Outbreak of Pseudomonas aeruginosa producing VIM carbapenemase in an intensive care unit and its termination by implementation of waterless patient care
| Autor: | Dominique S. Blanc, Patrice Nordmann, Romain Martischang, Filippo Boroli, Gesuele Renzi, Z. Koyluk Tomsuk, M. N. Chraïti, Jérôme Pugin, Stéphan Juergen Harbarth, Gaud Catho, Jacques Schrenzel, Yasmina B. Martin |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Epidemiology Sink Iatrogenic Disease Waterless Critical Care and Intensive Care Medicine medicine.disease_cause Patient care beta-Lactamases law.invention Disease Outbreaks Environmental water Bacterial Proteins law medicine Humans In patient Pseudomonas Infections Aquatic reservoir Carbapememase Outbreak Pseudomonas aeruginosa VIM cgMLST Aged ddc:616 Cross Infection business.industry RC86-88.9 Research Medical emergencies. Critical care. Intensive care. First aid Middle Aged Intensive care unit ddc:616.8 Intensive Care Units Adult intensive care unit Emergency medicine CgMLST Equipment Contamination Female business Switzerland |
| Zdroj: | Critical Care, Vol 25, Iss 1, Pp 1-10 (2021) Critical care, vol. 25, no. 1, pp. 301 Critical Care Critical Care, Vol. 25, No 1 (2021) P. 301 |
| ISSN: | 1364-8535 |
| Popis: | Background Long-term outbreaks of multidrug-resistant Gram-negative bacilli related to hospital-building water systems have been described. However, successful mitigation strategies have rarely been reported. In particular, environmental disinfection or replacement of contaminated equipment usually failed to eradicate environmental sources of Pseudomonas aeruginosa. Methods We report the investigation and termination of an outbreak of P. aeruginosa producing VIM carbapenemase (PA-VIM) in the adult intensive care unit (ICU) of a Swiss tertiary care hospital with active case finding, environmental sampling and whole genome sequencing (WGS) of patient and environmental strains. We also describe the implemented control strategies and their effectiveness on eradication of the environmental reservoir. Results Between April 2018 and September 2020, 21 patients became either infected or colonized with a PA-VIM strain. For 16 of them, an acquisition in the ICU was suspected. Among 131 environmental samples collected in the ICU, 13 grew PA-VIM in sink traps and drains. WGS confirmed the epidemiological link between clinical and environmental strains and the monoclonal pattern of the outbreak. After removing sinks from patient rooms and implementation of waterless patient care, no new acquisition was detected in the ICU within 8 months after the intervention. Discussion Implementation of waterless patient care with removal of the sinks in patient rooms was successful for termination of a PA-VIM ICU outbreak linked to multiple environmental water sources. WGS provides highly discriminatory accuracy to investigate environment-related outbreaks. |
| Databáze: | OpenAIRE |
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