The Centers for Disease Control and Prevention (CDC) has broadened its recommendation about giving docusate to patients as it continues to investigate a multistate outbreak of Burkholderia cepacia complex infections, which began in ventilated patients in the intensive care unit.
To date, 47 B. cepacia complex cases have been confirmed to match one of two outbreak strains identified from health care facilities in five states. There may be more in other states, but they have yet to be confirmed, according to the CDC.
The outbreak began at the end of June, but continues, according to the CDC, which at the time recommended that health care facilities not use any liquid docusate products for patients who are critically ill, ventilated or immunosuppressed. That recommendation was expanded this week, and the CDC said no patient should be given liquid docusate products as a stool softener or for any other reason.
- cepaciacomplex is a common group of bacteria that occurs in the environment and is not typically a problem for healthy patients, but can be a problem for the immunocompromised and is a pretty common cause of lung disease in cystic fibrosis (CF) patients.
Shortly after the outbreak occurred around June 24, the CDC, the FDA and public health officials investigating the cases linked it to contaminated docusate. Two samples of unused oral liquid docusate received from one of the affected hospitals have tested positive for B. cepacia complex, but they have not confirmed that the bacteria match the outbreak strains.
Institutions with non-CF patients in whom there are B. cepacia infections should sequester all liquid docusate products. If an oral liquid docusate stool softener is medically necessary, alternative medicines should be used.
Health care providers and laboratories should be on alert for B. cepacia cases occurring among non-CF patients and inform infection prevention staff when these infections occur. Cases should be reported to state or local public health authorities, according to the CDC.
Facilities that identify infections caused by B. cepacia complex among non-CF patients or clusters of these infections among CF patients should sequester and save all docusate products used in the facility.