New genotyping method discovers sustained nosocomial Pseudomonas aeruginosa outbreak in an intensive care burn unit.

Tissot, F; Blanc, D S; Basset, P; Zanetti, G; Berger, M M; Que, Yok-Ai; Eggimann, P; Senn, L (2016). New genotyping method discovers sustained nosocomial Pseudomonas aeruginosa outbreak in an intensive care burn unit. Journal of hospital infection, 94(1), pp. 2-7. Elsevier 10.1016/j.jhin.2016.05.011

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BACKGROUND Pseudomonas aeruginosa is a leading cause of healthcare-associated infections in the intensive care unit (ICU). AIM To investigate an unexplained increase in the incidence of P. aeruginosa recovered from clinical samples in the ICU over a two-year period. METHODS After unsuccessful epidemiological investigation by conventional tools, P. aeruginosa clinical isolates of all patients hospitalized between January 2010 and July 2012 were typed by a novel double-locus sequence typing (DLST) method and compared to environmental isolates recovered during the investigation period. FINDINGS In total, 509 clinical isolates from 218 patients and 91 environmental isolates were typed. Thirty-five different genotypic clusters were found in 154 out of 218 patients (71%). The largest cluster, DLST 1-18, included 23 patients who were mostly hospitalized during overlapping periods in the burn unit. Genotype DLST 1-18 was also recovered from floor traps, shower trolleys and the shower mattress in the hydrotherapy rooms, suggesting environmental contamination of the burn unit as the source of the outbreak. After implementation of appropriate infection control measures, this genotype was recovered only once in a clinical sample from a burned patient and twice in the environment, but never thereafter during a 12-month follow-up period. CONCLUSION The use of a novel DLST method allowed the genotyping of a large number of clinical and environmental isolates, leading to the identification of the environmental source of a large unrecognized outbreak in the burn unit. Eradication of the outbreak was confirmed after implementation of a continuous epidemiological surveillance of P. aeruginosa clones in the ICU.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Que, Yok-Ai

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0195-6701

Publisher:

Elsevier

Language:

English

Submitter:

Mirella Aeberhard

Date Deposited:

09 Jan 2017 12:43

Last Modified:

09 Jan 2017 12:43

Publisher DOI:

10.1016/j.jhin.2016.05.011

PubMed ID:

27451039

Uncontrolled Keywords:

Burns; Intensive care unit; Molecular typing; Outbreak; Pseudomonas aeruginosa

BORIS DOI:

10.7892/boris.90521

URI:

https://boris.unibe.ch/id/eprint/90521

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