Five-year VIM-producing Pseudomonas aeruginosa outbreak in four Belgian ICUs, an investigation report (2019-2023) - 13/11/24
, Robin Vanstokstraeten, PhD b, Florence Crombé, PhD b, Kurt Barbé, PhD c, Ingrid Wybo, MD, PhD b, Sabine D. Allard, MD, PhD a, Joop Jonckheer, MD, PhD d, Deborah De Geyter, PhD cRiassunto |
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.
Il testo completo di questo articolo è disponibile in PDF.Graphical Abstract |
Highlights |
• | Outbreak investigation at 1 Belgian university center with 4 intensive care units. |
• | Two Pseudomonas aeruginosa clones linked to sink-drains caused 5-year outbreak. |
• | Statistical models estimate higher colonization rates in 1 unit. |
• | Plumbing system studies provided key insights during outbreak investigation. |
Key Words : Hospital-acquired infections, Sink-drain, Plumbing system, Whole-genome sequencing, Core genome MLST
Mappa
| Conflicts of interest: None to report. |
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| Declaration of AI and AI-assisted technologies in the writing process: While none of the authors are native English speakers, the paper benefited from language improvements made by the AI tool, Gemini, developed by Google. Following this, the authors carefully reviewed and edited the content, they take full responsibility for the final publication. |
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| Ethics approval: All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was conducted following the study protocol, the Declaration of Helsinki, and applicable regulatory requirements. The local Institutional Review Board and Ethics Committee of the hospital UZ Brussel. Given the retrospective nature of the study, which did not demand a deviation from standard clinical care, and the fact that all data were anonymized, informed consent from the patient or the next of kin was not essential. |
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| Availability of data and materials: The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request. |
Vol 52 - N° 12
P. 1425-1431 - dicembre 2024 Ritorno al numero
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