{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:40:26Z","timestamp":1790185226967,"version":"4.1.0"},"reference-count":27,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,8]],"date-time":"2025-03-08T00:00:00Z","timestamp":1741392000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Background: We report a hospital outbreak caused by Burkholderia cepacia that occurred in 16 patients admitted to intensive care units in Elaz\u0131\u011f, T\u00fcrkiye, between 19 March and 23 April 2024. Methods: The outbreak investigation was initiated on 23 March 2024, four days after B. cepacia was detected in four different patients. Environmental samples were collected from various parts of the hospital to find the source of the outbreak. Arbitrarily Primed Polymerase Chain Reaction (AP-PCR) was performed to determine the genetic relationship between environmental and patient samples. Results: In total, 16 of 18 B. cepacia isolates were obtained from tracheal aspirate culture. A total of 10 of 16 patients developed hospital-acquired pneumonia due to B. cepacia. Among the environmental cultures in the intensive care units, only the respirator bacterial filter grew. The isolate obtained here was in the same cluster as the isolate obtained from patient samples, resulting in a dominant clustering rate of 94.4%. Conclusions: Improper and inappropriate use of respirators and equipment can lead to outbreaks. Early detection of the outbreak, identification of the source, and taking appropriate measures quickly to contain the outbreak are key.<\/jats:p>","DOI":"10.3390\/pathogens14030266","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T06:59:59Z","timestamp":1741589999000},"page":"266","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["An Intensive Care Outbreak Caused by Burkholderia cepacia from Bacterial Filters"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3305-6284","authenticated-orcid":false,"given":"\u00d6zlem","family":"Ayta\u00e7","sequence":"first","affiliation":[{"name":"Medical Microbiology, Elaz\u0131\u011f Fethi Sekin City Hospital, 23280 Elaz\u0131\u011f, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0449-0356","authenticated-orcid":false,"given":"Elif Seren","family":"Tanr\u0131verdi","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Inonu University, 44000 Malatya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6m\u00fcr","family":"G\u00fcnda\u011f","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Clinic Microbiology Department, Elaz\u0131\u011f Fethi Sekin City Hospital, 23280 Elaz\u0131\u011f, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4705-5757","authenticated-orcid":false,"given":"Feray Ferda","family":"\u015eenol","sequence":"additional","affiliation":[{"name":"Medical Microbiology, Elaz\u0131\u011f Fethi Sekin City Hospital, 23280 Elaz\u0131\u011f, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0754-1702","authenticated-orcid":false,"given":"G\u00fclden Eser","family":"Karl\u0131da\u011f","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Clinical Microbiology Clinic, Elaz\u0131\u011f Fethi Sekin City Hospital, Health Sciences University, 23280 Elaz\u0131\u011f, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bar\u0131\u015f","family":"Otlu","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Inonu University, 44000 Malatya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Jin, Y., Zhou, J., Zhou, J., Hu, M., Zhang, Q., Kong, N., Hongguang, R., Long, L., and Yue, J. (2020). Genomebased classification of Burkholderia cepacia complex provides new insight into its taxonomic status. Biol. Direct, 15.","DOI":"10.1186\/s13062-020-0258-5"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"216","DOI":"10.4103\/ijmm.IJMM_16_258","article-title":"An outbreak of Burkholderia cepacia complex in the paediatric unit of a tertiary care hospital","volume":"35","author":"Mali","year":"2017","journal-title":"Indian J. Med. Microbiol."},{"key":"ref_3","first-page":"124e5","article-title":"Burkholderia cepacia\u2013Friend and foe","volume":"66","author":"Govan","year":"2000","journal-title":"ASM NEWS"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"323e30","DOI":"10.3201\/eid2802.210945","article-title":"Invasive Burkholderia cepacia complex infections among persons who inject drugs, Hong Kong, China, 2016\u20132019","volume":"28","author":"Luk","year":"2022","journal-title":"Emerg. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1146\/annurev.phyto.39.1.225","article-title":"Diversity of the Burkholderia cepacia complex and implications for risk assessment of biological control strains","volume":"39","author":"Parke","year":"2001","journal-title":"Annu. Rev. Phytopathol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"466","DOI":"10.53350\/pjmhs2023176466","article-title":"Outbreak of Burkholderia Cepaciae Bacteremia in Neonatal Units of a Public Sector Hospital in Karachi, Pakistan","volume":"17","author":"Tasleem","year":"2023","journal-title":"Pak. J. Med. Health Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1186\/s13756-021-01004-8","article-title":"An outbreak investigation of Burkholderia cepacia infections related with contaminated chlorhexidine mouthwash solution in a tertiary care center in Turkey","volume":"10","author":"Bilgin","year":"2021","journal-title":"Antimicrob. Resist. Infect. Control."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Hell, M., Abel, C., Albrecht, A., Wojna, A., Chmelizek, G., Kern, J.M., Maass, M., and Apfalter, P. (2011). Burkholderia cepacia e outbreak in obstetric patients due to intrinsic contamination of non-sterile ultrasound gel. BMC Proc., 5.","DOI":"10.1186\/1753-6561-5-S6-O75"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"394e8","DOI":"10.1016\/j.ajic.2006.03.003","article-title":"Outbreak of Burkholderia cepacia bacteremia in immunocompetent children caused by contaminated nebulized sulbutamol in Saudi Arabia","volume":"34","author":"Ghazal","year":"2006","journal-title":"Am. J. Infect. Control."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.ijid.2014.07.016","article-title":"Healthcare-associated respiratory tract infection and colonization in an intensive care unit caused by Burkholderia cepacia isolated in mouthwash","volume":"29","author":"Zurita","year":"2014","journal-title":"Int. J. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1017\/ice.2020.184","article-title":"Global burden, point sources, and outbreak management of healthcare-associated Burkholderia cepacia infections: An integrative review","volume":"41","author":"Shaban","year":"2020","journal-title":"Infect. Control. Hosp. Epidemiol."},{"key":"ref_12","unstructured":"(2024, November 01). K\u00f6me\u00e7, Selda and Ceylan, Ay\u015fe Nur and \u00d6zalp, Onur and Durmu\u015f, Mehmet Akif and Gunduz, Alper and Yava\u015f, C\u00fcneyd and Korkusuz, Ramazan, Burkholderia cepacia Outbreak in Intensive Care Units, T\u00fcrkiye. Available online: https:\/\/ssrn.com\/abstract=5033636."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"80","DOI":"10.4037\/ccn2021314","article-title":"Oral Hygiene Care to Prevent Ventilator-Associated Pneumonia in Critically Ill Patients","volume":"41","author":"Cooper","year":"2021","journal-title":"Crit. Care Nurse"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1097\/TA.0b013e31824d10fa","article-title":"Ventilator-associated pneumonia rates at major trauma centers compared with a national benchmark: A multi-institutional study of the AAST","volume":"72","author":"Michetti","year":"2012","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_15","first-page":"37","article-title":"Nosocomial pneumonia in intensive care","volume":"7","author":"Esen","year":"2002","journal-title":"Curr. Med. J."},{"key":"ref_16","first-page":"200","article-title":"Rare Pathogenic Lower Respiratory Tract Factors and Antibiotic Sensitivity Situa-tions in Respiratory Intensive Care","volume":"6","author":"Gegin","year":"2024","journal-title":"Hitit Med. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.ajic.2008.03.002","article-title":"CDC\/NHSN surveillance defnition of health care-associated infection and criteria for specifc types of infections in the acute care setting","volume":"36","author":"Horan","year":"2008","journal-title":"Am. J. Infect. Control"},{"key":"ref_18","unstructured":"(2017). Performance Standards for Antimicrobial Susceptibility Testing, Clinical and Laboratory Standards Institute. [27th ed.]. Available online: https:\/\/clsi.org\/media\/1469\/m100s27_sample.pdf."},{"key":"ref_19","unstructured":"Durmaz, R. (2001). Acinetobacter baumannii izolatlar\u0131n\u0131n molek\u00fcler epidemiyolojisinde \u201cArbitrarily Primed\u201d PZR ve \u201cPulsed-Field Gel\u201d elektroforezi. Uygulamal\u0131 Molek\u00fcler Mikrobiyoloji, Nobel T\u0131p Kitabevleri. [2nd ed.]."},{"key":"ref_20","unstructured":"Durmaz, R. (2008). Why are bacterial typing studies necessary? XXXIII. Congress Book, Turkish Microbiology Congress."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1111\/j.1574-6976.2009.00182.x","article-title":"Bacterial strain typing in the genomic era","volume":"33","author":"Li","year":"2009","journal-title":"FEMS Microbiol. Rev."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Bolcato, V., Bassetti, M., Basile, G., Bianco Prevot, L., Speziale, G., Tremoli, E., Maffessanti, F., and Tronconi, L.P. (2024). The State-of-the-Art of Mycobacterium chimaera Infections and the Causal Link with Health Settings: A Systematic Review. Healthcare, 12.","DOI":"10.3390\/healthcare12171788"},{"key":"ref_23","first-page":"509","article-title":"Bronkoskopi ile ili\u015fkili salg\u0131nlar ve yalanc\u0131 salg\u0131nlar: Sistematik bir derleme","volume":"45","author":"Kakoullis","year":"2024","journal-title":"Enfeksiyon Kontrol\u00fc Ve Hastan. Epidemiyolojisi"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Mazzotta, M., Salaris, S., Pascale, M.R., Girolamini, L., and Cristino, S. (2021). Legionella spp. \u0130nsan Yap\u0131m\u0131 Su Kaynaklar\u0131nda: Emilia-Romagna B\u00f6lgesinde \u0130zolat Da\u011f\u0131l\u0131m\u0131 ve Filogenetik Karakterizasyon. Pathogens, 10.","DOI":"10.3390\/pathogens10050552"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/s13256-020-02415-8","article-title":"Investigation of Burkholderia cepacia complex bacteremia outbreak in a neonatal intensive care unit: A case series","volume":"14","author":"Bharara","year":"2020","journal-title":"J. Med. Case Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"100359","DOI":"10.1016\/j.infpip.2024.100359","article-title":"An outbreak of Burkholderia cepacia complex exit site infection among peritoneal dialysis patients caused by contaminated spray dressing","volume":"6","author":"Cheng","year":"2024","journal-title":"Infect. Prev. Pract."},{"key":"ref_27","unstructured":"Clinical and Laboratory Standards Institute (CLSI) (2024, December 10). Document M100-S25 Performance Standards for Antimicrobial Susceptibility Testing. Available online: https:\/\/www.nih.org.pk\/wp-content\/uploads\/2021\/02\/CLSI-2020.pdf."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/3\/266\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:49:25Z","timestamp":1760028565000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/3\/266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,8]]},"references-count":27,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["pathogens14030266"],"URL":"https:\/\/doi.org\/10.3390\/pathogens14030266","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,8]]}}}