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Two Consecutive Outbreaks of Stenotrophomonas Maltophilia (Xanthomonas Maltophilia) in an Intensive-care Unit Defined by Restriction Fragment-Length Polymorphism Typing

Published online by Cambridge University Press:  02 January 2015

Nancy Alfieri ,
Karam Ramotar ,
Pamela Armstrong ,
Mary E. Spornitz ,
Glenda Ross ,
James Winnick  and
D. Roy Cook
Nancy Alfieri*
Affiliation:
Calgary District Hospital Group, Calgary, Alberta, Canada
Karam Ramotar
Affiliation:
Calgary General Hospital and University of Calgary, Calgary, Alberta, Canada
Pamela Armstrong
Affiliation:
Calgary District Hospital Group, Calgary, Alberta, Canada
Mary E. Spornitz
Affiliation:
Calgary District Hospital Group, Calgary, Alberta, Canada
Glenda Ross
Affiliation:
Calgary District Hospital Group, Calgary, Alberta, Canada
James Winnick
Affiliation:
Calgary District Hospital Group, Calgary, Alberta, Canada
D. Roy Cook
Affiliation:
Calgary District Hospital Group, Calgary, Alberta, Canada
*
Infection Control, Calgary District Hospital Group, 7007–14 St SW, Calgary, Alberta T2V 1P9, Canada
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Abstract

Objective:

To investigate and control consecutive outbreaks of Stenotrophomonas maltophilia infections in intensive-care–unit (ICU) patients.

Design:

Epidemiological investigation; restriction fragment-length polymorphism typing by pulsed-field gel electrophoresis (PFGE) of genomic DNA of outbreak strains; institution of infection control measures to limit spread.

Setting:

The medical-surgical ICU in an 800-bed tertiary-care center in Calgary, Alberta, Canada.

Results:

S maltophilia was recovered from 14 ICU patients (12 infected, 2 colonized) between February 1993 and February 1994. Ten of the 14 patient isolates and 1 environmental isolate were available for PFGE typing. Patient isolates from 6 of the first 10 patients were identical. Isolates from the next 3 of 4 patients and an isolate recovered from a ventilator being used by a patient not infected with S maltophilia also were identical, but different from the first 6. The ventilator isolate was temporally associated with the latter 4 patients.

Conclusion:

Molecular typing allowed us to determine that there were two separate consecutive S maltophilia outbreaks rather than a single protracted outbreak. Recovery of S maltophilia from patient ventilators and an in-line suction catheter suggests that the organism may have been spread by cross-contamination from contaminated equipment or from an environmental source.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 8 , August 1999 , pp. 553 - 556
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

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