Pseudo-outbreaks of Stenotrophomonas maltophilia on an intensive care unit in England

Waite, Thomas D.; Georgiou, Andreas; Abrishami, Mohamadreza; Beck, Charles R.

doi:10.1016/j.jhin.2015.12.014

Cited by 22 publications

(24 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Eighty‐six of these patients were reported to have a bronchoscope‐linked manifestation of infection, including pneumonia or other respiratory tract infection. Seven of the included studies contained a missing data‐point relating to the number of bronchoscopic procedures (five studies) and the number of patients who underwent a bronchoscopy (two studies) . These missing data‐points were predicted using a linear regression method.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

A systematic review and cost effectiveness analysis of reusable vs. single‐use flexible bronchoscopes

Mouritsen

Ehlers

Kovaleva³

et al. 2019

Anaesthesia

View full text Add to dashboard Cite

Summary The cost effectiveness of reusable vs. single‐use flexible bronchoscopy in the peri‐operative setting has yet to be determined. We therefore aimed to determine this and hypothesised that single‐use flexible bronchoscopes are cost effective compared with reusable flexible bronchoscopes. We conducted a systematic review of the literature, seeking all reports of cross‐contamination or infection following reusable bronchoscope use in any clinical setting. We calculated the incidence of these outcomes and then determined the cost per patient of treating clinical consequences of bronchoscope‐induced infection. We also performed a micro‐costing analysis to quantify the economics of reusable flexible bronchoscopes in the peri‐operative setting from a high‐throughput tertiary centre. This produced an accurate estimate of the cost per use of reusable flexible bronchoscopes. We then performed a cost effectiveness analysis, combining the data obtained from the systematic review and micro‐costing analysis. We included 16 studies, with a reported incidence of cross‐contamination or infection of 2.8%. In the micro‐costing analysis, the total cost per use of a reusable flexible bronchoscope was calculated to be £249 sterling. The cost per use of a single‐use flexible bronchoscope was £220 sterling. The cost effectiveness analysis demonstrated that reusable flexible bronchoscopes have a cost per patient use of £511 sterling due to the costs of treatment of infection. The findings from this study suggest benefits from the use of single‐use flexible bronchoscopes in terms of cost effectiveness, cross‐contamination and resource utilisation.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Sixteen studies identified for quantitative analysis of the cross-contamination and infection risk. Values are number or mean (SD) 12,30,31,35,63,64,68]…”

mentioning

confidence: 99%

A systematic review and cost effectiveness analysis of reusable vs. single‐use flexible bronchoscopes

Mouritsen

Ehlers

Kovaleva³

et al. 2019

Anaesthesia

View full text Add to dashboard Cite

show abstract

“…S. maltophilia is recognized as an important nosocomial pathogen that causes health care-associated infections (HCAIs) through direct contact, ingestion, aspiration, aerosolization of potable water or the hands of healthcare workers (Guyot et al, 2013). This opportunistic pathogen can cause severe infections, such as bacteremia, sepsis, pneumonia, meningitis after neurosurgical procedures, endocarditis, urinary tract infection, septic arthritis, and endophthalmitis, in immunocompromised patients (Denton and Kerr, 1998;Park et al, 2008;Botana-Rial et al, 2016;Waite et al, 2016). HCAI-associated S. maltophilia strains exhibit resistance to a broad spectrum of antibiotics, including β-lactams, macrolides, fluoroquinolones, aminoglycosides, chloramphenicol (C), tetracyclines (TEs), polymyxins, and trimethoprim-sulfamethoxazole (SXT) (Wu et al, 2006;Chang et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Molecular Epidemiology, Antibiotic Resistance, and Virulence Traits of Stenotrophomonas maltophilia Strains Associated With an Outbreak in a Mexican Tertiary Care Hospital

Cruz‐Córdova

Mancilla-Rojano

Luna-Pineda

et al. 2020

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

Stenotrophomonas maltophilia, an emerging opportunistic pathogen, is widely distributed in the environment the resistance mechanisms, and virulence factors of this bacterium facilitate its dissemination in hospitals. This study aimed to characterize the molecular epidemiology of S. maltophilia strains associated with an outbreak in the Children's Hospital of México Federico Gómez (HIMFG). Twenty-one clinical S. maltophilia strains were recovered from cultures of blood and urine samples from 10 pediatric patients at the emergency department, and nine environmental S. maltophilia strains recovered from faucets in the same area were also included. Two of the 10 patients were related with health care-associated infections (HCAIs), and the other eight patients (8/10) were infected with environmental S. maltophilia strains. The outbreak was controlled by monthly disinfection of the faucets in the emergency department. Typing using pulsedfield gel electrophoresis (PFGE) showed a 52% genetic diversity with seven pulsotypes denoted P1-P7 among all S. maltophilia strains. Three pulsotypes (P2, P3, and P7) were identified among both the clinical and environmental S. maltophilia strains and associated with two type sequences (STs), namely, ST304 and ST24. Moreover, 80% (24/30) of the strains exhibited resistance mainly to tetracycline, 76.66% (23/30) to trimethoprimsulfamethoxazole, and 23.33% (7/30) to the extended-spectrum β-lactamase (ESBL) phenotype. The main resistance genes identified by multiplex PCR were sul1 in 100% (30/30), qnr in 86.66% (26/30), and intl1 in 80% (24/30) of the samples, respectively. Furthermore, the pilU, hlylII, and rmlA genes were identified in 96.6% (29/30), 90% (27/30), and 83.33% (25/30) of the samples, respectively. Additionally, 76.66% (23/30) of the S. maltophilia strains exhibited high swimming motility, 46.66% (14/30) showed moderate biofilm formation capacity, 43.33% (13/30) displayed moderate Cruz-Córdova et al. Outbreak Associated With Stenotrophomonas maltophilia twitching motility, and 20% (6/30) exhibited high adherence. The clinical S. maltophilia strains isolated from blood most strongly adhered to HTB-9 cells. In conclusion, the molecular epidemiology and some of the features such as resistance, and virulence genes associated with colonization patterns are pathogenic attributes that can promote S. maltophilia dissemination, persistence, and facilitate the outbreak that occurred in the HIMFG. This study supports the need for faucet disinfection as a control strategy for clinical outbreaks.

show abstract

“…In recent years, an increasing incidence of S. maltophilia is reported on oncologic wards [ 5 ]. Moreover, several outbreaks and pseudo-outbreaks caused by this pathogen have been reported [ 6 , 7 ]. In addition to epidemiological investigations, different typing methods, e.g.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Stenotrophomonas maltophilia bacteremia cluster in hematopoietic stem cell transplantation recipients using whole genome sequencing

Kampmeier

Pillukat

Pettke

et al. 2017

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

Background Stenotrophomonas maltophilia ubiquitously occurs in the hospital environment. This opportunistic pathogen can cause severe infections in immunocompromised hosts such as hematopoietic stem cell transplantation (HSCT) recipients. Between February and July 2016, a cluster of four patients on the HSCT unit suffered from S. maltophilia bloodstream infections (BSI).MethodsFor epidemiological investigation we retrospectively identified the colonization status of patients admitted to the ward during this time period and performed environmental monitoring of shower heads, shower outlets, washbasins and toilets in patient rooms. We tested antibiotic susceptibility of detected S. maltophilia isolates. Environmental and blood culture samples were subjected to whole genome sequence (WGS)-based typing.ResultsOf four patients with S. maltophlilia BSI, three were found to be colonized previously. In addition, retrospective investigations revealed two patients being colonized in anal swab samples but not infected. Environmental monitoring revealed one shower outlet contaminated with S. maltophilia. Antibiotic susceptibility testing of seven S. maltophlia strains resulted in two trimethoprim/sulfamethoxazole resistant and five susceptible isolates, however, not excluding an outbreak scenario. WGS-based typing did not result in any close genotypic relationship among the patients’ isolates. In contrast, one environmental isolate from a shower outlet was closely related to a single patient’s isolate.ConclusionWGS-based typing successfully refuted an outbreak of S. maltophilia on a HSCT ward but uncoverd that sanitary installations can be an actual source of S. maltophilia transmissions.

show abstract

Pseudo-outbreaks of Stenotrophomonas maltophilia on an intensive care unit in England

Cited by 22 publications

References 10 publications

A systematic review and cost effectiveness analysis of reusable vs. single‐use flexible bronchoscopes

A systematic review and cost effectiveness analysis of reusable vs. single‐use flexible bronchoscopes

Molecular Epidemiology, Antibiotic Resistance, and Virulence Traits of Stenotrophomonas maltophilia Strains Associated With an Outbreak in a Mexican Tertiary Care Hospital

Evaluation of a Stenotrophomonas maltophilia bacteremia cluster in hematopoietic stem cell transplantation recipients using whole genome sequencing

Contact Info

Product

Resources

About