Bacteria in child ward at hospital fed off antibiotic
Sumitra Debroy | TNN | Updated: Mar 12, 2019, 09:29 IST
MUMBAI: Blood samples of 909 children in the 1-12 age bracket who were treated at Nair Hospital six years ago found the presence of bacteria burkholderia cenocepacia complex (BCC). For the first time, a genomic study of the samples linked the infection in children with its source (medicine vial), conclusively proving that BCC is commonly present in Indian hospitals and can feed off an antibiotic—the very medicine meant to kill it.
The hospital had picked up the infection through common blood tests back in 2012 after the paediatric department raised an alarm following unusually high infection cases. “With the help of molecular tests, we could establish that the genome sequence of the bacteria from blood samples of the children and the cap of the amikacin vial was the exact same, thereby establishing the source of contamination without any room for doubt,” said Dr Vikas Gautam, professor of microbiology from PGI, Chandigarh.
“The study underlines the need for microbiologists and physicians to stay vigilant towards any sudden increase in infection rates,” said Dr Jayanthi Shastri, who heads Nair’s microbiology department. “Some pathogens like BCC can use antibiotics as a food source. This organism has been recognized as the commonest contaminant of pharmaceutical products by USFDA,” she said, adding the hospital has not found traces of the bacteria in the past two years after stringent infection control practices came in.
In 2012, the paediatric department observed that several children undergoing treatment at the PICU and wards for lower respiratory tract infections and congenital heart diseases suffered from recurrent infections. It found that common invasive procedures such as IV (saline) catheterization had been performed in all children, with some even being on ventilator. At least 57 of the 76 children had received amikacin. It is assumed that in children who didn’t receive the amikacin and still got the infected, the lacunae were in adherence to infection control protocols. Despite treatment, persistent sepsis was found in some, stated the study published in Frontiers of Microbiology and previously in the Indian Journal of Microbiology. While 42 responded to treatment, 21succumbed and 13 were lost to follow-up.
Only three outbreaks involving BCC were documented in India so far, of which the source was conclusively proven on a molecular basis in two. In both, the source was traced to injections. Dr Shastri said the study was unique as it was carried out by Indian researchers without help from foreign counterparts. Using specific polymerase chain reaction markers designed by IMTECH team under Dr Prabhu B Patil, the PGI team found the strain in patients from north India. “We must control the infection before it takes a big shape,” said Dr Gautam.
The hospital had picked up the infection through common blood tests back in 2012 after the paediatric department raised an alarm following unusually high infection cases. “With the help of molecular tests, we could establish that the genome sequence of the bacteria from blood samples of the children and the cap of the amikacin vial was the exact same, thereby establishing the source of contamination without any room for doubt,” said Dr Vikas Gautam, professor of microbiology from PGI, Chandigarh.
“The study underlines the need for microbiologists and physicians to stay vigilant towards any sudden increase in infection rates,” said Dr Jayanthi Shastri, who heads Nair’s microbiology department. “Some pathogens like BCC can use antibiotics as a food source. This organism has been recognized as the commonest contaminant of pharmaceutical products by USFDA,” she said, adding the hospital has not found traces of the bacteria in the past two years after stringent infection control practices came in.
In 2012, the paediatric department observed that several children undergoing treatment at the PICU and wards for lower respiratory tract infections and congenital heart diseases suffered from recurrent infections. It found that common invasive procedures such as IV (saline) catheterization had been performed in all children, with some even being on ventilator. At least 57 of the 76 children had received amikacin. It is assumed that in children who didn’t receive the amikacin and still got the infected, the lacunae were in adherence to infection control protocols. Despite treatment, persistent sepsis was found in some, stated the study published in Frontiers of Microbiology and previously in the Indian Journal of Microbiology. While 42 responded to treatment, 21succumbed and 13 were lost to follow-up.
Only three outbreaks involving BCC were documented in India so far, of which the source was conclusively proven on a molecular basis in two. In both, the source was traced to injections. Dr Shastri said the study was unique as it was carried out by Indian researchers without help from foreign counterparts. Using specific polymerase chain reaction markers designed by IMTECH team under Dr Prabhu B Patil, the PGI team found the strain in patients from north India. “We must control the infection before it takes a big shape,” said Dr Gautam.
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