Carbapenem-Resistant Acinetobacter baumannii: Concomitant Contamination of Air and Environmental Surfaces

2016 ◽  
Vol 37 (7) ◽  
pp. 777-781 ◽  
Author(s):  
Luis A. Shimose ◽  
Eriko Masuda ◽  
Maroun Sfeir ◽  
Ana Berbel Caban ◽  
Maria X. Bueno ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Gel Electrophoresis ◽  
Environmental Samples ◽  
Pulsed Field Gel Electrophoresis ◽  
Prospective Surveillance ◽  
Air Samples ◽  
Air Contamination ◽  
Carbapenem Resistant ◽  
Environmental Surfaces ◽  
Environmental Surface

OBJECTIVETo concomitantly determine the differential degrees of air and environmental contamination by Acinetobacter baumannii based on anatomic source of colonization and type of ICU layout (single-occupancy vs open layout).DESIGNLongitudinal prospective surveillance study of air and environmental surfaces in patient rooms.SETTINGA 1,500-bed public teaching hospital in Miami, Florida.PATIENTSConsecutive A. baumannii–colonized patients admitted to our ICUs between October 2013 and February 2014.METHODSAir and environmental surfaces of the rooms of A. baumannii–colonized patients were sampled daily for up to 10 days. Pulsed-field gel electrophoresis (PFGE) was used to type and match the matching air, environmental, and clinical A. baumannii isolates.RESULTSA total of 25 A. baumannii–colonized patients were identified during the study period; 17 were colonized in the respiratory tract and 8 were colonized in the rectum. In rooms with rectally colonized patients, 38.3% of air samples were positive for A. baumannii; in rooms of patients with respiratory colonization, 13.1% of air samples were positive (P=.0001). In rooms with rectally colonized patients, 15.5% of environmental samples were positive for A. baumannii; in rooms of patients with respiratory colonization, 9.5% of environmental samples were positive (P=.02). The rates of air contamination in the open-layout and single-occupancy ICUs were 17.9% and 21.8%, respectively (P=.5). Environmental surfaces were positive in 9.5% of instances in open-layout ICUs versus 13.4% in single-occupancy ICUs (P=.09).CONCLUSIONSAir and environmental surface contaminations were significantly greater among rectally colonized patients; however, ICU layout did not influence the rate of contamination.Infect Control Hosp Epidemiol 2016;37:777–781

scholarly journals Population Structure Analysis of Carbapenem-Resistant Acinetobacter baumannii Clinical Isolates from Brazil Reveals Predominance of Clonal Complexes 1, 15, and 79

2016 ◽  
Vol 60 (4) ◽  
pp. 2545-2547 ◽  
Author(s):  
Carlos Henrique Camargo ◽  
Monique Ribeiro Tiba ◽  
Marta Regina Saes ◽  
Francielli Mahnic de Vasconcellos ◽  
Luis Fernando dos Santos ◽  
...  
Keyword(s):  
Population Structure ◽  
Acinetobacter Baumannii ◽  
Gel Electrophoresis ◽  
Multilocus Sequence Typing ◽  
Clonal Complex ◽  
Pulsed Field Gel Electrophoresis ◽  
Clinical Isolates ◽  
Content Type ◽  
Carbapenem Resistant ◽  
Population Structure Analysis

ABSTRACTThe population structure of 71 carbapenem-resistantAcinetobacter baumanniiclinical isolates from several hospitals in Brazil was investigated by ApaI pulsed-field gel electrophoresis,blaOXA-51-like subtyping, and multilocus sequence typing (Institute Pasteur scheme). In addition to the predominance of strains carryingblaOXA-23, we detected the presence ofblaOXA-72andblaOXA-231. We observed a predominance of clonal complex 1 (CC1), CC15, and CC79 and representative strains of the worldwide-disseminated international clone I.

scholarly journals Duodenoscope-Associated Outbreak of a Carbapenem Resistant Enterobacteriaceae

2020 ◽  
Vol 41 (S1) ◽  
pp. s197-s197
Author(s):  
Sung Ran Kim ◽  
Joon Young Song ◽  
Min Hee Cho ◽  
Ji Yeon Song
Keyword(s):  
Gel Electrophoresis ◽  
Case Control ◽  
Pulsed Field Gel Electrophoresis ◽  
Control Analysis ◽  
Endoscopic Retrograde ◽  
Carbapenem Resistant ◽  
Case Control Analysis ◽  
Record Review ◽  
Carbapenem Resistant Enterobacteriaceae ◽  
Cleaning Protocol

Background: We describe and evaluate our outbreak of carbapenem-resistant K. pneumoniae transmitted by contaminated duodenoscopes during endoscopic retrograde cholangiopancreatography (ERCP) procedures. Methods: An outbreak investigation was performed when Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) were identified from bile specimens of 4 patients. The investigation included medical record review, practice audits, and surveillance cultures of duodenoscopes and environmental sites. If available, clinical specimens were obtained from patients who had undergone ERCP in the previous 3 months. Carbapenem-resistant Enterobacteriaceae (CRE) screening cultures were performed to identify additional patients until no CRE cases were detected during 2 consecutive weeks. Pulsed-field gel electrophoresis (PFGE) of KPC-KP isolates was implemented. Results: In total, 12 cases were identified with exposure to duodenoscope from February 2019 through April 2019, including 6 cases with infections and 6 asymptomatic carriers. Case-control analysis showed that 2 specific duodenoscopes would be associated with the KPC-KP outbreak. Duodenoscope reprocessing procedures did not deviate from manufacturer recommendations for reprocessing. After ethylene oxide (EO) gas sterilization, the outbreak was terminated. Conclusions: Meticulous cleaning protocol and enhanced surveillance are necessary to prevent outbreaks of CRE. Notably, enhanced cleaning measures, such as sterilization for duodenoscopes, would be required after procedures with KPC-KP carriers.Funding: NoneDisclosures: None

Monitoring of Chicken Houses and an Attached Egg-Processing Facility in a Laying Farm for Salmonella Contamination between 1994 and 1998

2001 ◽  
Vol 64 (12) ◽  
pp. 1912-1916 ◽  
Author(s):  
TOSHIYUKI MURASE ◽  
KAZUKO SENJYU ◽  
TAKESHI MAEDA ◽  
MASAYUKI TANAKA ◽  
HIROSHI SAKAE ◽  
...  
Keyword(s):  
Gel Electrophoresis ◽  
Salmonella Enterica ◽  
Environmental Samples ◽  
Pfge Pattern ◽  
Pulsed Field Gel Electrophoresis ◽  
Drain Water ◽  
Pulsed Field ◽  
Processing Facility ◽  
Single Clone

Two chicken houses and an attached egg-processing facility in a laying farm were sampled between 1994 and 1998 to investigate Salmonella contamination. Each of the houses was environmentally controlled and fitted with egg belts that transported eggs from the houses to the egg-processing facility. Four hundred twenty-eight Salmonella isolates were obtained from 904 environmental samples collected from the houses. Two hundred fifty-two of the 428 (58.9%) isolates yielded five serotypes as follows: Salmonella enterica subsp. enterica serovar Livingstone, Salmonella serovar Cerro, Salmonella serovar Montevideo, Salmonella serovar Mbandaka, and Salmonella serovar Corvallis. The remaining (41.1%, 176 of 428) isolates included four other serotypes and isolates that were untypeable. Salmonella isolates obtained from the drain water collected after the washing of the eggs in the egg-processing facility yielded the same serotypes as those found in the chicken houses. Strains having an identical pulsed-field gel electrophoresis (PFGE) pattern were continually recovered from a house for more than 1 year. Several strains of Salmonella Cerro, Salmonella Mbandaka, and Salmonella Montevideo obtained from both the houses and from the egg-processing facility were indistinguishable by PFGE, respectively. These results suggest that Salmonella organisms originating from a single clone colonized the chicken houses and that the egg belts are likely to be one of the means by which Salmonella organisms are spread from one house to the others.

Salmonella Outbreaks in Restaurants in Minnesota, 1995 through 2003: Evaluation of the Role of Infected Foodworkers

2006 ◽  
Vol 69 (8) ◽  
pp. 1870-1878 ◽  
Author(s):  
CARLOTA MEDUS ◽  
KIRK E. SMITH ◽  
JEFFREY B. BENDER ◽  
JOHN M. BESSER ◽  
CRAIG W. HEDBERG
Keyword(s):  
Median Duration ◽  
Gel Electrophoresis ◽  
Environmental Samples ◽  
Median Number ◽  
Pulsed Field Gel Electrophoresis ◽  
Gastrointestinal Illness ◽  
Pulsed Field ◽  
Specific Food

The 23 restaurant-associated salmonellosis outbreaks that occurred in Minnesota from 1995 through 2003 were reviewed to characterize the role of infected foodworkers. The median duration of the outbreaks was 21 days (range, 1 to 517 days). The median number of culture-confirmed patron cases per outbreak was seven (range, 1 to 36 cases). The median incubation for patron cases ranged from9hto5.9 days. A specific food vehicle was implicated in four outbreaks and suspected in five. Salmonella of the same serotype and pulsed-field gel electrophoresis subtype as that found in patrons was recovered from foodworkers in 19 outbreaks. Overall, 12% (129 of 1,033) of foodworkers tested positive for Salmonella. Sixty-four (53%) of 121 Salmonella-positive foodworkers reported not having had a recent gastrointestinal illness. Overall, the median duration of Salmonella shedding was 16 days. Among foodworkers who reported gastrointestinal illness, the median shedding duration was 30 days as compared with 3 days for asymptomatic foodworkers. Positive environmental samples were recovered in 4 (33%) of 12 outbreaks. No specific food vehicle was identified in any outbreaks associated with Salmonella-positive environmental samples. The median duration of outbreaks with positive environmental samples (187 days) was significantly longer than the median duration of outbreaks with negative environmental results (26 days, P = 0.03). A higher proportion of Salmonella-positive foodworkers (22 versus 8%) was identified in outbreaks with positive environmental samples. Salmonella outbreaks in restaurants are frequently prolonged yet produce a small number of confirmed patron cases. Prolonged outbreak durations suggest a persistent reservoir of contamination. Infected foodworkers likely serve as an important source for Salmonella transmission. Therefore, assessment of foodworker infection is essential for controlling restaurant outbreaks.

The Predominance of Strain Replacement Among Enterobacteriaceae Pairs With Emerging Carbapenem Resistance During Hospitalization

2020 ◽  
Vol 221 (Supplement_2) ◽  
pp. S215-S219
Author(s):  
Baixing Ding ◽  
Zhen Shen ◽  
Xiaohua Qin ◽  
Yang Yang ◽  
Xiaogang Xu ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Gel Electrophoresis ◽  
Carbapenem Resistance ◽  
Tertiary Hospital ◽  
Pulsed Field Gel Electrophoresis ◽  
Pulsed Field ◽  
Carbapenem Resistant ◽  
Sequence Types ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Isolates of Enterobacteriaceae collected from the same patient can lose carbapenem susceptibility during antimicrobial therapy, but little attention has been given to how this conversion takes place. In the current study, we retrospectively analyzed microbiological and clinical data from patients with enterobacterial infections at a tertiary hospital in Shanghai, China. After screening 4795 patients and 7120 Enterobacteriaceae isolates over the 3-year study period, we found the change from carbapenem susceptible to carbapenem resistant in 41 pairs of isolates, of which 35 pairs (85.4%) were K. pneumoniae and 25 (61.0%) were from the same anatomic sites. Thirty-six isolate pairs showed different pulsed-field gel electrophoresis patterns between the carbapenem-susceptible and the corresponding resistant strain, and 5 pairs displayed identical pulsed-field gel electrophoresis patterns. Thirty-three (91.7%) of the 36 pairs of Enterobacteriaceae isolates were carbapenem-resistant K. pneumoniae with blaKPC-2, and 28 pairs (90.3%) of K. pneumoniae isolates had different sequence types (STs), with ST11 the most common ST found in carbapenem-resistant K. pneumoniae isolates. Forty of the 41 patients had received antimicrobial therapy such as carbapenems, cephalosporins, and fluoroquinolones, before the isolation of carbapenem-resistant Enterobacteriaceae. These results demonstrated that strain replacement is the main cause of emerging carbapenem resistance in Enterobacteriaceae during hospitalization. The loss of carbapenem susceptibility was not mainly due to in vivo development of carbapenem resistance.

scholarly journals Surveillance of Carbapenem-Resistant Pseudomonas aeruginosa Isolates from Puerto Rican Medical Center Hospitals: Dissemination of KPC and IMP-18 β-Lactamases

2009 ◽  
Vol 53 (4) ◽  
pp. 1660-1664 ◽  
Author(s):  
Daniel J. Wolter ◽  
Noha Khalaf ◽  
Iraida E. Robledo ◽  
Guillermo J. Vázquez ◽  
Maria I. Santé ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Puerto Rican ◽  
Gel Electrophoresis ◽  
Medical Center ◽  
Pulsed Field Gel Electrophoresis ◽  
Pulsed Field ◽  
Carbapenem Resistant ◽  
Clonal Spread

ABSTRACT During a 6-month period, 37/513 (7.2%) Pseudomonas aeruginosa isolates belonging to 13 pulsed-field gel electrophoresis (PFGE) groups from Puerto Rican hospitals were carbapenem nonsusceptible. Seven of 37 isolates from four PFGE groups carried bla IMP-18, and 25/37 isolates from seven PFGE groups carried bla KPC. The results indicated the clonal spread of bla KPC-positive P. aeruginosa isolates into several Puerto Rican hospitals and the dissemination of bla IMP-18 and bla KPC into genetically unrelated isolates.

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