Ventilator touchscreen as source of ESBL-producing Klebsiella pneumoniae outbreak

Narciso, Ana Clara; Gonçalves, Laura Fernandes; Costa, Adalberto Coelho da; Godinho, A.; Fernandes, Fiona; Duarte, A. P. M.

doi:10.1186/1753-6561-5-s6-o78

Cited by 3 publications

(4 citation statements)

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“…In 2011, six patients at the Intensive Care Unit were infected with a ESBL-producing K. pneumoniae ST15 strain [39], one of which was included in the present study for comparative purposes in a total of 23 patients. These patients were admitted and/or stayed at four distinct wards: Intensive Care Unit ( n =11), Surgery ( n =6), Medicine ( n =4) and Observation Service ( n =2).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 22 patients with clinical history consistent with an ESBL/carbapenemase-producing K. pneumoniae infection and/or colonization already upon admittance were identified between 2013 and 2016 in SAMS Hospital, a tertiary-care hospital in Lisbon, Portugal. In 2011, six patients at the Intensive Care Unit were infected with a ESBL-producing K. pneumoniae ST15 strain [ 39 ], one of which was included in the present study for comparative purposes in a total of 23 patients. These patients were admitted and/or stayed at four distinct wards: Intensive Care Unit ( n =11), Surgery ( n =6), Medicine ( n =4) and Observation Service ( n =2).…”

Section: Resultsmentioning

confidence: 99%

“…In this study, one of the primary working hypotheses was to verify if the ESBL-producing K. pneumoniae ST15 strain, which infected six intensive care unit patients in 2011 is related to the strains identified later in the years 2013–2016 [39]. Over this time period and using high-resolution genome-wide analysis of 39 K .…”

Section: Discussionmentioning

confidence: 99%

“…Over the past two decades, owing to the dissemination of CTX-M type β-lactamases, there have been numerous reports about the increasing incidence of Enterobacteriaceae-producing ESBLs. In this study, one of the primary working hypotheses was to verify if the ESBL-producing K. pneumoniae ST15 strain, which infected six intensive care unit patients in 2011 is related to the strains identified later in the years 2013-2016 [39]. Over this time period and using high-resolution genome-wide analysis of 39 K. pneumoniae isolates, the present study demonstrates the occurrence of sporadic multiclonal K. pneumoniae outbreaks along with the dissemination and lateral transfer of multiple ESBLs and carbapenemases mobilized by distinct genetic elements.…”

Section: Discussionmentioning

confidence: 99%

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Whole-genome sequencing resolves a polyclonal outbreak by extended-spectrum beta-lactam and carbapenem-resistant Klebsiella pneumoniae in a Portuguese tertiary-care hospital

Perdigão

Modesto

Pereira³

et al. 2021

Microbial Genomics

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Klebsiella pneumoniae has emerged as an important nosocomial pathogen, with whole-genome sequencing (WGS) significantly improving our ability to characterize associated outbreaks. Our study sought to perform a genome-wide analysis of multiclonal K. pneumoniae isolates (n=39; 23 patients) producing extended spectrum beta-lactamases and/or carbapenemases sourced between 2011 and 2016 in a Portuguese tertiary-care hospital. All isolates showed resistance to third-generation cephalosporins and six isolates (five patients) were also carbapenem resistant. Genome-wide-based phylogenetic analysis revealed a topology representing ongoing dissemination of three main sequence-type (ST) clades (ST15, ST147 and ST307) and transmission across different wards, compatible with missing links that can take the form of undetected colonized patients. Two carbapenemase-coding genes were detected: blaKPC-3 , located on a Tn4401d transposon, and blaGES-5 on a novel class 3 integron. Additionally, four genes coding for ESBLs (blaBEL-1 , blaCTX-M-8 , blaCTX-M-15 and blaCTX-M-32 ) were also detected. ESBL horizontal dissemination across five clades is highlighted by the similar genetic environments of blaCTX-M-15 gene upstream of ISEcp1 on a Tn3-like transposon. Overall, this study provides a high-resolution genome-wide perspective on the epidemiology of ESBL and carbapenemase-producing K. pneumoniae in a healthcare setting while contributing for the adoption of appropriate intervention and prevention strategies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Whole-genome sequencing resolves a polyclonal outbreak by extended-spectrum beta-lactam and carbapenem-resistant Klebsiella pneumoniae in a Portuguese tertiary-care hospital

Perdigão

Modesto

Pereira³

et al. 2021

Microbial Genomics

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Epidemiologic characteristics of <i>Klebsiella pneumoniae</i> isolates in ventilator-associated pneumonia in intensive care units

Sharkawy¹,

Mansour²,

Helmy³

et al. 2016

Af J Clin Exp Micro

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Recommendations for Prevention and Control of Infection in Non-Invasive Ventilation in Hospital Environment

Méndez,

Caneiras,

Oliveira Reis

et al. 2023

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There are numerous studies and recommendations on the complications associated with invasive mechanical ventilation, but few on prevention and control of infection in non-invasive ventilation (NIV), especially at the hospital environment. Healthcare workers (HCW) should be alert to the potential risk of transmission of infection in NIV. The main goal of this manuscript is to establish and promote good practices in the prevention and control of infections associated with NIV, as well as the development of a document that can serve as a guideline for HCW. A review of the literature on cleaning and disinfection of devices in NIV was carried out between February 2019 and August 2020 and the technical specifications of NIV devices, published by the manufacturers, were also analyzed. NIV devices require a high level of disinfection using chemical disinfectants. It is necessary to clean and disinfect the surface of the ventilator daily, while the rest of the components should be cleaned and disinfected with a weekly frequency. It should avoid active humidification when possible, favoring passive humidification. Using a bacteriological filter is extremely important in a hospital environment and should be considered. In patients with COVID-19, it is also recommended to use non-ventilated interfaces and 2 filters, one bacteriological at the outlet of the ventilator and another preferably Heat and Moisture Exchanging Filter (HMEF) in the interface. The cleaning and disinfection instructions for NIV are based on recommendations for decontamination of semi-critical material and basic infection control precautions. This document provides an orientation guide of the main procedures to be implemented in the prevention and control of infection in NIV that must be adapted to each hospital.

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Ventilator touchscreen as source of ESBL-producing Klebsiella pneumoniae outbreak

Cited by 3 publications

References 0 publications

Whole-genome sequencing resolves a polyclonal outbreak by extended-spectrum beta-lactam and carbapenem-resistant Klebsiella pneumoniae in a Portuguese tertiary-care hospital

Whole-genome sequencing resolves a polyclonal outbreak by extended-spectrum beta-lactam and carbapenem-resistant Klebsiella pneumoniae in a Portuguese tertiary-care hospital

Epidemiologic characteristics of <i>Klebsiella pneumoniae</i> isolates in ventilator-associated pneumonia in intensive care units

Recommendations for Prevention and Control of Infection in Non-Invasive Ventilation in Hospital Environment

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