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Open AccessCase Report

Burkholderia contaminans Colonization from Contaminated Liquid Docusate (Colace) in a Immunocompetent Adult with Legionnaire’s Disease: Infection Control Implications and the Potential Role of Candida pellucosa

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Infectious Disease Division, Winthrop-University Hospital, Mineola, New York, NY 11501, USA
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Infection Control Department, Winthrop-University Hospital, Mineola, New York, NY 11501, USA
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Pharmacy Department, Winthrop-University Hospital, Mineola, New York, NY 11501, USA
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Medical Microbiology Laboratory, Winthrop-University Hospital, 222 Station Plaza North, Mineola, New York, NY 11501, USA
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State University of New York, School of Medicine, Stony Brook, New York, NY 11501, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Nazir Savji
J. Clin. Med. 2016, 5(12), 110; https://doi.org/10.3390/jcm5120110
Received: 24 October 2016 / Revised: 14 November 2016 / Accepted: 18 November 2016 / Published: 30 November 2016
Objective: B. contaminans was cultured from respiratory secretions and liquid docusate (Colace) in a Neurosurgical Intensive Care Unit (NICU) patient with community-acquired Legionnaire’s disease but not from another bottle given to the patient. Unexpectedly, C. pelliculosa was cultured from two bottles, but not the B. contaminans bottle or respiratory secretions. Methods: B. cepacia, later identified as B. contaminans, was cultured from a bottle of liquid docusate (Colace) dispensed to a non-cystic fibrosis patient. His respiratory secretions were colonized with B. contaminans. Results: Eradication of B. contaminans colonization in the patient’s respiratory secretions was attempted. With levofloxacin, B. contaminans developed multidrug resistance (MDR). Subsequent TMP-SMX therapy did not result in further MDR. Nine other ICU patients were given docusate from the same lot, but there were no other B. contaminans isolates. Conclusion: B. contaminans colonization of respiratory secretion may be difficult to eliminate. The significance of C. pelliculosa cultured from liquid docusate (Colace) remains to be elucidated. In this case, it appeared that B. contaminans may have inhibited the growth of C. pelliculosa in the same bottle. Others should be alerted to the possibility that C. pelliculosa may be present in B. contaminans–contaminated lots of liquid docusate (Colace). View Full-Text
Keywords: Candida pullucosa; Burkholderia cepacia outbreaks; Burkholderia cepacia; complex (BCC) colonization; B. contaminans outbreaks; doxycycline; levofloxacin; TMP-SMX; contaminated medications; antibiotic resistance; Legionnaire’s disease; occidiofungin Hansenula anomala; colonization of respiratory secretions; Gram negative bacilli (GNB); multidrug resistant (MDR) Candida pullucosa; Burkholderia cepacia outbreaks; Burkholderia cepacia; complex (BCC) colonization; B. contaminans outbreaks; doxycycline; levofloxacin; TMP-SMX; contaminated medications; antibiotic resistance; Legionnaire’s disease; occidiofungin Hansenula anomala; colonization of respiratory secretions; Gram negative bacilli (GNB); multidrug resistant (MDR)
MDPI and ACS Style

Cunha, B.A.; Gian, J.; Dieguez, B.; Santos-Cruz, E.; Matassa, D.; Gerson, S.; Daniels, P.; Rosales, C.; Silletti, R.P. Burkholderia contaminans Colonization from Contaminated Liquid Docusate (Colace) in a Immunocompetent Adult with Legionnaire’s Disease: Infection Control Implications and the Potential Role of Candida pellucosa. J. Clin. Med. 2016, 5, 110.

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