Nosocomial outbreak of extended-spectrum β-lactamase-producing Enterobacter cloacae among cardiothoracic surgical patients: causes and consequences
| Autor: | S. Dupont, Isabel Leroux-Roels, M. de Barsy, Audrey Noël, Pierre Bogaerts, Youri Glupczynski, Anne-Sophie Dincq, C. Dransart, Te-Din Huang, B. Delaere, Isabelle Michaux, L. Melly, C. Vastrade, Benoît Rondelet, T. Van Maerken |
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| Rok vydání: | 2018 |
| Předmět: |
Microbiology (medical)
Male medicine.medical_specialty Microbiological culture Genotyping Techniques 030501 epidemiology beta-Lactamases law.invention Disease Outbreaks 03 medical and health sciences Belgium law Internal medicine Epidemiology Enterobacter cloacae Medicine Humans Typing Aged Retrospective Studies Aged 80 and over 0303 health sciences Cross Infection biology 030306 microbiology business.industry Mortality rate Enterobacteriaceae Infections Outbreak General Medicine Middle Aged Thoracic Surgical Procedures biology.organism_classification Intensive care unit Infectious Diseases Cardiothoracic surgery Case-Control Studies Female 0305 other medical science business Echocardiography Transesophageal Multilocus Sequence Typing |
| Zdroj: | The Journal of hospital infection. 102(1) |
| ISSN: | 1532-2939 |
| Popis: | Summary Background Enterobacteriaceae are recognized as leading pathogens of healthcare-associated infections. Aim To report the investigation of a nosocomial outbreak of extended-spectrum β-lactamase-producing Enterobacter cloacae affecting cardiothoracic surgery patients in a Belgian academic hospital. Methods Cases were defined based on epidemiological and microbiological investigations, including molecular typing using repetitive element-based polymerase chain reaction and multi-locus sequence typing. Case–control studies followed by field evaluations allowed the identification of a possible reservoir, and the retrospective assessment of human and financial consequences. Findings Over a three-month period, 42 patients were infected or colonized by CTX-M-15-producing E. cloacae strains that belonged to the same clonal lineage. Acquisition mainly occurred in the intensive care unit (N = 23) and in the cardiothoracic surgery ward (N = 16). All but one patient had, prior to acquisition, undergone a cardiothoracic surgical procedure, monitored by the same transoesophageal echocardiography (TOE) probe in the operating room. Despite negative microbiological culture results, the exclusion of the suspected probe resulted in rapid termination of the outbreak. Overall, the outbreak was associated with a high mortality rate among infected patients (40%) as well as significant costs (€266,550). Conclusion The outbreak was indirectly shown to be associated with the contamination of a manually disinfected TOE probe used per-operatively during cardiothoracic surgery procedures, because withdrawal of the putative device led to rapid termination of the outbreak. |
| Databáze: | OpenAIRE |
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