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

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State: Public
Version: Author's accepted manuscript
Serval ID
serval:BIB_8FB4BF675C6C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
New genotyping method discovers sustained nosocomial Pseudomonas aeruginosa outbreak in an intensive care burn unit.
Journal
The Journal of hospital infection
Author(s)
Tissot F., Blanc D.S., Basset P., Zanetti G., Berger M.M., Que Y.A., Eggimann P., Senn L.
ISSN
1532-2939 (Electronic)
ISSN-L
0195-6701
Publication state
Published
Issued date
09/2016
Volume
94
Number
1
Pages
2-7
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Pseudomonas aeruginosa is a leading cause of healthcare-associated infections in the intensive care unit (ICU).
To investigate an unexplained increase in the incidence of P. aeruginosa recovered from clinical samples in the ICU over a two-year period.
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.
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.
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.

Keywords
Adult, Aged, Aged, 80 and over, Burn Units, Child, Preschool, Cross Infection/epidemiology, Cross Infection/microbiology, Disease Outbreaks, Environmental Microbiology, Epidemiological Monitoring, Female, Genotype, Humans, Infection Control/methods, Intensive Care Units, Male, Middle Aged, Molecular Epidemiology/methods, Molecular Typing/methods, Pseudomonas Infections/epidemiology, Pseudomonas Infections/microbiology, Pseudomonas aeruginosa/classification, Pseudomonas aeruginosa/genetics, Pseudomonas aeruginosa/isolation & purification, Young Adult
Pubmed
Open Access
Yes
Create date
30/11/2016 11:20
Last modification date
20/08/2019 14:53
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