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B. cepacia outbreak prompts CDC to request halt on liquid docusate use
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The CDC recommends clinicians not use any liquid docusate product as a stool softener for patients until further notice since the origin of a multistate outbreak of Burkholderia cepacia infections at five health care facilities reported in June remains undetermined.
As of July 8, 47 B. cepacia complex cases have been reported, primarily in ventilated patients without cystic fibrosis being treated in ICUs, according to the CDC. The CDC recommended on June 24 that clinicians cease the use of liquid docusate products after one case was reportedly related to its use.
A CDC spokeswoman told Infectious Disease News, “CDC and FDA are currently working to gather additional information about this situation. We will update as … information becomes available.”
Since June 24, two samples of unused oral liquid docusate received from one of the affected hospitals tested positive for B. cepacia complex. Further testing is underway to determine if bacteria from these samples match the outbreak strains. In addition, the FDA is testing multiple liquid docusate products that are epidemiologically linked to reported B. cepacia complex cases. Health care facilities that identify infections caused by B. cepacia complex among any patients should save all docusate products and report them to the CDC.
“At this time, CDC continues to recommend that clinicians not use any liquid docusate product as a stool softener or for any other medical purpose,” the CDC said. “This recommendation is now expanded to all patient populations. If an oral liquid docusate stool softener is medically necessary, alternative medicines should be used.”
On June 24, the CDC announced a collaboration with the FDA to investigate a multistate outbreak of B. cepacia infections. Preliminary information indicated that a contaminated liquid docusate product may have been related to one case in one state. Five days later, the CDC said that state was the only case to indicate contaminated oral liquid docusate products might be related to B. cepacia, and there was no epidemiologic or laboratory evidence to suggest oral capsules or enemas are affected. The CDC recommended facilities that experience B. cepacia infections among patients with noncystic fibrosis or clusters of B. cepacia complex infections among patients with cystic fibrosis should stop using all oral liquid docusate products.
Reports of possible cases from additional states are being investigated by the CDC.
For more information:
https://www.cdc.gov/hai/outbreaks/b-cepacia/index.html.