Format

Send to

Choose Destination
J Hosp Infect. 2016 Sep;94(1):2-7. doi: 10.1016/j.jhin.2016.05.011. Epub 2016 May 26.

New genotyping method discovers sustained nosocomial Pseudomonas aeruginosa outbreak in an intensive care burn unit.

Author information

1
Service of Hospital Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: frederic.tissot@chuv.ch.
2
Service of Hospital Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
3
Intensive Care Service, Lausanne University Hospital, Lausanne, Switzerland.

Abstract

BACKGROUND:

Pseudomonas aeruginosa is a leading cause of healthcare-associated infections in the intensive care unit (ICU).

AIM:

To investigate an unexplained increase in the incidence of P. aeruginosa recovered from clinical samples in the ICU over a two-year period.

METHODS:

After unsuccessful epidemiological investigation by conventional tools, P. aeruginosa clinical isolates of all patients hospitalized between January 2010 and July 2012 were typed by a novel double-locus sequence typing (DLST) method and compared to environmental isolates recovered during the investigation period.

FINDINGS:

In total, 509 clinical isolates from 218 patients and 91 environmental isolates were typed. Thirty-five different genotypic clusters were found in 154 out of 218 patients (71%). The largest cluster, DLST 1-18, included 23 patients who were mostly hospitalized during overlapping periods in the burn unit. Genotype DLST 1-18 was also recovered from floor traps, shower trolleys and the shower mattress in the hydrotherapy rooms, suggesting environmental contamination of the burn unit as the source of the outbreak. After implementation of appropriate infection control measures, this genotype was recovered only once in a clinical sample from a burned patient and twice in the environment, but never thereafter during a 12-month follow-up period.

CONCLUSION:

The use of a novel DLST method allowed the genotyping of a large number of clinical and environmental isolates, leading to the identification of the environmental source of a large unrecognized outbreak in the burn unit. Eradication of the outbreak was confirmed after implementation of a continuous epidemiological surveillance of P. aeruginosa clones in the ICU.

KEYWORDS:

Burns; Intensive care unit; Molecular typing; Outbreak; Pseudomonas aeruginosa

PMID:
27451039
DOI:
10.1016/j.jhin.2016.05.011
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science Icon for University of Lausanne/CHUV - Serval
Loading ...
Support Center