Persisting transmission of carbapenemase-producing Klebsiella pneumoniae due to an environmental reservoir in a university hospital, France, 2012 to 2014

被引:40
作者
Clarivet, B. [1 ]
Grau, D. [1 ]
Jumas-Bilak, E. [1 ,2 ]
Jean-Pierre, H. [3 ]
Pantel, A. [4 ,5 ]
Parer, S. [1 ,2 ]
Lotthe, A. [1 ,2 ]
机构
[1] Univ Hosp Montpellier, Dept Infect Control & Prevent, Montpellier, France
[2] Univ Montpellier, UFR Pharm, Team Pathogenes Hydr Sante Environm, UMR HydroSci Montpellier 5569,Unit Bacteriol, Montpellier, France
[3] Univ Hosp Montpellier, Dept Bacteriol Virol, Montpellier, France
[4] Univ Nimes Hosp, Dept Microbiol, Nimes, France
[5] Univ Montpellier, UFR Med, INSERM, U1047 Nimes, Montpellier, France
关键词
INTENSIVE-CARE-UNIT; PRIOR ROOM OCCUPANTS; LACTAMASE-PRODUCING ENTEROBACTERIACEAE; PSEUDOMONAS-AERUGINOSA; RESISTANT BACTERIA; ESCHERICHIA-COLI; OUTBREAK; RISK; CONTAMINATION; ORGANISM;
D O I
10.2807/1560-7917.ES.2016.21.17.30213
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
In France, the proportion of episodes of carbapenemase-producing Enterobacteriaceae (CPE) with no recent stay or hospitalisation abroad is increasing. In this study, we investigate epidemiological links between apparently unrelated cases of OXA-48-producing Klebsiella pneumoniae (Kp OXA-48) colonisation or infection. We genotyped detected organisms by repetitive sequence-based PCR, and used a dynamic registry of cases and contacts to cross-reference patients' hospital stays. Between 1 November 2012 and 28 February 2014, 23 Kp OXA-48 cases were detected in a university hospital in Montpellier, of which 15 were involved in three outbreaks: outbreaks I and II occurred in November 2012 and outbreak III in October 2013. Molecular comparison of bacterial strains revealed clonal identity between cases involved in outbreaks II and III and four single cases. Cross-referencing of hospital stays revealed that these single cases and the index case of outbreak III had occupied the same room. Active case search among former occupants of that room found an additional Kp OXA-48 carrier. A clonal strain was isolated from the sink of that room. The epidemiological link between the contaminated room and outbreak II remained undetected. This study is a reminder that environmental reservoirs should be considered as a source of CPE transmission.
引用
收藏
页码:17 / 22
页数:6
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