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Risk factors for Burkholderia cepacia complex bacteremia among intensive care unit patients without cystic fibrosis: a case-control study.

Publication ,  Journal Article
Bressler, AM; Kaye, KS; LiPuma, JJ; Alexander, BD; Moore, CM; Reller, LB; Woods, CW
Published in: Infect Control Hosp Epidemiol
August 2007

BACKGROUND: The Burkholderia cepacia complex is associated with colonization or disease in patients with cystic fibrosis (CF). For patients without CF, this complex is poorly understood apart from its presence in occasional point source outbreaks. OBJECTIVE: To investigate risk factors for B. cepacia bacteremia in hospitalized, intensive care unit patients without CF. METHODS: We identified patients with 1 or more blood cultures positive for B. cepacia between May 1, 1996, and March 31, 2002, excluding those with CF. Control patients were matched to case patients by ward, duration of hospitalization, and onset date of bacteremia. Matched analyses were used to identify risk factors for B. cepacia bacteremia. RESULTS: We enrolled 40 patients with B. cepacia bacteremia into the study. No environmental or other point source for B. cepacia complex was identified, although horizontal spread was suspected. Implementation of contact precautions was effective in decreasing the incidence of B. cepacia bacteremia. We selected 119 matched controls. Age, sex, and race were similar between cases and controls. In multivariable analysis, renal failure that required dialysis, recent abdominal surgery, 2 or more bronchoscopic procedures before detection of B. cepacia bacteremia, tracheostomy, and presence of a central line before detection of B. cepacia bacteremia were independently associated with development of B. cepacia bacteremia, whereas presence of a percutaneous feeding tube was associated with a lower risk of disease. CONCLUSIONS: B. cepacia complex is an important emerging group of nosocomial pathogens in patients with and patients without CF. Nosocomial spread is likely facilitated by cross-transmission, frequent pulmonary procedures, and central venous access. Infection control measures appear useful for limiting the spread of virulent, transmissible clones of B. cepacia complex.

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Published In

Infect Control Hosp Epidemiol

DOI

ISSN

0899-823X

Publication Date

August 2007

Volume

28

Issue

8

Start / End Page

951 / 958

Location

United States

Related Subject Headings

  • Risk Factors
  • Odds Ratio
  • North Carolina
  • Middle Aged
  • Male
  • Lung Transplantation
  • Intensive Care Units
  • Humans
  • Female
  • Epidemiology
 

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Bressler, A. M., Kaye, K. S., LiPuma, J. J., Alexander, B. D., Moore, C. M., Reller, L. B., & Woods, C. W. (2007). Risk factors for Burkholderia cepacia complex bacteremia among intensive care unit patients without cystic fibrosis: a case-control study. Infect Control Hosp Epidemiol, 28(8), 951–958. https://doi.org/10.1086/519177
Bressler, Adam M., Keith S. Kaye, John J. LiPuma, Barbara D. Alexander, Christopher M. Moore, L Barth Reller, and Christopher W. Woods. “Risk factors for Burkholderia cepacia complex bacteremia among intensive care unit patients without cystic fibrosis: a case-control study.Infect Control Hosp Epidemiol 28, no. 8 (August 2007): 951–58. https://doi.org/10.1086/519177.
Bressler AM, Kaye KS, LiPuma JJ, Alexander BD, Moore CM, Reller LB, et al. Risk factors for Burkholderia cepacia complex bacteremia among intensive care unit patients without cystic fibrosis: a case-control study. Infect Control Hosp Epidemiol. 2007 Aug;28(8):951–8.
Bressler, Adam M., et al. “Risk factors for Burkholderia cepacia complex bacteremia among intensive care unit patients without cystic fibrosis: a case-control study.Infect Control Hosp Epidemiol, vol. 28, no. 8, Aug. 2007, pp. 951–58. Pubmed, doi:10.1086/519177.
Bressler AM, Kaye KS, LiPuma JJ, Alexander BD, Moore CM, Reller LB, Woods CW. Risk factors for Burkholderia cepacia complex bacteremia among intensive care unit patients without cystic fibrosis: a case-control study. Infect Control Hosp Epidemiol. 2007 Aug;28(8):951–958.
Journal cover image

Published In

Infect Control Hosp Epidemiol

DOI

ISSN

0899-823X

Publication Date

August 2007

Volume

28

Issue

8

Start / End Page

951 / 958

Location

United States

Related Subject Headings

  • Risk Factors
  • Odds Ratio
  • North Carolina
  • Middle Aged
  • Male
  • Lung Transplantation
  • Intensive Care Units
  • Humans
  • Female
  • Epidemiology