Pediatrics

Concurrent Education Session - 60 minutes

1303 - State View of a Burkholderia cepacia Outbreak Among Pediatric Patients

Wednesday, June 14
3:00 PM - 4:00 PM
Location: Oregon Convention Center, A 105-106

On May 3, 2016, the Texas Department of State Health Services (DSHS) received notification of an unusual Burkholderia cepacia outbreak in a pediatric population. B. cepacia is typically seen in the immunocompromised, such as individuals with cystic fibrosis, and is typically resistant to antibiotics. This outbreak was in non-cystic-fibrosis pediatric patients and most strains were generally susceptible to antibiotics.

The initial report was 15 pediatric patients within one hospital. The CDC was notified the same day of the outbreak, at which time they had no knowledge of current and comparable outbreaks. Within 2 days, the CDC reported to DSHS that one other state was describing a similar outbreak. A site visit was performed by DSHS and local health authorities at the initial reporting facility in Texas, with no infection control findings noted. A call for cases in the state of Texas began on June 23, 2016, and gave light to potentially 46 additional B. cepacia infections or colonizations related to the outbreak.

Product testing from a Texas hospital revealed a medication tested positive for B. cepacia and was later determined to match the outbreak strain. On July 16, 2016, an FDA MedWatch was issued on a voluntary recall for an oral liquid docusate sodium. This safety alert was shared by DSHS with multiple contacts across the state in hopes of quickly ceasing use of the medication. The last known and linked case to the outbreak strain was cultured on July 4, 2016. At the time of this writing, full analysis of the outbreak by the CDC is pending. This session will help attendees determine when to consider an unusual event as an outbreak and identify the action steps. We will also cover the health department’s role in assisting facilities in multijurisdictional healthcare events.

Learning Objectives:


Bobbiejean Garcia

Healthcare-Associated Infection Epidemiologist
Texas Department of State Health Services
Houston, Texas

Bobbiejean Garcia moved to Houston in 2005 from San Antonio, Texas, for graduate school to attain her MPH. She began working in infection control later that year. She was certified in infection control in 2009. Her experience as an infection preventionist ranges from acute and long-term acute care to rehabilitation services. In 2013, she began working as a healthcare-associated infection epidemiologist for the Texas Department of State Health Services. She serves as subject matter expert for multidrug-resistant organisms and infection prevention best practices within her 16-county region. She is a member of the APIC Houston chapter and currently serves as chapter treasurer.

Presentation(s):

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Jessica Ross

Healthcare-Associated Infection Epidemiologist
Texas Department of State Health Services
Liberty Hill, Texas

Jessica Ross is a healthcare-associated infection (HAI) epidemiologist for the Infectious Disease Control Unit within the Texas Department of State Health Services. She is responsible for providing professional consultations including training and education, and designing and directing epidemiological studies, surveillance projects, and infectious disease outbreak investigations. Jessica’s specific emphasis is on infection control and prevention, multidrug-resistant organisms, and HAIs. Prior to this position, Ms. Ross served as an infection preventionist for 10 years at a variety of different organizations and is certified in infection prevention and control. Ms. Ross also serves as a member of APIC and as a member of CSTE. Ms. Ross received a BS in biology from Texas Tech University. Aside from the vast array of epidemiologic and infection prevention tasks, Jessica enjoys scuba diving and spending time with family and her two dogs.

Presentation(s):

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Jessica Silvaggio

Infection Preventionist
Children’s Hospital Los Angeles
Los Angeles, California

Jessica Silvaggio is an infection preventionist at Children’s Hospital Los Angeles. She previously worked as an applied epidemiology fellow with the CDC and CSTE, focusing on infectious diseases and healthcare-associated infections in Los Angeles County. During her two-year CDC/CSTE fellowship, she was deployed to work at CDC headquarters in Atlanta, Georgia to support the Ebola response, participated in multistate outbreaks, helped create the 2013 Los Angeles County antibiogram (providing a snapshot of resistance to antibiotics countywide), co-led epidemiologic responses in hospital outbreaks, performed cost benefit analysis studies, and conducted research to explore the implications of the health officer order mandating influenza vaccination among healthcare workers. Jessica is interested in multidrug-resistant organisms in healthcare settings, emerging infectious diseases, antimicrobial stewardship, and emergency preparedness. She serves as an active board member as the chapter legislative representative for California APIC and as communications chair for the APIC Greater Los Angeles chapter.

Presentation(s):

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