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Burkholderia cepacia Complex (Bcc) Infections

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Burkholderia cepacia Complex (Bcc) Infections Associated with Contaminated Ultrasound Gel

Health advisory

August 5, 2021

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  • Healthcare facilities should immediately stop use of all lots of Eco-Gel 200® ultrasound gel due to concern for bacterial contamination.
    • Destroy or return products from lots B029, B030, B031, B032, B040, B041, B048, B055. The lot numbers are identifiable on all labels on the cases and bottles.
    • Stop use and quarantine all other lots of Eco-Gel 200® ultrasound gel.
    • Eco-Gel 200® ultrasound gel is also distributed in the US under these brand names:
      • MediChoice Ultrasound Gel, by Owens & Minor (United States)
      • MediChoice Ultrasound Gel, by Mac Medical Supply Co Inc. (United States)
      • Chattanooga Conductor USA, by DJO Global (United States)
      • DJO Conductor, by DJO Global (United States)
      • Liquasonic, by Athena Medical Products Inc. (United States)
      • Medline, by Medline Industries Inc. (United States)
      • NDC Eco-Gel 200 Ultrasound Gel, by NDC Inc. (United States)
      • Omni, by Accelerated Care Plus Leasing Inc. (United States)

  • Identify and report to public health cases of Burkholderia cepacia complex (Bcc) infections since March 26, 2021 in persons who had ultrasonography in preparation for or during a transcutaneous procedure (e.g., placement of central and peripheral intravenous lines, amniocentesis, paracentesis) within 2 weeks of onset of symptoms associated with the infection.

  • Use single-use, sterile ultrasound gel packets for ultrasonography used in preparation for or during transcutaneous procedures, such as placement of central and peripheral intravenous lines, amniocentesis, and paracentesis. This includes avoiding use of bottles of nonsterile ultrasound gel for visualization prior to such procedures (e.g., vein marking, visualizing ascites).

  • Review facility practices related to ultrasound probe reprocessing to ensure they are aligned with manufacturer's instructions for use and appropriate professional society guidelines.

  • Ensure all equipment and surfaces potentially contaminated with Eco-Gel 200® ultrasound gel is thoroughly cleaned and disinfected (using U.S. Environmental Protection Agency (EPA)'s Registered Tuberculocide Products List B).

  • Ensure that all ultrasound procedures adhere to proper infection prevention practices, including skin preparation prior to percutaneous procedures.


US Centers for Disease Control and Prevention is investigating at least 15 Burkholderia stabilis infections across multiple states proven to be related by whole genome sequencing to bacterial contamination in unopened Eco-Gel 200® ultrasound gel.
Additional infections have been identified that may also be associated. The earliest production date for the recalled lots of ultrasound gel is March 26, 2021.

Healthcare facilities that perform ultrasound should review their stock of ultrasound gel and follow the appropriate quarantine or recall instructions above.

The Washington State Department of Health is seeking additional cases potentially associated with this contaminated product. Please review laboratory reports of Burkholderia cepacia complex infections in persons who had an ultrasound guided transcutaneous procedure in the 2 weeks prior to infection onset.

Please report any suspected cases to Public Health – Seattle & King County at 206-296-4774.

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