Burkholderia multivorans Infections Associated with Use of Ice and Water from Ice Machines for Patient Care Activities - Four Hospitals, California and Colorado, 2020-2024

Ice machines can harbor water-related organisms, and the use of ice or tap water for clinical care activities has been associated with infections in health care settings. During 2021-2022, a total of 23 cases of infection by Burkholderia multivorans (sequence type ST659) were reported at two souther...

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Bibliographic Details
Published in:	MMWR. Morbidity and mortality weekly report Vol. 73; no. 39; pp. 883 - 887
Main Authors:	Vazquez Deida, Axel A, Spicer, Kevin B, McNamara, Kiara X, Arduino, Matthew J, Gable, Paige, Halpin, Alison L, Caverly, Lindsay J, LiPuma, John J, Bardach, Braden, Mayle, Cayla, Baird, Samuel N, Czaja, Christopher A, Chinn, Raymond, Siegel, Jane D, Perkins, Kiran M
Format:	Journal Article Newsletter
Language:	English
Published:	United States U.S. Government Printing Office 03-10-2024 U.S. Center for Disease Control Centers for Disease Control and Prevention
Subjects:	Adolescent Adult Aged Aged, 80 and over Burkholderia cepacia complex - isolation & purification Burkholderia Infections - epidemiology Burkholderia multivorans California - epidemiology Child Clinical isolates Colorado - epidemiology Cross Infection - epidemiology Cross Infection - prevention & control Cystic fibrosis Descaling Disease Outbreaks Drinking water Equipment Contamination Female Food preparation equipment Full Report Genomes Genomics Health aspects Health care Health care facilities Hospitals Hospitals - statistics & numerical data Humans Ice Infection Infections Male Medical equipment Medical laboratories Medical personnel Medical records Middle Aged Patient Care Patients Polymerase chain reaction Public health Water Microbiology Young Adult Colorado California United States > US
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Summary:	Ice machines can harbor water-related organisms, and the use of ice or tap water for clinical care activities has been associated with infections in health care settings. During 2021-2022, a total of 23 cases of infection by Burkholderia multivorans (sequence type ST659) were reported at two southern California hospitals and linked to contaminated ice and water from ice machines. In addition to these 23 cases, this report also includes 23 previously unreported cases of B. multivorans ST659 infections that occurred during 2020-2024: 13 at a northern California hospital, eight at a hospital in Colorado, and two additional cases at one of the southern California hospitals. The same brand of ice machine and brands of filters, descaling, and sanitizing products were used by all four hospitals; B. multivorans was isolated from samples collected from ice machines in two of the hospitals. Whole genome sequencing indicated that all clinical and ice machine isolates were highly genetically similar (0-14 single nucleotide variant differences across 81% of the selected reference genome). Recommendations from public health officials to halt the outbreak included avoiding ice and tap water during clinical care activities. An investigation is ongoing to determine possible sources of ice machine contamination. During outbreaks of water-related organisms in health care facilities, health care personnel should consider avoiding the use of tap water, including ice and water from ice machines, for patient care.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0149-2195 1545-861X 1545-861X
DOI:	10.15585/mmwr.mm7339a4