Nosocomial Transmission of New Delhi Metallo-β-Lactamase-1-ProducingKlebsiella pneumoniaein Toronto, Canada

Abstract

Two distinct clones of NDM1-Kp were transmitted to 7 inpatient contacts over several months. Implementation of contact precautions, screening of contacts for NDM1-Kp carriage, and attention to environmental disinfection contributed to the interruption of subsequent spread of the organism. The appropriate duration and frequency of screening contacts of NDM1-Kp-positive patients require further study.

Risk of infection following colonization with carbapenem-resistant Enterobactericeae: A systematic review

“…[11][12][13][14][15][16][17][18][19][20] Characteristics of the studies meeting inclusion criteria are reported in Table 1. Among these 10 studies, 1,806 colonized patients were used in our analysis.…”

“…20 Seven reported site of infection [11][12][13][14]17,19,20 and 6 studies included data on length of stay amongst CRE cases, 12,[14][15][16][17]20 whereas only 5 included mortality data. 12,[14][15][16][17] For those studies that reported data on gender, 11,14,17,18,20 men accounted for 33%-69.6% of patients colonized or infected with CRE.…”

“…15,17,18,20 Risk of infection after colonization with CRE Colonization was defined as gastrointestinal tract carriage determined by rectal swab in the majority of studies. 11,12,14,15,[18][19][20] Five studies cultured specimens on MacConkey agar. 11,14,15,[18][19][20] Alternative methods used included inoculation of brain-heart infusion broth 14,15 and use of CHROMagar K pneumonia carbapenemase Petri dishes (CHROMagar, Paris, France) for some or all specimens.…”

“…11,12,14,15,[18][19][20] Five studies cultured specimens on MacConkey agar. 11,14,15,[18][19][20] Alternative methods used included inoculation of brain-heart infusion broth 14,15 and use of CHROMagar K pneumonia carbapenemase Petri dishes (CHROMagar, Paris, France) for some or all specimens. 12,16,19 The study by Cho et al 13 was unique in using nasal swabs cultured on 5% sheep's blood agar plates.…”

“…11,14,15,[18][19][20] Alternative methods used included inoculation of brain-heart infusion broth 14,15 and use of CHROMagar K pneumonia carbapenemase Petri dishes (CHROMagar, Paris, France) for some or all specimens. 12,16,19 The study by Cho et al 13 was unique in using nasal swabs cultured on 5% sheep's blood agar plates. One study did not specify microbiologic techniques sufficiently to allow interpretation.…”