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Outbreak of NDM-1-Producing Escherichia coli in a Coronavirus Disease 2019 Intensive Care Unit in a Mexican Tertiary Care Center.
- Source :
-
Microbiology spectrum [Microbiol Spectr] 2022 Feb 23; Vol. 10 (1), pp. e0201521. Date of Electronic Publication: 2022 Jan 12. - Publication Year :
- 2022
-
Abstract
- Emergency department areas were repurposed as intensive care units (ICUs) for patients with acute respiratory distress syndrome during the initial months of the coronavirus disease 2019 (COVID-19) pandemic. We describe an outbreak of New Delhi metallo-β-lactamase 1 (NDM-1)-producing Escherichia coli infections in critically ill COVID-19 patients admitted to one of the repurposed units. Seven patients developed infections (6 ventilator-associated pneumonia [VAP] and 1 urinary tract infection [UTI]) due to carbapenem-resistant E. coli, and only two survived. Five of the affected patients and four additional patients had rectal carriage of carbapenem-resistant E. coli. The E. coli strain from the affected patients corresponded to a single sequence type. Rectal screening identified isolates of two other sequence types bearing bla <subscript>NDM-1</subscript> . Isolates of all three sequence types harbored an IncFII plasmid. The plasmid was confirmed to carry bla <subscript>NDM-1</subscript> through conjugation. An outbreak of clonal NDM-1-producing E. coli isolates and subsequent dissemination of NDM-1 through mobile elements to other E. coli strains occurred after hospital conversion during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. This emphasizes the need for infection control practices in surge scenarios. IMPORTANCE The SARS-CoV-2 pandemic has resulted in a surge of critically ill patients. Hospitals have had to adapt to the demand by repurposing areas as intensive care units. This has resulted in high workload and disruption of usual hospital workflows. Surge capacity guidelines and pandemic response plans do not contemplate how to limit collateral damage from issues like hospital-acquired infections. It is vital to ensure quality of care in surge scenarios.
- Subjects :
- Adult
Aged
COVID-19 epidemiology
COVID-19 virology
Conjugation, Genetic
Cross Infection epidemiology
Disease Outbreaks
Escherichia coli classification
Escherichia coli genetics
Escherichia coli Infections epidemiology
Escherichia coli Infections mortality
Female
Humans
Intensive Care Units statistics & numerical data
Male
Mexico epidemiology
Middle Aged
Plasmids genetics
SARS-CoV-2 physiology
Tertiary Care Centers statistics & numerical data
beta-Lactamases genetics
Cross Infection microbiology
Escherichia coli enzymology
Escherichia coli isolation & purification
Escherichia coli Infections microbiology
beta-Lactamases metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 2165-0497
- Volume :
- 10
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Microbiology spectrum
- Publication Type :
- Academic Journal
- Accession number :
- 35019697
- Full Text :
- https://doi.org/10.1128/spectrum.02015-21