A hospital outbreak of an NDM-producing ST167 Escherichia coli with a possible link to a toilet

Andrews, Vigith; Hasman, Henrik; Midttun, M.; Feldthaus, M. Bjerregaard; Porsbo, Lone Jannok; Holzknecht, Barbara Juliane; Scheutz, Flemming; Hess, Christina; Olesen, Bente

doi:10.1016/j.jhin.2021.08.023

Cited by 5 publications

(3 citation statements)

References 6 publications

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“…While we did not identify CPE, the study of Phee et al highlighted the key role universal screening has in identifying the true prevalence of carbapenemase-producing organisms [7]. Some of the sequence types (ST) that were found among ESBL-E. coli in our study have been reported to spread in hospitals with a bla NDM gene (ST10 in Mexico and ST167 in Denmark) [18,19].…”

Section: Discussionmentioning

confidence: 54%

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Universal screening or a universal risk assessment combined with risk-based screening for multidrug-resistant microorganisms upon admission: Comparing strategies

et al. 2023

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Objective Timely identification of patients who carry multidrug-resistant microorganisms (MDRO) is needed to prevent nosocomial spread to other patients and to the hospital environment. We aimed to compare the yield of a universal screening strategy upon admission to the currently installed universal risk assessment combined with risk-based screening upon admission. Methods This observational study was conducted within a prospective cohort study. From January 1, 2018, until September 1, 2019, patients admitted to our hospital were asked to participate. Nasal and perianal samples were taken upon admission and checked for the presence of MDRO. The results of the universal risk assessment and risk-based screening were collected retrospectively from electronic health records. Results In total, 1017 patients with 1069 separate hospital admissions participated in the study. Universal screening identified 38 (3.6%) unknown MDRO carriers upon admission (37 individual patients), all carrying extended-spectrum beta-lactamase-producing Enterobacterales. For 946 of 1069 (88.5%) patients, both the universal risk assessment and universal screening were performed. For 19 (2.0%) admissions, ≥1 risk factor was identified. The universal risk assessment identified one (0.1%) unknown carrier, compared to 37 out of 946 carriers for the universal screening (P<0.001). Of the 37 carriers identified through the universal screening, 35 (94.6%) reported no risk factors. Conclusions Our results show that in our low endemic setting, a universal screening strategy identified significantly more MDRO carriers than the currently implemented universal risk-assessment. When implementing a universal risk-assessment, risk factors should be carefully selected to be able to identify ESBL-E carriers. While the universal screening identified more MDRO carriers, further research is needed to determine the cost-effectiveness of this strategy.

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Section: Discussionmentioning

confidence: 54%

“…Some of the sequence types (ST) that were found among ESBL- E . coli in our study have been reported to spread in hospitals with a bla NDM gene (ST10 in Mexico and ST167 in Denmark) [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 94%

Universal screening or a universal risk assessment combined with risk-based screening for multidrug-resistant microorganisms upon admission: Comparing strategies

et al. 2023

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“…An important route of transmission of ESBL-producing bacteria in healthcare is via the healthcare environment. In particular, toilets have been reported to be a noteworthy infection source [ 3 , 4 ]. This study reports an outbreak in a 692-bed university hospital, in which the toilet and shower room bath chair were the potential sources of the transmission of ESBL-producing Escherichia coli .…”

mentioning

confidence: 99%

Hospital outbreak of extended-spectrum beta-lactamase-producing Escherichia coli potentially caused by toilet and bath chair use

Okada

Takahashi

Yano

et al. 2022

Infection Prevention in Practice

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Transmission of clones of carbapenem-resistant Escherichia coli between a hospital and an urban wastewater treatment plant

Wang,

Berglund,

et al. 2023

Environmental Pollution

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A hospital outbreak of an NDM-producing ST167 Escherichia coli with a possible link to a toilet

Cited by 5 publications

References 6 publications

Universal screening or a universal risk assessment combined with risk-based screening for multidrug-resistant microorganisms upon admission: Comparing strategies

Universal screening or a universal risk assessment combined with risk-based screening for multidrug-resistant microorganisms upon admission: Comparing strategies

Hospital outbreak of extended-spectrum beta-lactamase-producing Escherichia coli potentially caused by toilet and bath chair use

Transmission of clones of carbapenem-resistant Escherichia coli between a hospital and an urban wastewater treatment plant

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