Nosocomial outbreak linked to a flexible gastrointestinal endoscope contaminated with an amikacin-resistant ST17 clone of Pseudomonas aeruginosa
| Autor: | Julio López-Méndez, Gabriel Cabot, Esther Recacha, Inés Portillo, Jesús Rodríguez-Baño, Álvaro Pascual, Antonio Oliver, Lorena López-Cerero, Felipe Fernández-Cuenca |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) 030106 microbiology Clone (cell biology) Virulence Biology medicine.disease_cause Disease Outbreaks Microbiology 03 medical and health sciences 0302 clinical medicine Endoscope Drug Resistance Bacterial Pulsed-field gel electrophoresis medicine Humans Pseudomonas Infections 030212 general & internal medicine Amikacin ST17 clone Aged Aged 80 and over Cross Infection Pseudomonas aeruginosa Outbreak General Medicine Middle Aged Anti-Bacterial Agents 3. Good health Endoscopes Gastrointestinal Infectious Diseases Spain Equipment Contamination Multilocus sequence typing Female Sample collection medicine.drug |
| Zdroj: | Digital.CSIC. Repositorio Institucional del CSIC instname European Journal of Clinical Microbiology & Infectious Diseases |
| ISSN: | 1435-4373 0934-9723 |
| DOI: | 10.1007/s10096-020-03915-7 |
| Popis: | Endoscope contamination is infrequent but can be the source of nosocomial infections and outbreaks. In August 2016, an unexpected increase in the incidence of amikacin-resistant P. aeruginosa isolates (AK-Pae) was observed at a tertiary care center in the south of Spain. An epidemiological and microbiological investigation (August-October 2016) was performed to explain this finding. Isolates from clinical and environmental samples (2 endoscopes used for retrograde cholangiopancreatography; ERCP) were identified by MALDI-TOF. Antimicrobial susceptibility testing was performed using the MicroScan system. Whole-Genome-Sequencing (Miseq, Illumina) was performed to determine the resistome and virulome. Clonal relatedness among isolates was assessed by SpeI-PFGE and MLST. A Caenorhabditis elegans killing assay was performed for virulence testing. Biofilm formation was performed using a colorimetric assay. Four of the 5 patients infected and/or colonized with AK-Pae in August 2016 had undergone ERCP ≤5 days before sample collection. Two endoscopes were contaminated with AK-Pae. Isolates from one endoscope showed an identical PFGE pattern to 9 isolates (cluster I) and differed (1–2 bands) to 5 isolates (cluster II). Isolates from these clusters belonged to the ST17 clone. This S17 clone was characterized by its low virulence in the C. elegans killing assay, and its biofilm-forming ability, slightly superior to that of high-risk clones of P. aeruginosa ST175 and ST235. This outbreak was caused by an endoscope used for ERCP contaminated with an invasive, moderately virulent, biofilm-forming AK-Pae ST17 clone, suggesting the possible emergence of a new high-risk lineage of this clone. |
| Databáze: | OpenAIRE |
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