“The CDC local health departments and numerous healthcare facilities are investigating a multistate outbreak of Burkholderia cepacia infections. These infections have occurred primarily in ventilated patients without cystic fibrosis and who are being treated in intensive care units. The preliminary information indicates that a contaminated liquid docusate product might be related to cases in one state. Until more information is available, the CDC recommends that facilities 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 agencies.”

So what does this mean for the frail elder population? They are more susceptible to any infection, since their immune response has decline due to age and health. Infections such as influenza or norvirus (diarrhea) can spread quickly, especially in residential facilities or day programs. Burholderia Cepacia 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 multidrug resistant. We have seen serious respiratory infections in a number of frail elders this year. The challenge is getting a sputum sample to determine the bacterial etiology of the pneumonia. Almost none of my patients can produce a sample. I think for the frail elder population, particularly those elders with dementia, all liquid ducosate (Colace) should be discontinued and replaced.

Elizabeth Landsverk, MD