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After dozens of children at local hospital test positive for bacteria, tap water found to be the source

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The Boston Globe

A surgical technician washed her hands after exiting an operating room at a local hospital. Erin Clark / The Boston Globe

Franciscan Children’s hospital is restricting the use of tap water after discovering another occurrence of a potentially harmful bacteria that it first detected in 2019.

Since Nov. 22, the Brighton hospital has not allowed anyone located in two areas of the pediatric rehab facility to consume tap water, after detecting the presence of the bacteria in two water sources. On Monday, it allowed staff to resume using water from now-filtered taps to bathe children

“Out of an abundance of caution, we immediately stopped using the water in those two areas for drinking and bathing,” Dr. Jane O’Brien, chief medical officer of Franciscan Children’s, said in a statement.

Known as Burkholderia cepacia, the bacteria was first detected in the facility three years ago, when a sample from a routine test of a patient came back positive. Since then, 36 children have either arrived at the hospital with the bacteria or tested positive for it after admission, according to Franciscan officials; one patient developed an infection, was treated, and recovered.

Burkholderia is commonly found in water and soil, and like many bacteria, it generally poses little medical risk to healthy individuals. However, it can trigger infections and other illnesses in medically compromised people. Moreover, Burkholderia is often resistant to common antibiotics, so can be problematic for patients with cystic fibrosis — whose lungs accumulate thick mucus that the body can’t readily clear — and lung transplant recipients.

Some patients can have detectable levels of the bacteria and never develop symptoms.

Franciscan Children’s officials say they had been working with the Massachusetts Department of Public Health and the Centers for Disease Control and Prevention to identify the source of the contamination. The investigation included extensive water testing throughout its campus, which yielded the positive test last month in the water source of two areas in the same building.

In addition to limiting the use of water for consumption and bathing, staff were also told to sanitize their hands after washing them in the sink.

In light of the ongoing clusters, the hospital is currently not accepting transfers of patients with lung transplants, who are particularly vulnerable to infection. Franciscan is the only pediatric post-acute provider in New England, and specializes in mental health disorders and the rehabilitation of severely ill children, including those on breathing tubes.

“We partnered with DPH and CDC to ensure patients who could potentially be vulnerable to Burkholderia were not transferred to Franciscan Children’s, and that all patients transferred from Franciscan to other hospitals are first tested to prevent the spread of the bacteria,” O’Brien said.

Dr. Robert T. Schooley, a professor of medicine in the Division of Infectious Diseases and Global Public Health at the University of California San Diego, said bacteria from the environment can sometimes colonize water sources and, while usually harmless, it can threaten those with particular illnesses or compromised immune systems.

Burkholderia is known to cause infections in hospitalized patients, including a 2020 cluster at Brigham and Women’s Hospital that led to the deaths of three patients in its cardiothoracic intensive care unit. A recent review published by Infection Prevention in Practice identified 111 outbreaks caused by Burkholderia in health care settings since 1971, most caused by contaminated medications or medical solutions . Of 2,390 patients tracked in the report, 28 died as a direct result of their infections.

Dr. Daniel Kuritzkes, chief of the division of infectious diseases at Brigham and Women’s, said providers occasionally encounter Burkholderia through routine testing of patients, but generally hold off treating them with antibiotics until there are symptoms indicating an infection, to prevent the bacteria from further developing resistance to antibiotics.

“We would see this crop up a few times a year,” Kuritzkes said. “There are a variety of bacteria we encounter in the ICU. Burk is one of them, but fortunately it isn’t as common as some of the others.”

One Franciscan staff member, who spoke on the condition of anonymity due to concerns about their job, said staff had long had concerns about the presence of the bacteria, though the hospital acted swiftly after identifying the contamination. But this person added that the hospital had provided staff with 8-ounce bottles of water for all patient and family needs. Some families told staff they felt bad asking for the small water bottles multiple times a day. To give children baths, providers would open several small bottles and microwave the water in cups, this person said..

The hospital said that the small bottles were what was available immediately after they got the test results, and that they also provided gallon bottles. The hospital added that it was following DPH guidelines.

Since November, filters have been installed throughout the medical and dental units and in operating rooms. As of Monday, the DPH and CDC gave the hospital clearance to resume bathing patients in filtered tap water.



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