Notes from the Field: Verona Integron-Encoded Metallo-Beta-Lactamase–Producing Carbapenem-Resistant Enterobacteriaceae in a Neonatal and Adult Intensive Care Unit — Kentucky, 2015

Autor: Andrea Flinchum, Anna Q Yaffee, Lynn Roser, Kimberly Daniels, Douglas Thoroughman, Robert Brawley, Kraig Humbaugh
Rok vydání: 2016
Předmět:
Adult
Male
0301 basic medicine
Pediatrics
medicine.medical_specialty
Health (social science)
Neonatal intensive care unit
Adolescent
Epidemiology
Klebsiella pneumoniae
Health
Toxicology and Mutagenesis
030106 microbiology
Population
Kentucky
Carbapenem-resistant enterobacteriaceae
Disease cluster
beta-Lactamases
Integrons
Young Adult
03 medical and health sciences
0302 clinical medicine
Enterobacteriaceae
Health Information Management
Intensive Care Units
Neonatal
Drug Resistance
Bacterial
Health care
Humans
Medicine
Colonization
030212 general & internal medicine
Child
education
Aged
education.field_of_study
biology
business.industry
Infant
Newborn
Infant
General Medicine
Middle Aged
biology.organism_classification
Intensive Care Units
Carbapenems
Child
Preschool
Female
business
Enterobacter cloacae
Zdroj: MMWR. Morbidity and Mortality Weekly Report. 65:190
ISSN: 1545-861X
0149-2195
DOI: 10.15585/mmwr.mm6507a5
Popis: During August 4-September 1, 2015, eight cases of Verona integron-encoded metallo-beta-lactamase (VIM)-producing Carbapenem-resistant Enterobacteriaceae (CRE) colonization were identified in six patients, using weekly active surveillance perirectal cultures in a Kentucky tertiary care hospital. No cases of clinical infection or complications attributable to colonization were reported. Four of the eight isolates were identified as Enterobacter cloacae; other organisms included Raoultella species (one), Escherichia coli (one), and Klebsiella pneumoniae (two). Six isolates were reported in a neonatal intensive care unit (ICU), and two isolates in an adult trauma and surgical ICU. Patient ages at isolate culture date ranged from 21 days to 68 years. Fifty percent of the patients were male. Previously, only one VIM-producing CRE-colonized patient (an adult, in 2013) had been reported by the same hospital. The six cases are the largest occurrence of VIM-producing CRE colonization reported in the United States and the only recognized cluster of VIM-producing CRE colonization in the United States reported to include a neonatal population. Despite environmental sampling over the same period, surveying patients for exposure to health care outside the United States, surveying health care providers for risk factors, and surveillance culturing of health care provider nares and axillae, a source of VIM-producing CRE has not been identified for this cluster. Prevention measures throughout the ICUs have been enhanced in response to this cluster, as detailed in CDC's 2015 CRE toolkit update.
Databáze: OpenAIRE
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