Abstract
AbsractBackgroundTo describe the course and intervention of an hospital-wide IMI-Producing Enterobacter ludwigii outbreak.MethodsThis was an outbreak interventional study, done at a tertiary care center in Tel-Aviv, Israel. Data was collected on the course of the outbreak and the demographic and clinical characteristics of all patients involved in the outbreak. The intervention measures included patients’ cohorting, contact isolation precautions, environmental cleaning and screening of contacts. The molecular features and phylogeny of outbreak-related isolates were studied by whole-genome based analysis.ResultsThe outbreak included 34 patients that were colonized by IMI-Producing E. ludwigii and were identified in 24 wards throughout the hospital. Colonization was identified in the first 72 h of admission in 13/34 patients (38.2%). Most patients (91.2%) were admitted from home and had relatively low level of comorbidities. The majority of them (88%) had no recent use of invasive catheters and none had previous carriage of other multi-drug resistant bacteria. All available isolates harbored the blaIMI-17 allele and belonged to Sequence-Type 385. With the exception of two isolates, all isolates were closely related with less than a 20-SNP difference between them.ConclusionsThis outbreak had most likely originated in the community and subsequently disseminated inside our institution. More studies are required in order to elucidate the epidemiology of IMI-Producing E. ludwigii and the possible role of environmental sources in its dissemination.
Highlights
Since the beginning of the millennium, carbapenemaseproducing Enterobacterales (CPE) have become a major problem in health-care systems worldwide
The outbreak included 34 patients that were colonized by IMI-Producing E. ludwigii and were identified in 24 wards throughout the hospital
More studies are required in order to elucidate the epidemiology of IMI-Producing E. ludwigii and the possible role of environmental sources in its dissemination
Summary
Since the beginning of the millennium, carbapenemaseproducing Enterobacterales (CPE) have become a major problem in health-care systems worldwide. In Israel, a nationwide outbreak of CPE emerged in 2006, consisting primarily of nosocomial spread of KPC-producing. Even prior to that outbreak, the first reported cases of CPE in Israel were due to KPC-producing Enterobacter cloacae [2]. In addition to KPC, several studies described outbreaks that were caused by VIM-producing E. cloacae [3, 4]. Carbapenemase-producing E. cloacae is the third most common CPE species (following K. pneumoniae and Escherichia coli) [5] or even becoming as prevalent as CPE K. pneumoniae [6]. In addition to common carbapenemase enzymes such as KPC or VIM that can be found in many different Enterobacterales species, the E. cloacae complex (ECC) species may produce a species-unique carbapenemase. To describe the course and intervention of an hospital-wide IMI-Producing Enterobacter ludwigii outbreak
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
