Outbreak of New Delhi Metallo-Beta-lactamase Carbapenemase Producing Enterobacterales on a bone marrow transplant unit: Role of the environment
| Autor: | Karren Staniforth, Ros Montgomery, Carl Yates, Tim Boswell, Katherine Prescott, Natalie Vaughan, Harriet Billam, Mitch Clarke, N. Mahida |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Carbapenemase Producing Enterobacterales (CPE) Isolation (health care) Transmission (medicine) business.industry Bone marrow transplant unit Outbreak Carbapenemase producing Infectious and parasitic diseases RC109-216 biochemical phenomena metabolism and nutrition Environment New Delhi Metallo-Beta-lactamase (NDM) New Delhi metallo-beta-lactamase Enterobacterales Emergency medicine medicine Pulsed-field gel electrophoresis Kitchen Original Research Article Public aspects of medicine RA1-1270 Erratum business |
| Zdroj: | Infect Prev Pract Infection Prevention in Practice, Vol 3, Iss 2, Pp 100125-(2021) Infection Prevention in Practice |
| ISSN: | 2590-0889 |
| Popis: | Background Carbapenemase Producing Enterobacterales (CPE) are a global health concern. Nosocomial outbreaks have been reported globally with patient-to-patient transmission felt to be the most frequent route of cross-transmission. Aim To describe the investigation and control of an outbreak of healthcare-associated New Delhi Metallo-beta-lactamase (NDM) CPE on a haematology ward, over 2 months. Methods Four patients acquired CPE; all had gastrointestinal tract colonisation with two subsequently developing bacteraemias. The outbreak team performed a retrospective review, prospective case finding and environmental sampling using swabs, settle plates, air and water sampling. Immediate control measures were implemented including appropriate isolation of cases and additional ward cleaning with chlorine disinfectant, ultra-violet light decontamination and hydrogen peroxide. Findings Following two cases of nosocomial acquired CPE prospective case finding identified two further cases. 4.6% of the initial environmental samples were positive for CPE including from waste water sites, the ward sluice and the ward kitchen. Three of the four CPE isolates were identical on pulse field gel electrophoresis (PFGE) typing. Detection of the CPE from the ward kitchen environmental samples suggests a possible role for cross transmission. Conclusion This is the first CPE outbreak report to highlight the role of a ward kitchen as a possible source of cross-transmission. In view of this we suggest ward kitchens are reviewed and investigated in nosocomial CPE outbreaks. |
| Databáze: | OpenAIRE |
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