Outbreak of CTX-M-15–producing Enterobacter cloacae associated with therapeutic beds and syphons in an intensive care unit

Bousquet, Aurore; Mee-Marquet, Nathalie van der; Dubost, C; Bigaillon, C.; Larréché, S.; Bugier, Sarah; Surcouf, Corinne; Mérat, Stéphane; Blanchard, H; Mérens, Audrey

doi:10.1016/j.ajic.2017.04.010

Cited by 16 publications

(9 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The duration of the outbreaks before implementation of initial mitigation activities directed at WWDs was often substantial in the 21 studies that allowed for such a determination (Table 1). While the interval was only 1 month in 3 studies, 11 , 20 , 22 it was between 6 and 12 months in 7 studies 4 – 8 , 16 , 17 (mean, 8.8 months) and between 24 and 84 months in an additional 7 studies (mean, 53 months) 9 11 , 15 , 19 , 21 , 24 Once an outbreak was recognized, 19 sites implemented multiple enhanced infection prevention interventions such as increased hand hygiene education, hand hygiene monitoring, reinforced contact precautions, cohorting infected and colonized patients, cohorting staff caring for such patients, and increased emphasis on daily as well as terminal cleaning practices.…”

Section: Resultsmentioning

confidence: 99%

“…Overall, 16 of 21 reports (76%) did not describe culture-based WWD evaluation of the effectiveness of these apparently final interventions 3 4 , 6 – 8 , 10 , 11 , 13 , 14 , 16 , 17 , 20 – 23 Although 3 reports described a partial response to interventions, 13 , 18 , 24 6 studies described objectively confirmed failure of final mitigation activities 5 9 , 11 , 15 , 19 , 24 Of the studies evaluating a response to mitigation activities, only 4 sites used culture-based assessment of the effectiveness of sink system replacement, and all 4 confirmed ongoing or recurrent WWD colonization with ObS organisms 5 …”

Section: Resultsmentioning

confidence: 99%

“…Also, 22 outbreaks (95%) were associated with high-risk patient settings. Furthermore, 19 outbreaks (87%) were related to a single CRO: P. aeruginosa (n=9), 3 – 5 , 11 , 15 , 17 , 19 , 21 K. pneumonia (n=3), 6 , 7 , 12 E. coli (n=3), 18 , 20 ,22 K. oxytoca (n=3), 8 , 10 , 16 and a Serratia species (n=1) 13 (Table 1). In addition, 4 outbreaks (17%) involved between 2 and 6 species of CROs that shared the same resistance gene or genes 9 …”

Section: Resultsmentioning

confidence: 99%

“…19 While not quantified, 7 studies noted that the design of sinks and sink areas might have had a role in outbreak perpetuation. 9,11,13,15,16,24 Also, 14 sites described WWD system replacement, usually of multiple sinks, 3,4,[6][7][8][13][14][15][16][20][21][22][23][24] as part of subsequent interventions. Overall, 16 of 21 reports (76%) did not describe culture-based WWD evaluation of the effectiveness of these apparently final interventions.…”

Section: Interventions To Mitigate Outbreaksmentioning

confidence: 99%

See 3 more Smart Citations

Wastewater drains: epidemiology and interventions in 23 carbapenem-resistant organism outbreaks

Carling

2018

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

For many years, patient-area wastewater drains (ie, sink and shower drains) have been considered a potential source of bacterial pathogens that can be transmitted to patients. Recently, evolving genomic epidemiology tools combined with new insights into the ecology of wastewater drain (WWD) biofilm have provided new perspectives on the clinical relevance and hospital-associated infection (HAI) transmission risks related to these fixtures. To further clarify the clinical relevance of WWD-associated pathogen transmission, reports of outbreaks attributed to WWDs were selected for review that (1) investigated the outbreak epidemiology of WWD-associated transmission of bacterial pathogens, (2) utilized advanced microbiologic methods to establish clonality of outbreak pathogens and/or resistance genes, or (3) described interventions implemented to mitigate transmission of the outbreak pathogens from WWDs. These reports were collated, compared, and analyzed, and the results are presented here.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Interventions To Mitigate Outbreaksmentioning

confidence: 99%

See 2 more Smart Citations

Wastewater drains: epidemiology and interventions in 23 carbapenem-resistant organism outbreaks

Carling

2018

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

show abstract

“…2 Numerous studies have linked the hospital mattress to HAIs including OXA-48-producing Klebsiella pneumoniae and CTX-M-15-producing Enterobacter cloacae. [3][4][5] Most mattress covers today are made of polyurethane coated fabric and are typically cleaned and disinfected by manually wiping the surface 1 time with a health care disinfectant. Currently used disinfectants include quaternary ammonia compounds, sodium hypochlorite (bleach), hydrogen peroxide, and peroxyacetic acid (peracetic acid), hydrogen peroxide/peroxyacetic acid combination, and phenolics.…”

Section: Introductionmentioning

confidence: 99%

Successful Removal of Clostridioides Difficile Spores and Pathogenic Bacteria From a Launderable Barrier Using a Commercial Laundry Process

Hooker

Ulrich²,

Brooks³

2020

Infect Dis (Auckl)

View full text Add to dashboard Cite

Background: To properly clean and disinfect hospital mattresses, bed manufacturers recommend a 3- to 6-step process to remove all pathogenic bacteria. An alternative is to use a removable barrier on the mattress, which is laundered after each use. The current study was to determine efficacy of a commercial laundry process in eliminating Clostridioides difficile (C diff) spores, Mycobacterium terrae (M terrae), methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa (P aeruginosa), Klebsiella pneumoniae (K pneumoniae), and Escherichia coli (E coli) from a barrier. Methods: A test barrier received 3 unique microbial suspensions in separate locations, each suspension having a known quantity of specific microorganisms: C diff spores, M terrae, and a mixed suspension of MRSA, S aureus, P aeruginosa, K pneumoniae, and E coli. A wash load contained the test barrier and 11 additional ballast barriers. Various soils were spread onto the barriers to simulate heavy soiling that may occur in a wash load: Each barrier received a small amount of mixed soil, 50% received urine, 25% received blood, and 25% received a large amount of additional mixed soil. The load was laundered using 71°C (160°F) water, detergent, and chlorine bleach, with final drying at 71°C (160°F). After laundering, remaining colony-forming units (CFUs) of each microorganism were counted at the applied locations. Each test was replicated 3 times. Industry-accepted methods were used to produce suspensions, apply inoculum, and recover organisms after laundering. Results: Before laundering, test barriers contained at least 7.0 log10 cfu/mL of each microorganism distributed over 103 cm2. After laundering, in all cases, no residual CFUs were detected over the test area, resulting in greater than 6.0 log10 reductions for every organism. ( P < .05). Conclusions: Under extreme test conditions including the presence of soil, the laundry process removed all detectable pathogenic bacteria and spores from the barrier.

show abstract

Risikofaktoren für Schließungen von neonatologischen und pädiatrischen Stationen in nosokomialen Ausbrüchen

Edler

Chhatwal²,

Albrecht

et al. 2022

Monatsschr Kinderheilkd

View full text Add to dashboard Cite

Zusammenfassung Hintergrund Im Fall eines nosokomialen Ausbruchs (NA) in der Pädiatrie und Neonatologie wird neben einer Vielzahl weiterer Maßnahmen mintunter die gesamte Station für Neuaufnahmen geschlossen. Dies ist infektionsprophylaktisch zwar oft effektiv, jedoch ökonomisch oft auch sehr nachteilig. Wichtig sind daher Kenntnisse darüber, wann eine solche Schließung sehr wahrscheinlich unvermeidbar ist, um diese dann frühestmöglich durchzuführen. Ziel der Arbeit Ermittlung von Charakteristika, die eine Schließung letztlich wahrscheinlich machen. Material und Methoden Systematische Literaturrecherche der Worldwide Outbreak Database und weiterer internationaler Datenbanken zu NA mit und ohne Schließung. Ergebnisse Es wurden 198 NA aus der Pädiatrie (darunter 25 NA mit und 173 NA ohne Schließung) sowie weitere 413 NA aus der Neonatologie (darunter 52 NA mit und 361 NA ohne Schließung) eingeschlossen. In 446 dieser 611 NA waren auch Intensivstationen (ITS) betroffen. Insgesamt waren 16.107 Patienten betroffen und es ereigneten sich 3155 Infektionen mit 1542 Todesfällen. Die Gesamtdauer der NA betrug dabei 2 bis 4380 Tage; sofern erfolgt, betrug die Dauer der Schließung 2 bis 210 Tage. Die am häufigsten nachgewiesenen Erreger in Ausbrüchen mit Schließung waren S. marcescens, E. cloacae und K. pneumoniae. Die Beteiligung einer ITS sowie hohe Fallzahlen korrelierten signifikant mit der Wahrscheinlichkeit für eine spätere Schließung. Diskussion Insbesondere für die Neonatologie wird bei der Beteiligung einer ITS an einem NA empfohlen, eine Schließung des Bereiches frühzeitig zu erwägen. Zudem kann in NA die Definition lokal festgelegter Schwellenwerte für Patientenzahlen, bei deren Überschreiten bestimmte Hygienemaßnahmen, wie z. B. die Schließung der Station, initiiert werden, sinnvoll sein.

show abstract

Outbreak of CTX-M-15–producing Enterobacter cloacae associated with therapeutic beds and syphons in an intensive care unit

Cited by 16 publications

References 8 publications

Wastewater drains: epidemiology and interventions in 23 carbapenem-resistant organism outbreaks

Wastewater drains: epidemiology and interventions in 23 carbapenem-resistant organism outbreaks

Successful Removal of Clostridioides Difficile Spores and Pathogenic Bacteria From a Launderable Barrier Using a Commercial Laundry Process

Risikofaktoren für Schließungen von neonatologischen und pädiatrischen Stationen in nosokomialen Ausbrüchen

Contact Info

Product

Resources

About