Titre
Outbreak of Pseudomonas aeruginosa producing VIM carbapenemase in an intensive care unit and its termination by implementation of waterless patient care.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Catho, G.
Auteure/Auteur
Martischang, R.
Auteure/Auteur
Boroli, F.
Auteure/Auteur
Chraïti, M.N.
Auteure/Auteur
Martin, Y.
Auteure/Auteur
Koyluk Tomsuk, Z.
Auteure/Auteur
Renzi, G.
Auteure/Auteur
Schrenzel, J.
Auteure/Auteur
Pugin, J.
Auteure/Auteur
Nordmann, P.
Auteure/Auteur
Blanc, D.S.
Auteure/Auteur
Harbarth, S.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1466-609X
Statut éditorial
Publié
Date de publication
2021-08-19
Volume
25
Numéro
1
Première page
301
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Résumé
Long-term outbreaks of multidrug-resistant Gram-negative bacilli related to hospital-building water systems have been described. However, successful mitigation strategies have rarely been reported. In particular, environmental disinfection or replacement of contaminated equipment usually failed to eradicate environmental sources of Pseudomonas aeruginosa.
We report the investigation and termination of an outbreak of P. aeruginosa producing VIM carbapenemase (PA-VIM) in the adult intensive care unit (ICU) of a Swiss tertiary care hospital with active case finding, environmental sampling and whole genome sequencing (WGS) of patient and environmental strains. We also describe the implemented control strategies and their effectiveness on eradication of the environmental reservoir.
Between April 2018 and September 2020, 21 patients became either infected or colonized with a PA-VIM strain. For 16 of them, an acquisition in the ICU was suspected. Among 131 environmental samples collected in the ICU, 13 grew PA-VIM in sink traps and drains. WGS confirmed the epidemiological link between clinical and environmental strains and the monoclonal pattern of the outbreak. After removing sinks from patient rooms and implementation of waterless patient care, no new acquisition was detected in the ICU within 8 months after the intervention.
Implementation of waterless patient care with removal of the sinks in patient rooms was successful for termination of a PA-VIM ICU outbreak linked to multiple environmental water sources. WGS provides highly discriminatory accuracy to investigate environment-related outbreaks.
We report the investigation and termination of an outbreak of P. aeruginosa producing VIM carbapenemase (PA-VIM) in the adult intensive care unit (ICU) of a Swiss tertiary care hospital with active case finding, environmental sampling and whole genome sequencing (WGS) of patient and environmental strains. We also describe the implemented control strategies and their effectiveness on eradication of the environmental reservoir.
Between April 2018 and September 2020, 21 patients became either infected or colonized with a PA-VIM strain. For 16 of them, an acquisition in the ICU was suspected. Among 131 environmental samples collected in the ICU, 13 grew PA-VIM in sink traps and drains. WGS confirmed the epidemiological link between clinical and environmental strains and the monoclonal pattern of the outbreak. After removing sinks from patient rooms and implementation of waterless patient care, no new acquisition was detected in the ICU within 8 months after the intervention.
Implementation of waterless patient care with removal of the sinks in patient rooms was successful for termination of a PA-VIM ICU outbreak linked to multiple environmental water sources. WGS provides highly discriminatory accuracy to investigate environment-related outbreaks.
PID Serval
serval:BIB_E6BB3887D16C
PMID
Open Access
Oui
Date de création
2021-09-03T16:11:24.116Z
Date de création dans IRIS
2025-05-21T06:42:51Z
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Nom
Catho_2021_CriticalCare_VIM Paeruginosa outbreak.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by/4.0
Taille
1.45 MB
Format
Adobe PDF
PID Serval
serval:BIB_E6BB3887D16C.P001
URN
urn:nbn:ch:serval-BIB_E6BB3887D16C2
Somme de contrôle
(MD5):0630c42458666ece002357a15b80024b