Successful control of an outbreak of GES-5 extended-spectrum β-lactamase-producing Pseudomonas aeruginosa in a long-term care facility in Japan

Abstract

An outbreak of MDRP with an antimicrobial resistance gene, blaGES-5, occurred in a Japanese LTCF. It was successfully controlled by enhanced infection control measures, which neighbouring hospitals and a local public health centre supported.

A systematic review on the causes of the transmission and control measures of outbreaks in long-term care facilities: Back to basics of infection control

“…The quality of 20 studies was assessed and the results are summarized in Fig 2. One study was at high risk for five criteria [14]. Six studies were at low risk for all criteria [15][16][17][18][19][20]. Problems related to recall bias and standardization of self-reported measurement created a high risk of bias for the measurement of the exposure domain in seven studies [14,[21][22][23][24][25][26].…”

“…Three reports of GAS outbreaks found lapses in wound care practice such as inconsistent cleaning and disinfection [20,37,38]. The outbreaks of MDROs and hepatitis B reported device related issues including sharing of a device and inappropriate use of reusable devices [15,18,21,34]. Hepatitis B and C outbreaks commonly reported that lapses during podiatry care and point-of-care testing procedures (blood glucose test and international normalized ratio monitoring) caused the transmission of bloodborne pathogens among residents [18,19,21,28,30].…”

“…Several studies demonstrated host factors associated with the outbreaks in case-control analysis, that were identified as: age [29], sex [16], cognitive impairment [29], nutritional status [27], comorbidities [23,24], use of an indwelling device [15,17], and dependence level [31]. Although not the result of the case-control analysis, the study by Spires et al [50] reported that all cases of RSV and HMPV were dependent dementia patients, implicating that dependence was an important factor.…”

“…All 30 studies reported that one or more NPIs were applied to control the outbreaks. From a rigorous perspective, only one study on a multidrug-resistant Pseudomonas aeruginosa (MRPA) outbreak implemented all the measures recommended to control an outbreak by pathogens [15]. Work restriction of ill workers was less frequently reported compared to other measures.…”

“…Work restriction of ill workers was less frequently reported compared to other measures. Only five studies reported the creation of outbreak control teams for effective management of the outbreaks [15,17,23,27,43]. Most facilities notified public health authorities or institutions about the outbreaks and received advice and assistance to manage the outbreaks.…”