Invasive Burkholderia cepacia Complex Infections among Persons Who Inject Drugs, Hong Kong, China, 2016-2019

• Published in: Emerging infectious diseases Vol. 28; no. 2; pp. 323 - 330
• Main Authors: Luk, Kristine Shik, Tsang, Yat-Ming, Ho, Alex Yat-Man, To, Wing-Kin, Wong, Ben Kwok-Ho, Wong, Maureen Mo-Lin, Wong, Yiu-Chung
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01-02-2022; Centers for Disease Control and Prevention
• Subjects: Antimicrobial agents; Arthritis; Burkholderia; Burkholderia cepacia; Burkholderia cepacia complex; Burkholderia Infections - epidemiology; Causes of; China - epidemiology; Cluster analysis; Complex Infections among Persons Who Inject Drugs, Hong Kong, China, 2016–2019; Cross Infection - epidemiology; disease outbreak; Disease Outbreaks; Diseases; Drug addicts; Drug Users; Drugs; Electrophoresis, Gel, Pulsed-Field; Endocarditis; Epidemics; Genomes; Gram-negative bacterial infections; Hepatitis; Heroin; Hong Kong - epidemiology; Hospitals; Humans; Invasive; Iodine; Laboratories; Necrotizing fasciitis; Nosocomial infections; Patients; persons who inject drugs; Public health; pulsed-field gel electrophoresis; Risk factors; Statistics; Substance Abuse, Intravenous - complications; Substance Abuse, Intravenous - epidemiology; Hong Kong; China; Hong Kong China; persons who inject drugs; disease outbreak; Hong Kong; bacteria; pulsed-field gel electrophoresis; Burkholderia; Burkholderia cepacia complex; drug users
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid2802.210945

During March 2016-January 2019, Burkholderia cepacia complex (BCC) infection developed in 13 persons who inject drugs (PWID) in Kowloon West Region, Hong Kong, China. Seven cases were infective spondylitis, 2 endocarditis, 2 septic arthritis, 1 intramuscular abscess and bacteremia, and 1 necrotizing fasciitis. Pulsed-field gel electrophoresis revealed that the isolates from 9 patients were clonally related. This clone caused major illness, and 11 of the 13 patients required surgical treatment. Clinicians should be aware of this pathogen and the appropriate broad-spectrum antimicrobial drugs to empirically prescribe for PWID with this life-threatening infection. Close collaboration among public health authorities, outreach social workers, and methadone clinics is essential for timely prevention and control of outbreaks in the PWID population.