs) pose a significant challenge in intensive care units (ICUs).
    • Disinfectants like chlorhexidine are crucial for infection control but can be subject to microbial contamination.

    Purpose of the Study:

    • To investigate the source and genomic characteristics of Burkholderia lata isolates from intensive care patients.
    • To determine the relationship between clinical and environmental isolates.
    • To identify potential mechanisms contributing to bacterial survival in the presence of chlorhexidine.

    Main Methods:

    • Isolation and identification of Burkholderia lata from clinical samples and environmental sources.
    • Whole-genome sequencing of clinical and environmental isolates.
    • Genomic analysis to identify relevant genes, including those associated with biocide resistance.

    Main Results:

    • Burkholderia lata was identified in 8 intensive care patients across two Australian tertiary hospitals.
    • Whole-genome sequencing confirmed that clinical and environmental isolates were linked to a common source: contaminated chlorhexidine mouthwash.
    • Genomic analysis revealed the presence of efflux pump-encoding genes, suggesting a role in bacterial persistence against the biocide.

    Conclusions:

    • Contaminated chlorhexidine mouthwash was identified as the source of Burkholderia lata outbreaks in ICUs.
    • Genomic data highlights the importance of monitoring disinfectant quality and microbial contamination.
    • Efflux pump genes represent a potential mechanism for Burkholderia lata's survival in biocidal environments, informing infection control strategies.
    Keywords:
    AustraliaBurkholderia latabacteriachlorhexidine mouthwashgenome analysisintensive care unitnosocomial infections

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