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Molecular Epidemiology of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae Isolated From Environmental and Clinical Specimens in a Cardiac Surgery Intensive Care Unit

Published online by Cambridge University Press:  02 January 2015

Guillaume Kac ,
Isabelle Podglajen ,
Sabine Vaupré ,
Nathalie Colardelle ,
Annie Buu-Hoï  and
Laurent Gutmann
Guillaume Kac*
Affiliation:
Unité D'Hygiène Hospitalière, Hôpital Broussais, Paris, France
Isabelle Podglajen
Affiliation:
Laboratoire de Microbiologie, Hôpital Broussais, Paris, France
Sabine Vaupré
Affiliation:
Unité D'Hygiène Hospitalière, Hôpital Broussais, Paris, France
Nathalie Colardelle
Affiliation:
Laboratoire de Microbiologie, Hôpital Broussais, Paris, France
Annie Buu-Hoï
Affiliation:
Laboratoire de Microbiologie, Hôpital Broussais, Paris, France
Laurent Gutmann
Affiliation:
Laboratoire de Microbiologie, Hôpital Broussais, Paris, France
*
Unité D'Hygiène Hospitalière, Hôpital Européen Georges Pompidou, 20-40 rue Leblanc, 75908 Paris cedex 15, France
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Abstract

Objectives:

To investigate environmental contamination by extended-spectrum beta-lactamase-producing Enterobacteriaceae and to perform a comparative molecular analysis of clinical and environmental strains.

Setting:

A 17-bed cardiac surgery intensive care unit of a 480-bed university teaching hospital.

Methods:

Following an outbreak of extended-spectrum beta-lactamase-producing Enterobacteriaceae, an environmental survey revealed extensive contamination of the environment (particularly faucets, sink drains, and the joints of the countertops) by extended-spectrum beta-lactamase-producing Enterobacteriaceae. Environmental strains were compared with clinical strains by pulsed-field gel electrophoresis and randomly amplified polymorphic DNA.

Results:

A total of 62 environmental strains belonging to 4 species of extended-spectrum beta-lactamase-producing Enterobacteriaceae were analyzed and compared with 43 clinical strains obtained from 34 patients. Comparative molecular analysis revealed 4 identical or closely related patterns (3 from Klebsiella oxytoca and 1 from Enterobacter cloacae) between environmental and clinical strains.

Conclusions:

Moist surfaces may serve as sources of multiply resistant Enterobacteriaceae in the intensive care unit. Identification and disinfection of such sources may therefore be helpful in prevention and control of outbreaks.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 10 , October 2004 , pp. 852 - 855
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004 

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References

1. Paterson, DL, Yu, VL. Extended-spectrum beta-lactamases: a call for improved detection and control. Clin Infect Dis 1999;29:1419–1422.Google Scholar
2. Lucet, JC, Chevret, S, Deere, D, et al. Outbreak of multiply resistant Enterobacteriaceae in an intensive care unit: epidemiology and risk factors for acquisition. Clin Infect Dis 1996;22:430–436.10.1093/clinids/22.3.430Google Scholar
3. Eisen, D, Russell, EG, Tymms, M, Roper, EJ, Grayson, ML, Turnidge, J. Random amplified polymorphic DNA and plasmid analyses used in investigation of an outbreak of multiresistant Klebsiella pneumoniae . J Clin Microbiol 1995;33:713–717.10.1128/jcm.33.3.713-717.1995Google Scholar
4. Davin-Regli, A, Monnet, D, Saux, P, et al. Molecular epidemiology of Enterobacter aerogenes acquisition: one-year prospective study in two intensive care units. J Clin Microbiol 1996;34:1474–1480.10.1128/jcm.34.6.1474-1480.1996Google Scholar
5. Shi, ZY, Liu, PY, Lau, YJ, Lin, YH, Hu, BS. Epidemiological typing of isolates from an outbreak of infection with multidrug-resistant Enterobacter cloacae by repetitive extragenic palindromic unit M-primed PCR and pulsed-field gel electrophoresis. J Clin Microbiol 1996;34:2784–2790.Google Scholar
6. Hobson, RP, MacKenzie, FM, Gould, JM. An outbreak of multiply-resistant Klebsiella pneumoniae in the Grampian region of Scotland. J Hosp Infect 1996;33:249–262.Google Scholar
7. Antibiogram Committee of the French Society for Microbiology. Comité de l'Antibiogramme de la Société Française de Microbiologie report 2003. Int J Antimicrob Agents 2003;21:364–391.Google Scholar
8. Tenover, FC, Arbeit, RD, Goering, RV, et al. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33:2233–2239.10.1128/jcm.33.9.2233-2239.1995Google Scholar
9. Williams, JG, Kubelik, AR, Livak, KJ, Rafalski, JA, Tingey, SV. DNA polymorphisms amplified by arbitrary primers are useful as genetic markers. Nucleic Acids Res 1990;18:6531–6535.10.1093/nar/18.22.6531Google Scholar
10. D'Agata, EM, Venkataraman, L, DeGirolami, P, Samore, M. Molecular epidemiology of ceftazidime-resistant gram-negative bacilli on inanimate surfaces and their role in cross-transmission during nonoutbreak periods. J Clin Microbiol 1999;37:3065–3067.10.1128/JCM.37.9.3065-3067.1999Google Scholar
11. Gould, D, Chamberlain, A. Gram-negative bacteria: the challenge of preventing cross-infection in hospital wards. A review of the literature. J Clin Nurs 1994;3:339–345.Google Scholar
12. Lemmen, SW, Hafner, H, Zolldann, D, Amedick, G, Lutticken, R. Comparison of two sampling methods for the detection of gram-positive and gram-negative bacteria in the environment: moistened swabs versus Rodac plates. Int J Hyg Environ Health 2001;203:245–248.10.1078/S1438-4639(04)70035-8Google Scholar