Outbreak of carbapenemase-producing Enterobacteriaceae associated with a contaminated water dispenser and sink drains in the cardiology units of a Korean hospital

Jung, Jiwon; Choi, Hye-Seon; Jy, Lee; Sh, Ryu; Sk, Kim; Mj, Hong; Sh, Kwak; Kim, Hyung Jun; Ms, Lee; Sung, Heungsup; Mn, Kim; Sh, Kim

doi:10.1016/j.jhin.2019.11.015

Cited by 33 publications

(13 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A study by Chanola et al in 2017 showed a VDM-1 predominancy among Klebsiella isolates 25 . Similar to this, Jung J et al showed 66% NDM-1 and only 3% OXA-48 26 . Co-harboring of NDM-1+OXA-48 has been demonstrated in numerous studies and poses important challenges to clinicians due to limited treatment options and high dissemination rates 22 , 27 .…”

Section: Discussionsupporting

confidence: 76%

The evaluation of vancomycin-resistant enterococci and carbapenamase producing Klebsiella colonization among ICU-Hospitalized Patients

Karaşin¹,

Bayram²,

Parlak³

et al. 2021

Afr H. Sci.

View full text Add to dashboard Cite

Background: Multi-drug resistant organisms, especially Vancomycin-Resistant Enterococcus (VRE) and Carbapenam Resistant Klebsiella pneumoniae (KPC), are serious health threat. Early detection of resistant bacteria colonization amongpatients in intensive care units (ICUs) not only enables effective treatment but more importantly prevents disease and limits transmission. Therefore, we aimed to to assess the frequency of VRE and KPC colonization via rectal swab sampling. Methods: The study was carried out in ICUs of a tertiary hospital. Two rectal swab samples were collected within the first 24 hours of admission and another one was taken every subsequent 15 days to test for for VRE and KPC carriage. Results: A total 316 rectal swab samples taken from 230 patients. Forty-seven patients were screened at least 2 times. 183 patients were not further screened due to discharge, exitus or transfer to other wards. Thirty-six patients (16%) were determinedto be VRE (+). The most frequently isolated strain was E. faecium (80.5%) and its most common genotype was VanA (87.5%). Seven patients (3%) were identified as KPC (+). OXA-48 type crbapenamase was confirmed in all KPC isolates. Conclusion: This study shows that VRE and KPC colonization continues to be a serious threat in ICUs. Keywords: Carbapenam resistant klebsiella pneumoniae; vancomycin-resistant enterococci; intensive care units.

show abstract

Section: Discussionsupporting

confidence: 76%

The evaluation of vancomycin-resistant enterococci and carbapenamase producing Klebsiella colonization among ICU-Hospitalized Patients

Karaşin¹,

Bayram²,

Parlak³

et al. 2021

Afr H. Sci.

View full text Add to dashboard Cite

show abstract

“…We defined CPE as carbapenem-resistant Enterobacterales (CRE) with any carbapenemase ( Klebsiella pneumoniae carbapenemase [KPC], New Delhi metallo-β-lactamase [NDM], imipenemase [IMP], Verona integron–encoded metallo-β-lactamase [VIM], or oxacillinase 48 [OXA-48]), and CRE as Enterobacterales isolates demonstrating resistance to any carbapenem (ertapenem, meropenem, or imipenem) based on antimicrobial susceptibility testing [ 13 ]. We introduced Xpert Carba-R assay version 2 (Cepheid) for surveillance for CPE during outbreaks, as described previously [ 14 ]. We performed Xpert Carba-R assay using stool specimen and surveillance culture mostly using stool specimens and replaced with other specimens if stool samples were unavailable.…”

Section: Methodsmentioning

confidence: 99%

Comparison of the Clinical Outcomes of Patients With Positive Xpert Carba-R Tests for Carbapenemase-Producing Enterobacterales According to Culture Positivity

Seo

Ryu

Kwak

et al. 2022

Open Forum Infectious Diseases

View full text Add to dashboard Cite

Background We aimed to compare the clinical outcomes of patients with positive Xpert Carba-R assay results for carbapenemase-producing Enterobacterales (CPE) according to CPE culture positivity. Methods We retrospectively collected data for patients with positive CPE (positive Xpert Carba-R or culture) who underwent both tests from August 2018 to March 2021 in a 2700-bed tertiary referral hospital in Seoul, South Korea. We compared the clinical outcomes of patients positive for Xpert Carba-R according to whether they were positive (XPCP) or negative (XPCN) for CPE culture. Results Of 322 patients with CPE who underwent both Xpert Carba-R and culture, 313 (97%) were positive for Xpert Carba-R for CPE. Of these, 87 (28%) were XPCN, and 226 (72%) were XPCP. XPCN patients were less likely to have a history of previous antibiotic use (75.9% vs 90.3%; P = .001) and to have Klebsiella pneumoniae carbapenemase (21.8% vs 48.9%; P < .001). None of the XPCN patients developed infection from colonization within 6 months, whereas 13.4% (29/216) of the XPCP patients did (P < .001). XPCN patients had lower transmission rates than XPCP patients (3.0% [9/305] vs 6.3% [37/592]; P = .03). There was no significant difference in CPE clearance from positive culture results between XPCN and XPCP patients (40.0% [8/20] vs 26.7% [55/206]; P = .21). Conclusions Our study suggests that XPCN patients had lower rates of both infection and transmission than XPCP patients. The Xpert Carba-R assay is clinically useful not only for rapid identification of CPE but also for predicting risks of infection and transmission when performed along with culture.

show abstract

“…Whenever investigated, it was found that the water flow directly hit the basin drain resulting in splashing onto surfaces up to 1 m away, including medication and sterile dressing preparation areas. This study also acknowledged that microparticles and aerosols not visible may travel further than 1 m. Similarly, an outbreak of carbapenem-resistant Enterobacteria (CRE) in a cardiology unit was linked to the patient's environment when epidemiological investigations identified K. pneumoniae carbapenemase (KPC) producing E. coli , New Delhi metallo-beta-lactamase producing Citrobacter freundii and E. cloacae in water dispensers and sink drains [14 ▪ ]. Only after an extensive investigation, it was found that the pouring of contaminated human waste, such as dialysis fluid, into the handwashing sink was the direct cause of the KPC-producing E. coli outbreak.…”

Section: Mechanisms Of Contamination and Transmissionmentioning

confidence: 99%

Hospital water as the source of healthcare-associated infection and antimicrobial-resistant organisms

Hayward

Brown

Whiley

2022

Current Opinion in Infectious Diseases

View full text Add to dashboard Cite

Purpose of reviewDrinking water is considered one of the most overlooked and underestimated sources of healthcareassociated infections (HAIs). Recently, the prevention and control of opportunistic premise plumbing pathogens (OPPPs) in healthcare water systems has been receiving increasing attention in infection control guidelines. However, these fail to address colonization of pathogens that do not originate from source water. Subsequently, this review explores the role of water and premise plumbing biofilm in HAIs. The potential mechanisms of contamination and transmission of antimicrobial-resistant (AMR) pathogens originating both from supply water and human microbiota are discussed. Recent findingsOPPPs, such as Legionella pneumophila, Pseudomonas aeruginosa and Mycobacterium avium have been described as native to the plumbing environment. However, other pathogens, not found in the source water, have been found to proliferate in biofilms formed on outlets devices and cause HAI outbreaks.

show abstract

Outbreak of carbapenemase-producing Enterobacteriaceae associated with a contaminated water dispenser and sink drains in the cardiology units of a Korean hospital

Cited by 33 publications

References 17 publications

The evaluation of vancomycin-resistant enterococci and carbapenamase producing Klebsiella colonization among ICU-Hospitalized Patients

The evaluation of vancomycin-resistant enterococci and carbapenamase producing Klebsiella colonization among ICU-Hospitalized Patients

Comparison of the Clinical Outcomes of Patients With Positive Xpert Carba-R Tests for Carbapenemase-Producing Enterobacterales According to Culture Positivity

Hospital water as the source of healthcare-associated infection and antimicrobial-resistant organisms

Contact Info

Product

Resources

About