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The sink as a potential source of transmission of carbapenemase-producing Enterobacteriaceae in the intensive care unit
- Source :
- Antimicrobial Resistance and Infection Control, Antimicrobial Resistance and Infection Control, Vol 6, Iss 1, Pp 1-6 (2017)
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- Background Carbapenemase-producing Enterobacteriaceae (CPE) are emerging pathogens that represent a major public health threat. In the University Hospital of Brussels, the incidence of new patients with CPE rose from 1 case in 2010 to 35 cases in 2015. Between January and August 2015, five patients became infected/colonized with CPE during their stay in the same room in the intensive care unit (ICU). Since the time period between those patients was relatively short and the strains belonged to different species with different antibiograms and mechanisms of resistance, the hypothesis was that the environment could be a possible source of transmission. Methods and results Environmental samples suggested that a contaminated sink was the source of the outbreak. Besides other strains, Citrobacter freundii type OXA-48 was frequently isolated from patients and sinks. To investigate the phylogenetic relationschip between those strains, pulsed-field gel electrophoresis was performed. The strains isolated from patients and the sink in the implicated room were highly related and pointed to sink-to-patient transmission. In total, 7 of 8 sinks in the isolation rooms of the ICU were found to be CPE contaminated. To control the outbreak, the sinks and their plumbings were replaced by new ones with another structure, they were flushed every morning with a glucoprotamin solution and routines regarding sink practices were improved leading to discontinuation of the outbreak. Conclusions This outbreak highlights that hospital sink drains can accumulate strains with resistance genes and become a potential source of CPE.
- Subjects :
- 0301 basic medicine
Microbiology (medical)
medicine.medical_specialty
Carbapenemase-Producing Enterobacteriaceae
030106 microbiology
Drug resistance
030501 epidemiology
lcsh:Infectious and parasitic diseases
law.invention
Hospital sinks
03 medical and health sciences
Medical microbiology
law
Transmission
Medicine
lcsh:RC109-216
Intensive care unit
Pharmacology (medical)
Potential source
Carbapenemase-producing Enterobacteriaceae
Intensive care medicine
Medicine(all)
business.industry
Research
Public health
Public Health, Environmental and Occupational Health
Outbreak
biochemical phenomena, metabolism, and nutrition
University hospital
Infectious Diseases
Citrobacter freundii OXA-48
0305 other medical science
business
Subjects
Details
- ISSN :
- 20472994
- Volume :
- 6
- Database :
- OpenAIRE
- Journal :
- Antimicrobial Resistance & Infection Control
- Accession number :
- edsair.doi.dedup.....05a7335d01536d15c7cecdf1e2c0e838