Five-year VIM-producing Pseudomonas aeruginosa outbreak in four Belgian ICUs, an investigation report (2019-2023)

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control Pub Date : 2024-08-31 DOI:10.1016/j.ajic.2024.08.022

Marco Moretti MD , Robin Vanstokstraeten PhD , Florence Crombé PhD , Kurt Barbé PhD , Ingrid Wybo MD, PhD , Sabine D. Allard MD, PhD , Joop Jonckheer MD, PhD , Deborah De Geyter PhD

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引用次数: 0

Abstract

Background

Verona integron-encoded metallo-β-lactamase-producing Pseudomonas aeruginosa (VIM-PA) outbreaks are frequently linked to contaminated sink-drains in the intensive care unit (ICU). This study aims to investigate a VIM-PA outbreak occurring at 4 ICUs in a Belgian university center.

Methods

Between 01/01/2019 and 30/07/2023, data were retrospectively retrieved. Whole-genome sequencing of VIM-PA was carried out for available isolates and the core genome multilocus sequencing typing (cgMLST) was used to confirm clonality. New case incidence was estimated by analyzing the weekly data of at-risk and VIM-PA-colonized patients, fitting a regression model.

Results

Fifty-one patients were colonized, among them, 32 (63%) were infected by VIM-PA, which contributed to 7 deaths. The outbreak investigation showed that 19 (47%) of the examined sink-drains grew at least once a VIM-PA. Two major clusters were observed by cgMLST: ST111 (59 clones with 40 clinical isolates), and ST17 (8 clones with 6 clinical isolates). The estimated incidence rate of new cases was significantly higher in one unit.

Conclusions

A 5-year prolonged outbreak at the UZ Brussel ICUs was caused by only 2 VIM-PA clones, both linked to sink-drains, with minimal mutations occurring throughout the years. Statistical modeling found different incidence rates between units. Tailored interventions were hence prioritized.

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比利时四家重症监护室五年来暴发的产VIM铜绿假单胞菌疫情，调查报告（2019-2023年）。

背景：维罗纳整合子编码的产金属β-内酰胺酶铜绿假单胞菌（VIM-PA）疫情经常与重症监护室（ICU）中受污染的水槽排水有关：本研究旨在调查比利时一所大学中心的四间重症监护室爆发的 VIM-PA 疫情：方法：回顾性检索2019年1月1日至2023年7月30日期间的数据。对现有的临床和下沉排水分离株进行了 VIM-PA 全基因组测序，并使用核心基因组多焦点测序分型（cgMLST）来确认克隆性。通过分析高危患者和VIM-PA定植患者的每周数据，以对数链接拟合伽马回归法估算新病例发生率：结果：51 名患者有定植，其中 32 人（63%）感染了 VIM-PA，导致 7 人死亡。疫情调查显示，19 个（47%）接受检查的水槽-下水道至少滋生过一次 VIM-PA。cgMLST 观察到两个主要群集：ST 111（59 个克隆，40 个临床分离株）和 ST17（8 个克隆，6 个临床分离株）。一个重症监护病房的新病例估计发病率明显更高：结论：布鲁塞尔大学重症监护室持续五年的疫情爆发仅由两个 VIM-PA 克隆引起，这两个克隆都与下沉式排水系统有关，在这些年中发生的变异极少。统计建模发现，不同单位的发病率不同。因此，有针对性的干预措施被列为优先事项。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of infection control 医学-传染病学

CiteScore

7.40

自引率

4.10%

发文量

479

审稿时长

24 days

期刊介绍： AJIC covers key topics and issues in infection control and epidemiology. Infection control professionals, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC)