Detection of <i>Paraburkholderia</i> in Clinical Specimens Associated with Use of Nonsterile Ultrasound Gel for Percutaneous Procedures — United States, Canada, and Israel, May 2023⎯April 2025
Bibliographic record
Abstract
Contaminated nonsterile ultrasound gels have been implicated in outbreaks of Burkholderia infections associated with improper infection control practices before or during percutaneous procedures. In August 2024, the Minnesota Department of Health Public Health Laboratory noticed an increase in Paraburkholderia fungorum or Paraburkholderia species identified from referred clinical isolates. All isolates were recovered from blood cultures, and whole genome sequencing (WGS) confirmed that the isolates were genetically related. Because P. fungorum is not an established human pathogen and has rarely been reported in clinical specimens, an investigation was initiated, which was later joined by collaborators in Canada and Israel after similar observations in those countries. Forty-two patients from the United States, Canada, and Israel with genetically linked P. fungorum isolated from clinical specimens collected during May 2023-April 2025 were identified. Positive cultures were associated with the use of nonsterile ultrasound gel. Based on medical record review, treating clinicians deemed the isolate a culture contaminant in most cases; one patient had a confirmed invasive P. fungorum infection. WGS confirmed the relatedness of isolates from all three countries, including isolates cultured from clinical specimens as well as from nonsterile ultrasound gel products. Review of local practices revealed use of nonsterile ultrasound gel during point-of-care percutaneous procedures, including drawing blood, placing intravenous catheters, and paracentesis. This investigation underscores the continued importance of sterile gel use during percutaneous procedures and highlights the value of collaboration and shared WGS data for the investigation of international outbreaks.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".