Difficult-to-detect carbapenem-resistant IMP13-producing P. aeruginosa: experience feedback concerning a cluster of urinary tract infections at a surgical clinic in France
| Autor: | Xavier Bertrand, Anne-Sophie Valentin, Roland Quentin, Odile Milan, Nathalie van der Mee-Marquet, Patrick Plésiat, Laurent Debroize |
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| Přispěvatelé: | Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Hôpital Jean Minjoz, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Agents pathogènes et inflammation - UFC (EA 4266) ( API ), Université de Franche-Comté ( UFC ), Infectiologie et Santé Publique ( ISP ), Université de Tours-IFR136, Service de bactériologie et d'hygiène hospitalière [Tours], CHRU Tours-CHU Trousseau [APHP], Van Der Mee-Marquet, Nathalie, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Infectiologie et Santé Publique (UMR ISP), Institut National de la Recherche Agronomique (INRA)-Université de Tours (UT), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), This work was supported by the Centre de Coordination de la Lutte contre les Infections Nosocomiales de l’Ouest de la France (CCLIN Ouest), the Agence Régionale de Santé du Centre, and the Centre Hospitalier Universitaire de Tours, France., Institut National de la Recherche Agronomique (INRA)-Université de Tours |
| Jazyk: | angličtina |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Pediatrics Urinary system Short Report Drug resistance Disease cluster pseudomonas aeruginosa 03 medical and health sciences 0302 clinical medicine Medical microbiology [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology medicine Pharmacology (medical) 030212 general & internal medicine appareil urinaire 0303 health sciences Carbapenem resistant 030306 microbiology business.industry Microbiology and Parasitology Public Health Environmental and Occupational Health Experience feedback opération chirurgicale Microbiologie et Parasitologie infection 3. Good health Infectious Diseases [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology business |
| Zdroj: | Antimicrobial Resistance and Infection Control Antimicrob Resist Infect Control Antimicrob Resist Infect Control, 2013, 2 (1), pp.12. 〈10.1186/2047-2994-2-12〉 Antimicrobial Resistance and Infection Control 12 (2), 1-5. (2013) Antimicrob Resist Infect Control, 2013, 2 (1), pp.12. ⟨10.1186/2047-2994-2-12⟩ |
| ISSN: | 2047-2994 |
| DOI: | 10.1186/2047-2994-2-12 |
| Popis: | We report a carbapenem-resistant P. aeruginosa clone responsible for a cluster of urinary tract infections in elderly surgery patients, diagnosed during a three-month period in a 59-bed surgical clinic. The clonal nature of the cluster was established by molecular study of the P. aeruginosa isolates (PFGE and MLST). Despite an MIC of imipenem in the susceptibility range for two isolates, all were metallo-β-lactamase-producers (IMP13-type, clone ST621). We conducted a review of the medical and surgical procedures. We tested water delivered into the clinic and urological devices for the presence of the epidemic strain. The hygiene nurse observed hygiene practices. A week after the implementation of barrier precautions around the fourth infected patient, we studied the extent to which the patients hospitalised were colonised to assess whether the spread of the epidemic strain had been controlled. 1/ Our findings indicate the difficulties in the detection of the metallo-β-lactamase in this clone, that resulted in the alert being delayed. 2/ Unlike most investigations of UTI outbreaks described in urology wards, we did not detect any contaminated urological devices or water colonisation. 3/ Consistent with outbreaks involving the IMP-13 clone in critical care units, the observation of inadequate application of standard precautions argued for patient-to-patient transmission during urinary management of the urology patients. 4/ The implementation of barrier precautions around infected patients resulted in control of the spread of the epidemic clone. This report serves as an alert concerning a difficult-to-detect multidrug-resistant P. aeruginosa clone in elderly urology patients. |
| Databáze: | OpenAIRE |
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