Table 2. Environmental specimens collected and tested for investigation of Burkholderia cepacia complex outbreak in peritoneal dialysis unit, Hong Kong, China, March 13, 2018–September 6, 2019*.
| Characteristic | No. specimens | Culture result (mean, median, range), CFU/mL |
|---|---|---|
| Peritoneal dialysis unit | ||
| Environment | ||
| Air samples | 2 | Negative for BCC |
| Swab specimens from sink and faucet | 12 | |
| Water samples from sink in ward | 10 | |
| Soaps from dispensers next to patient sinks | 4 | |
| Swab specimens from wound dressing trolleys | 3 | |
| Blood pressure cuffs, gloves, and tissue paper | 6 (2 each) | |
| Connection shield SysIIK with povidone–iodine solution† | 3 | |
| Exit site care agents | ||
| In-use povidone–iodine | 10 | Negative for BCC |
| Single-use prepackaged saline and sterile water | 10 (5 each) | |
| White wine vinegar |
3 |
|
| Aqueous chlorhexidine | ||
| Brand A (outside hospital) | 51 | 43 with BCC only (3.6 × 103, 1.9 × 102, 2.7–7.6 × 104); 4 with Ralstonia species only (77, 85, 46–93); 4 with BCC and Ralstonia species (120, 120, 94–130) |
| Brand B (outside hospital) | 45 | 45 with BCC (5.9 × 104, 4.6 × 104, 2.9 × 104–1.2 × 105) |
| Brand C (outside hospital) | 4 | 4 with BCC (8.3 × 103, 6.8 × 103, 8 × 102–1.9 × 104) |
| Brand D (outside hospital) | 2 | 2 with BCC (2.8 × 105, 2.8 × 105, 2.4–3.2 × 105) |
| Brand E (outside hospital) | 1 | 1 with BCC (1.5 × 105) |
| Brand F (outside hospital) | 1 | Negative for BCC |
| Brand G (from hospital) | 47 | Negative for BCC |
| Brand H (from hospital) |
30 |
Negative for BCC |
| Brand B manufacturing site | ||
| Environment | ||
| Air samples | 2 | Negative for BCC |
| Plastic packaging | 1 | Negative for BCC |
| Plastic container in preparation room | 1 | Negative for BCC |
| Surface of fan in preparation room | 1 | Negative for BCC |
| Surface of air conditioner in preparation room | 1 | Negative for BCC |
| Specimens collected during dilution and packaging process | ||
| 5% chlorhexidine from original bottle | 1 | Negative for BCC |
| Chlorhexidine in measuring beaker | 1 | Negative for BCC |
| Distilled water | 1 | Negative for BCC |
| Diluted chlorhexidine in mixing compartment of semiautomated packaging machine ([I] in Figure 2), before mixing with stirring rod | 1 | BCC from enriched culture method with overnight incubation in neutralization broth |
| Stirring rod surface swab specimen, before mixing diluted chlorhexidine solution | 1 | Negative for BCC |
| Stirring rod surface swab specimen, after mixing diluted chlorhexidine solution | 1 | BCC from enriched culture method with overnight incubation in neutralization broth |
| Diluted chlorhexidine in mixing bowl of packaging machine, after mixing with stirring rod | 1 | BCC from enriched culture method with overnight incubation in neutralization broth |
| Newly packed 25 mL 0.05% aqueous chlorhexidine | 16 | 16‡ with BCC 1.2 × 105, 1.2 × 105, 3.6 × 104–2.4 × 105); 3 with concurrent Achromobacter species |
*BCC, Burkholderia cepacia complex. †Baxter Healthcare SA, https://www.baxter.com. ‡Three specimens had concurrent Achromobacter species found in culture.