Sink-traps are a major source for carbapenemase-producing Enterobacteriaceae transmission.
Infect Control Hosp Epidemiol
; 45(3): 284-291, 2024 Mar.
Article
en En
| MEDLINE
| ID: mdl-38149351
ABSTRACT
OBJECTIVE:
We studied the extent of carbapenemase-producing Enterobacteriaceae (CPE) sink contamination and transmission to patients in a nonoutbreak setting.METHODS:
During 2017-2019, 592 patient-room sinks were sampled in 34 departments. Patient weekly rectal swab CPE surveillance was universally performed. Repeated sink sampling was conducted in 9 departments. Isolates from patients and sinks were characterized using pulsed-field gel electrophoresis (PFGE), and pairs of high resemblance were sequenced by Oxford Nanopore and Illumina. Hybrid assembly was used to fully assemble plasmids, which are shared between paired isolates.RESULTS:
In total, 144 (24%) of 592 CPE-contaminated sinks were detected in 25 of 34 departments. Repeated sampling (n = 7,123) revealed that 52%-100% were contaminated at least once during the sampling period. Persistent contamination for >1 year by a dominant strain was common. During the study period, 318 patients acquired CPE. The most common species were Klebsiella pneumoniae, Escherichia coli, and Enterobacter spp. In 127 (40%) patients, a contaminated sink was the suspected source of CPE acquisition. For 20 cases with an identical sink-patient strain, temporal relation suggested sink-to-patient transmission. Hybrid assembly of specific sink-patient isolates revealed that shared plasmids were structurally identical, and SNP differences between shared pairs, along with signatures for potential recombination events, suggests recent sharing of the plasmids.CONCLUSIONS:
CPE-contaminated sinks are an important source of transmission to patients. Although traditionally person-to-person transmission has been considered the main route of CPE transmission, these data suggest a change in paradigm that may influence strategies of preventing CPE dissemination.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Infecciones por Enterobacteriaceae
/
Enterobacteriaceae Resistentes a los Carbapenémicos
Límite:
Humans
Idioma:
En
Revista:
Infect Control Hosp Epidemiol
Asunto de la revista:
DOENCAS TRANSMISSIVEIS
/
ENFERMAGEM
/
EPIDEMIOLOGIA
/
HOSPITAIS
Año:
2024
Tipo del documento:
Article
País de afiliación:
Israel