Pseudomonas aeruginosa outbreak linked to sink drainage design

Ling, Moi Lin; How, Kue Bien

doi:10.1071/hi13015

Cited by 8 publications

(5 citation statements)

References 6 publications

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“…9 Organisms from water outlets have the potential to colonize and infect patients, with sinks forming a potential reservoir for Gram-negative bacteria. [23][24][25][26] Biofilms, which may establish in sink traps, can display greater capacity for antimicrobial resistance and tolerance to chlorine and other disinfectants. 23 This systematic review and meta-analysis have important implications for infection control professionals, environmental cleaning services, administrators, and the wider public.…”

Section: Discussionmentioning

confidence: 99%

Risk of organism acquisition from prior room occupants: a systematic review and meta-analysis

Mitchell

Dancer

Anderson

et al. 2015

Journal of Hospital Infection

164

121

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Section: Discussionmentioning

confidence: 99%

Risk of organism acquisition from prior room occupants: a systematic review and meta-analysis

Mitchell

Dancer

Anderson

et al. 2015

Journal of Hospital Infection

164

121

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“…Continued surveillance of ST308 P. aeruginosa is critical, as previous studies have demonstrated the difficulties in eradicating P. aeruginosa in the hospital environment in spite of stringent infection control and cleaning measures, leading to sustained outbreaks [ 52 , 54 ]. In fact, our institution reported a polymyxin-susceptible only ST357 VEB-1-harbouring P. aeruginosa outbreak in 2009 where the source was traced to the sinks’ drainage system in the haematological wards [ 55 , 56 ]. Fortunately, we observed only isolated cases of ST357 P. aeruginosa in this survey.…”

Section: Discussionmentioning

confidence: 99%

Genomic characterization of carbapenem-non-susceptible Pseudomonas aeruginosa in Singapore

Teo

Tang

Lim

et al. 2021

Emerging Microbes & Infections

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Genomic Characterisation of Carbapenem Non-susceptible Pseudomonas aeruginosa in SingaporePseudomonas aeruginosa is a clinically important pathogen implicated in many hospitalacquired infections. Its propensity to acquire broad-spectrum resistance has earned the organism its status as a severe public health threat requiring urgent control measures.While whole genome sequencing-based genomic surveillance provides a mean to track antimicrobial resistance, its use in molecular epidemiological surveys of Pseudomonas aeruginosa remains limited, especially in the Southeast Asian region. We sequenced the whole genomes of 222 carbapenem non-susceptible P. aeruginosa (CNPA) isolates collected in 2006-2020 at the largest public acute care hospital in Singapore . Antimicrobial susceptibilities were determined using broth microdilution. Clonal relatedness, multi-locus sequence types and antimicrobial resistance determina nts (acquired and chromosomal) were determined. In this study, CNPA exhibited broadspectrum resistance (87.8% multi-drug resistance), retaining susceptibility only to polymyxin B (95.0%) and amikacin (55.0%). Carbapenemases were detected in 51.4% of the isolates, where IMP and NDM metallo-β-lactamases were the most frequent.Carbapenem resistance was also likely associated with OprD alterations or efflux mechanisms (ArmZ/NalD mutations), which occurred in strains with or without carbapenemases. The population of CNPA in the hospital was diverse; the 222 isolates grouped into 68 sequence types (ST), which includes various high-risk clones. We detected an emerging clone, the NDM-1-producing ST308, in addition to the global highrisk ST235 clone which was the predominant clone in our population. Our results thus provide a "snapshot" of the circulating lineages of CNPA locally and the prevailing 4 genetic mechanisms contributing to carbapenem resistance. This database also serves as the baseline for future prospective surveillance studies.

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“…The scope of the current study was too limited to answer this question. Since the majority of efflux isolates were from patients in the ICU, further surveillance studies would be advisable to determine whether these strains are in fact endemic and, if so, to locate and eliminate their environmental reservoirs such as within the plumbing and sinks (13,14). Other surveillance studies have shown similar MDR organisms may be aerosolized from such sources to cause sporadic infections in patients within close proximity.…”

Section: Discussionmentioning

confidence: 99%

Meropenem Efflux in Pseudomonas aeruginosa at a Tertiary Care Hospital in Jamaica

Thoms-Rodriguez¹,

Mazzulli²,

Christian³

et al. 2016

West Indian Med J

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Objective: Several mechanisms account for carbapenem resistance in Pseudomonas (P) aeruginosa which is an emerging problem at a tertiary care hospital (TCH) in Jamaica. The observed pattern of carbapenem resistance that results from efflux mechanisms is unique because it is specific to meropenem (MEM). An investigation of efflux as a mechanism of carbapenem resistance was needed as the information obtained could inform therapeutic and infection control strategies. Methods: At the Microbiology Laboratory of a TCH in Jamaica, from May 2009 to March 2011, of 105 multidrug-resistant Gram-negative bacilli isolated from clinical specimens submitted for routine identification and susceptibility testing, all the MEM-resistant P aeruginosa isolates (a total of 10) were selected. They were tested for efflux using the efflux inhibitor phenylalanine-arginine-β-naphthylamide (PAβN) in a method described by Giske et al in 2008. Results: This study detected evidence of MEM efflux in 80% of MEM-resistant P aeruginosa implicated in nosocomial infections at this TCH in Jamaica, using the PAβN inhibition assay. Meropenem-efflux-positive isolates belonged to two unrelated chromosomal lineages. Conclusion: These results underscored the need for improved surveillance and control to prevent this mechanism from emerging in further P aeruginosa strains.

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Pseudomonas aeruginosa outbreak linked to sink drainage design

Cited by 8 publications

References 6 publications

Risk of organism acquisition from prior room occupants: a systematic review and meta-analysis

Risk of organism acquisition from prior room occupants: a systematic review and meta-analysis

Genomic characterization of carbapenem-non-susceptible Pseudomonas aeruginosa in Singapore

Meropenem Efflux in Pseudomonas aeruginosa at a Tertiary Care Hospital in Jamaica

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