Death of 8 TN patients in 2023 traced to neuromelioidosis caused by contaminated saline at Dental clinic: Lancet Study

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Researchers from Christian Medical College, Vellore, Indian Council of Medical Research-National Institute of Epidemiology, Chennai, and other institutes attributed the cluster to invasive dental procedures -- injecting of a local anaesthetic and repeated irrigation with saline -- performed under suboptimal infection prevention and control conditions.

Whole genome sequencing of 209 isolates, obtained from tissue, blood, and cerebrospinal fluid samples of the affected, revealed 'ST1553' strain of the bacterium B pseudomallei as being associated with the neurological infection outbreak.

Along with suggesting a new process by which neuromelioidosis can be contracted, the findings highlighted the importance of molecular (genetic) methods of analysis in identifying the strain of the bacterium circulating in Southeast Asia.

Rigorous infection prevention and control practices across healthcare facilities, particularly those performing invasive procedures, need to be enforced, the authors said.

"We confirmed a large cluster of neuromelioidosis from south India, likely representing sporadic cases from environmental sources and cases linked to an iatrogenic source (complication resulting from treatment) at a dental clinic," the authors wrote, reports PTI.

"Rapid and high case fatality among dental cases supports the direct trans-neural spread of B pseudomallei to the brainstem following inoculation via contaminated saline," they wrote.

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