Schärer, Verena; Meier, Marie-Theres; Schuepbach, Reto A; Zinkernagel, Annelies S; Boumasmoud, Mathilde; Chakrakodi, Bhavya; Brugger, Silvio D; Fröhlich, Martin R; Wolfensberger, Aline; Sax, Hugo; Kuster, Stefan P; Schreiber, Peter W (2023). An intensive care unit outbreak with multidrug-resistant Pseudomonas aeruginosa - spot on sinks. The journal of hospital infection, 139, pp. 161-167. Elsevier 10.1016/j.jhin.2023.06.013
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BACKGROUND
Pseudomonas aeruginosa and other Gram-negative bacteria have the ability to persist in moist environments in healthcare settings, but their spread from these areas can result in outbreaks of healthcare-associated infections.
METHODS
We report the investigation and containment of a multidrug-resistant P. aeruginosa outbreak in 3 intensive care units of a Swiss university hospital. A total of 255 patients and 276 environmental samples were screened for the multidrug-resistant P. aeruginosa outbreak strain. We describe the environmental sampling and molecular characterization of patient and environmental strains, control strategies implemented, including waterless patient care.
RESULTS
Between March and November 2019, the outbreak affected 29 patients. Environmental sampling detected the outbreak strain in nine samples of sink siphons of three different intensive care units sharing an identical water sewage system and on one gastroscope. Three weeks after sink siphon replacement, the outbreak strain grew again in siphon-derived samples and newly-affected patients were identified. The outbreak ceased after removal of all sinks in the proximity of patients and in medication preparation areas and minimization of tap water use. Multilocus sequence typing indicated clonality (sequence type 316) in 28/29 patient isolates and all 10 environmental samples.
CONCLUSIONS
Sink removal combined with the introduction of waterless patient care terminated the multidrug-resistant P. aeruginosa outbreak. Sinks in intensive care units might pose a risk for point source outbreaks with P. aeruginosa and other bacteria persisting in moist environments.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology |
UniBE Contributor: |
Sax, Hugo Siegfried |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1532-2939 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
22 Jun 2023 14:47 |
Last Modified: |
27 Aug 2023 00:14 |
Publisher DOI: |
10.1016/j.jhin.2023.06.013 |
PubMed ID: |
37343769 |
Uncontrolled Keywords: |
Pseudomonas aeruginosa, multidrug resistance intensive care outbreak sink siphon waterless patient care |
BORIS DOI: |
10.48350/183633 |
URI: |
https://boris.unibe.ch/id/eprint/183633 |
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