Outbreak of Extended-Spectrum Beta-Lactamase Producing Enterobacter cloacae with High MICs of Quaternary Ammonium Compounds in a Hematology Ward Associated with Contaminated Sinks

Chapuis, Angélique; Amoureux, Lucie; Bador, Julien; Gavalas, Arthur; Siébor, Eliane; Chrétien, Marie‐Lorraine; Caillot, Denis; Janin, Marion; Curraize, Claire de; Neuwirth, Catherine

doi:10.3389/fmicb.2016.01070

Cited by 33 publications

(24 citation statements)

References 36 publications

(41 reference statements)

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“…The preferred method for addressing most of the environmentrelated transmission is to employ enhanced cleaning using chemical and physical agents (14,15). Unfortunately, routine approaches are inefficient in completely eliminating drug-resistant Gammaproteobacteria in an inaccessible microbiologically active area such as a sink trap (6,(16)(17)(18)(19)(20). The wet, humid, and relatively protected environment in a sink trap favors the formation of rich stable microbial communities (16,21,22).…”

mentioning

confidence: 99%

Spread from the Sink to the Patient: In Situ Study Using Green Fluorescent Protein (GFP)-Expressing Escherichia coli To Model Bacterial Dispersion from Hand-Washing Sink-Trap Reservoirs

Kotay

Chai

Guilford

et al. 2017

Appl Environ Microbiol

130

127

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There have been an increasing number of reports implicating Gammaproteobacteria as often carrying genes of drug resistance from colonized sink traps to vulnerable hospitalized patients. However, the mechanism of transmission from the wastewater of the sink P-trap to patients remains poorly understood. Herein we report the use of a designated hand-washing sink lab gallery to model dispersion of green fluorescent protein (GFP)-expressing Escherichia coli from sink wastewater to the surrounding environment. We found no dispersion of GFP-expressing E. coli directly from the P-trap to the sink basin or surrounding countertop with coincident water flow from a faucet. However, when the GFP-expressing E. coli cells were allowed to mature in the P-trap under conditions similar to those in a hospital environment, a GFP-expressing E. coli-containing putative biofilm extended upward over 7 days to reach the strainer. This subsequently resulted in droplet dispersion to the surrounding areas (<30 in.) during faucet operation. We also demonstrated that P-trap colonization could occur by retrograde transmission along a common pipe. We postulate that the organisms mobilize up to the strainer from the P-trap, resulting in droplet dispersion rather than dispersion directly from the P-trap. This work helps to further define the mode of transmission of bacteria from a P-trap reservoir to a vulnerable hospitalized patient.IMPORTANCE Many recent reports demonstrate that sink drain pipes become colonized with highly consequential multidrug-resistant bacteria, which then results in hospital-acquired infections. However, the mechanism of dispersal of bacteria from the sink to patients has not been fully elucidated. Through establishment of a unique sink gallery, this work found that a staged mode of transmission involving biofilm growth from the lower pipe to the sink strainer and subsequent splatter to the bowl and surrounding area occurs rather than splatter directly from the water in the lower pipe. We have also demonstrated that bacterial transmission can occur via connections in wastewater plumbing to neighboring sinks. This work helps to more clearly define the mechanism and risk of transmission from a wastewater source to hospitalized patients in a world with increasingly antibiotic-resistant bacteria that can thrive in wastewater environments and cause infections in vulnerable patients.

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mentioning

confidence: 99%

Spread from the Sink to the Patient: In Situ Study Using Green Fluorescent Protein (GFP)-Expressing Escherichia coli To Model Bacterial Dispersion from Hand-Washing Sink-Trap Reservoirs

Kotay

Chai

Guilford

et al. 2017

Appl Environ Microbiol

130

127

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“…Apart from Carbapenemes, which have good activity, resistance levels were high with respect to other molecules, particularly in the protected hematology ward. Chapuis et al showed the role of the environment in the diffusion of broad-spectrum betalactamase-producing E. cloacae strains in a hematology service, both in the protected area and in the unprotected area [23].…”

Section: Discussionmentioning

confidence: 99%

Microbial Ecology and Antibiotic Susceptibility Profile of Germs Isolated from Hospital Surfaces and Medical Devices in a Reference Hospital in Douala (Cameroon)

Ebongue¹,

Nguatcheussi²,

Mefo’o³

et al. 2018

AiM

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Background: The hospital environment is largely contaminated with pathogenic microorganisms. This colonization is a threat for hospitalized patients, especially in high-risk services. The purpose of this study was to identify the germs found on surfaces and medical devices in some departments of the General Hospital of Douala, and to establish their susceptibility profile to most commonly used antibiotics in this health facility. Results: We collected 114 surface and medical device samples, and seeded different culture media for Gram-positive and Gram-negative aerobic bacteria. Of the total samples, 108 were positive and 137 bacterial strains were isolated. The colony count

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“…Elles sont véhiculées par les turbulences de l'air et déposées directement ou indirectement dans la plaie lors de l'intervention chirurgicale. La contamination de l'eau peut provenir des mains du personnel soignant ou des équipements lors de l'utilisation de réseaux contaminés (Chapuis et al 2016).…”

Section: Contamination Par Voie Exogèneunclassified

Prévention des infections nosocomiales chez les animaux de compagnie par la biosécurité dans les établissements de soins vétérinaires

Keck¹,

Bernard²

2017

bavf

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Probablement sous-estimées en médecine vétérinaire, les infections nosocomiales ont des consé-quences sanitaires mais aussi économiques ; en outre elles peuvent ternir la réputation des établisse-ments. Elles sont associées à des facteurs de risque variés, intéressant plusieurs aspects de la médecine vétérinaire. Elles peuvent être d'origine endogène ou exogène, et dues à des agents pathogènes ou opportunistes divers. La maîtrise des infections nosocomiales vise à interrompre la chaîne de transmission et à réduire la vulnérabilité de l'hôte. Elle repose sur une approche globale, intégrant l'ensemble de l'organisation de l'établissement vétérinaire. La maîtrise des risques d'infection d'origine exogène repose essentiellement sur l'isolement des animaux infectés ou colonisés, la gestion des flux, les pratiques d'asepsie adaptées et les mesures d'hygiène. Elle concerne également l'utilisation d'équipe-ments adaptés afin de limiter les infections liées aux contaminants de l'environnement. Le contrôle de la qualité de l'environnement permet la surveillance de points critiques et la recherche des sources de contamination. Des procédures doivent décrire les règles de biosécurité dans l'établissement. Mots-clés

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Outbreak of Extended-Spectrum Beta-Lactamase Producing Enterobacter cloacae with High MICs of Quaternary Ammonium Compounds in a Hematology Ward Associated with Contaminated Sinks

Cited by 33 publications

References 36 publications

Spread from the Sink to the Patient: In Situ Study Using Green Fluorescent Protein (GFP)-Expressing Escherichia coli To Model Bacterial Dispersion from Hand-Washing Sink-Trap Reservoirs

Spread from the Sink to the Patient: In Situ Study Using Green Fluorescent Protein (GFP)-Expressing Escherichia coli To Model Bacterial Dispersion from Hand-Washing Sink-Trap Reservoirs

Microbial Ecology and Antibiotic Susceptibility Profile of Germs Isolated from Hospital Surfaces and Medical Devices in a Reference Hospital in Douala (Cameroon)

Prévention des infections nosocomiales chez les animaux de compagnie par la biosécurité dans les établissements de soins vétérinaires

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