Hospital bacteria outbreak linked to nasal spray

July 21, 2011, Society for Healthcare Epidemiology of America

Infection control researchers investigating a rare bacterial outbreak of Burholderia cepacia complex (Bcc) identified contaminated nasal spray as the root cause of the infections, leading to a national recall of the product. An article in the August issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America (SHEA), describes how researchers were able to trace the outbreak back to the nasal decongestant spray.

Bcc is a group of Gram-negative bacteria that can cause hard-to-treat infections. Patients with underlying medical conditions such as and weakened immune systems are at greater risk of contracting Bcc. When patients in a Denver children's hospital began testing positive for the bacteria in 2003, investigators suspected that a batch of Major Twice-a-Day , a brand that each of the patients had used, might be to blame. However, standard tests of the spray did not find any bacteria initially.

Noticing some peculiarities in the initial tests, the investigators decided to retest the spray using a non-standard culture medium. The second set of tests was positive for Bcc, the same strain as was identified in patients. The nasal spray contained a preservative agent that can interfere with standard and the second set of tests neutralized the preservative, allowing the detection of the bacteria.

The spray was voluntarily recalled by the manufacturer, but the findings raise lingering questions about how manufacturers should test nasal spray products before distribution. "If standard culturing methods were used by the manufacturer then they may not have [discovered] this organism," the researchers write.

"Nasal spray products are among the most widely used over-the-counter pharmaceuticals, but to date they are not required by the FDA to be sterile," said Susan Dolan, one of the article's authors. "Given the implications of Bcc infections we question this decision."

Other products, such as mouthwash, nebulization therapy, tap water, disinfectants, and reusable temperature probes have previously been implicated as Bcc outbreak sources.

More information: Susan A. Dolan, Elaine Dowell, John LiPuma, Sondra Valdez, Kenny Chan, and John F. James, "An Outbreak of Burkholderia cepacia Complex Associated with Intrinsically Contaminated Nasal Spray." Infection Control and Hospital Epidemiology 32:8 (August 2011).

Related Stories

Recommended for you

A multimodal intervention to reduce one of the most common healthcare-acquired infections

March 16, 2018
Surgical site infections are the most frequent health care-associated infections in developing countries. According to the World Health Organization (WHO), this type of infection can affect up to one-third of surgical patients ...

After infection, herpes lurks in nerve cells, ready to strike—New research reveals what enables the virus to do so

March 15, 2018
Once herpes simplex infects a person, the virus goes into hiding inside nerve cells, hibernating there for life, periodically waking up from its sleep to reignite infection, causing cold sores or genital lesions to recur.

New imaging approach offers unprecedented views of staph infection

March 14, 2018
Eric Skaar, PhD, MPH, marvels at the images on his computer screen—3-D molecular-level views of infection in a mouse. "I'm pretty convinced that these are the most advanced images in infection biology," said Skaar, Ernest ...

Parasitic worms need their intestinal microflora too

March 14, 2018
Scientists at The University of Manchester have cast new light on a little understood group of worm infections, which collectively afflicts 1 in 4 people, mainly children—in the developing the world.

Compound scores key win in battle against antibiotic resistance

March 14, 2018
Researchers at Oregon State University have made a key advance in the fight against drug resistance, crafting a compound that genetically neutralizes a widespread bacterial pathogen's ability to thwart antibiotics.

Helicobacter creates immune system blind spot

March 13, 2018
The gastric bacterium H. pylori colonizes the stomachs of around half the human population and can lead to the development of gastric cancer. It is usually acquired in childhood and persists life-long, despite a strong inflammatory ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.