The Centers for Disease Control and Prevention (CDC) is collaborating with the Food and Drug Administration (FDA), multiple state and local health departments, and numerous healthcare facilities to investigate a multi-state outbreak of Burkholderia cepacia infections. These infections have occurred primarily in ventilated patients without cystic fibrosis and those who are being treated in intensive care units.
Preliminary information indicates that a contaminated liquid docusate product might e related to cases in one state. Until more information is available, CDC recommends that facilties not use any liquid docusate products for patients who are critically ill, ventilated, or immunosuppressed. Institutions with non-cystic fibrosis patients in whom there are B. cepacia infections should sequester all liquid docusate products.
Healthcare providers and laboratories should be on alert for B. cepacia cases occurring among non-cystic fibrosis patients and should inform infection prevention staff when these infections occur. Cases should be reported to state or local public health authorities.
CDC will provide an update to this announcement as they know more. Please direct all questions to CDC at firstname.lastname@example.org.
So what does this mean for the frail elder population? They are more susceptible to any infection, since their immune response has declined due to age and health. Infections such as influenza or norvirus (diarrhea) can be spread quickly, especially in residential facilities or day programs. B. cepacia (formerly known as Pseudomonas cepacia) is a gram-negative rod that commonly colonizes the lungs of patients with cystic fibrosis and is frequently multi-drug resistant. The challenge is getting a sputum sample to determine the bacterial etiology of the pneumonia. Frail elders have problems producing a sample.
Geriatrician, Dr. Elizabeth Landsverk states, "I think for the frail elder population, particularly those elders with dementia, all liquid ducosate - (Colace) - should be discontinued and replaced."
Elizabeth Landsverk, M.D. Geriatrician posted this article today on LinkedIn
CDC Alert issued on June 27, 2016
I Have worn many hats in my day: Nursing Home Assistant Admin and Activities Director, Assisted Living Admin, Case Management for the State-wide Medicaid Program, and Trainer for Dept of Elder Affairs.