A Tran-Dinh1, C Neulier2, M Amara3, N Nebot4, G Troché5, N Breton2, B Zuber5, S Cavelot5, B Pangon3, J P Bedos5, J Merrer2, D Grimaldi6. 1. Service de réanimation, 78150, Centre Hospitalier De Versailles, Le Chesnay, France; Département d'anesthésie et de réanimation chirurgicale, 75018, Centre Hospitalier de Bichat, Paris, France. Electronic address: alexy.trandinh@gmail.com. 2. Service de Prévention du Risque Infectieux, Centre Hospitalier de Versailles, Le Chesnay, France. 3. Service de Biologie, Unité de microbiologie, 78157, Centre Hospitalier De Versailles, Le Chesnay, France. 4. Service de pharmacie, 78150, Centre Hospitalier De Versailles, Le Chesnay, France. 5. Service de réanimation, 78150, Centre Hospitalier De Versailles, Le Chesnay, France. 6. Département de réanimation, CUB-Erasme, Université Libre de Bruxelles (ULB), Bruxelles, Belgium.
Abstract
BACKGROUND: To assess the impact of the incidental relocation of an intensive care unit (ICU) on the risk of colonizations/infections with Pseudomonas aeruginosa exhibiting OprD-mediated resistance to imipenem (PA-OprD). AIM: The primary aim was to compare the proportion of PA-OprD among P. aeruginosa samples before and after an incidental relocation of the ICU. The role of tap water as a route of contamination for colonization/infection of patients with PA-OprD was assessed as a secondary aim. METHODS: A single-centre, observational, before/after comparison study was conducted from October 2013 to October 2015. The ICU was relocated at the end of October 2014. All P. aeruginosa-positive samples isolated from patients hospitalized ≥48 h in the ICU were included. Tap water specimens were collected every three months in the ICU. PA-OprD strains isolated from patients and tap water were genotyped using pulse-field gel electrophoresis. FINDINGS: A total of 139 clinical specimens of P. aeruginosa and 19 tap water samples were analysed. The proportion of PA-OprD strains decreased significantly from 31% to 7.7% after the relocation of the ICU (P = 0.004). All PA-OprD clinical specimens had a distinct genotype. Surprisingly, tap water was colonized with a single PA-OprD strain during both periods, but this single clone has never been isolated from clinical specimens. CONCLUSION: Relocation of the ICU was associated with a marked decrease in P. aeruginosa strains resistant to imipenem. The polyclonal character of PA-OprD strains isolated from patients and the absence of tap-water-to-patient contamination highlight the complexity of the environmental impact on the endogenous colonization/infection with P. aeruginosa.
BACKGROUND: To assess the impact of the incidental relocation of an intensive care unit (ICU) on the risk of colonizations/infections with Pseudomonas aeruginosa exhibiting OprD-mediated resistance to imipenem (PA-OprD). AIM: The primary aim was to compare the proportion of PA-OprD among P. aeruginosa samples before and after an incidental relocation of the ICU. The role of tapwater as a route of contamination for colonization/infection of patients with PA-OprD was assessed as a secondary aim. METHODS: A single-centre, observational, before/after comparison study was conducted from October 2013 to October 2015. The ICU was relocated at the end of October 2014. All P. aeruginosa-positive samples isolated from patients hospitalized ≥48 h in the ICU were included. Tapwater specimens were collected every three months in the ICU. PA-OprD strains isolated from patients and tapwater were genotyped using pulse-field gel electrophoresis. FINDINGS: A total of 139 clinical specimens of P. aeruginosa and 19 tapwater samples were analysed. The proportion of PA-OprD strains decreased significantly from 31% to 7.7% after the relocation of the ICU (P = 0.004). All PA-OprD clinical specimens had a distinct genotype. Surprisingly, tapwater was colonized with a single PA-OprD strain during both periods, but this single clone has never been isolated from clinical specimens. CONCLUSION: Relocation of the ICU was associated with a marked decrease in P. aeruginosa strains resistant to imipenem. The polyclonal character of PA-OprD strains isolated from patients and the absence of tap-water-to-patient contamination highlight the complexity of the environmental impact on the endogenous colonization/infection with P. aeruginosa.
Authors: Annika Schönfeld; Rudolf Ascherl; Stefanie Petzold-Quinque; Norman Lippmann; Arne C Rodloff; Wieland Kiess Journal: BMC Res Notes Date: 2020-05-13