Abstract Pseudomonas aeruginosa is well adapted to the hospital setting and can cause a wide array of nosocomial infections, which occasionally culminate in recalcitrant outbreaks. Here we describe the first nosocomial outbreak of infection caused by bla(VIM-2) positive P. aeruginosa in Germany. In November and December 2007 highly resistant P. aeruginosa strains were isolated from the urine of eleven patients of the Department of Urology of a University Hospital. Bacterial isolates were typed with Multi-Locus-Sequence-Typing (MLST) and screened for known Metallo-Beta-Lactamase (MBL) genes with PCR. Environmental sources of transmission were tested for bacterial contamination using surveillance cultures. Furthermore, a matched case-control study was performed in search of medical procedures significantly associated with case status. Typing of recovered strains confirmed VIM-2 Metallo-Beta-Lactamase producing P. aeruginosa of Sequence Type (ST) 175 in all cases. Surveillance cultures failed to verify an environmental source of the outbreak strain. Case-control analysis revealed retrograde urography as the only exposure significantly associated with case status. Our analyses suggest the transmission of a single clone of VIM-2 MBL producing P. aeruginosa leading to the infection of 11 patients within 47 days. Events in temporal proximity to retrograde urographies seem to have facilitated infection in the majority of cases. Department-specific infection control measures including reinforced hygienic procedures during retrograde urographies quickly terminated the outbreak.
%0 Journal Article
%1 elias_nosocomial_2009
%A Elias, Johannes
%A Schoen, Christoph
%A Heinze, Georg
%A Valenza, Giuseppe
%A Gerharz, Elmar
%A Riedmiller, Hubertus
%A Vogel, Ulrich
%D 2009
%J Clinical Microbiology and Infection: The Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
%K imported
%R 10.1111/j.1469-0691.2009.03146.x
%T Nosocomial Outbreak of VIM-2 Metallo-Beta-Lactamase Producing Pseudomonas aeruginosa Associated With Retrograde Urography
%U http://www.ncbi.nlm.nih.gov/pubmed/20041895
%X Abstract Pseudomonas aeruginosa is well adapted to the hospital setting and can cause a wide array of nosocomial infections, which occasionally culminate in recalcitrant outbreaks. Here we describe the first nosocomial outbreak of infection caused by bla(VIM-2) positive P. aeruginosa in Germany. In November and December 2007 highly resistant P. aeruginosa strains were isolated from the urine of eleven patients of the Department of Urology of a University Hospital. Bacterial isolates were typed with Multi-Locus-Sequence-Typing (MLST) and screened for known Metallo-Beta-Lactamase (MBL) genes with PCR. Environmental sources of transmission were tested for bacterial contamination using surveillance cultures. Furthermore, a matched case-control study was performed in search of medical procedures significantly associated with case status. Typing of recovered strains confirmed VIM-2 Metallo-Beta-Lactamase producing P. aeruginosa of Sequence Type (ST) 175 in all cases. Surveillance cultures failed to verify an environmental source of the outbreak strain. Case-control analysis revealed retrograde urography as the only exposure significantly associated with case status. Our analyses suggest the transmission of a single clone of VIM-2 MBL producing P. aeruginosa leading to the infection of 11 patients within 47 days. Events in temporal proximity to retrograde urographies seem to have facilitated infection in the majority of cases. Department-specific infection control measures including reinforced hygienic procedures during retrograde urographies quickly terminated the outbreak.
@article{elias_nosocomial_2009,
abstract = {Abstract Pseudomonas aeruginosa is well adapted to the hospital setting and can cause a wide array of nosocomial infections, which occasionally culminate in recalcitrant outbreaks. Here we describe the first nosocomial outbreak of infection caused by {bla(VIM-2)} positive P. aeruginosa in Germany. In November and December 2007 highly resistant P. aeruginosa strains were isolated from the urine of eleven patients of the Department of Urology of a University Hospital. Bacterial isolates were typed with {Multi-Locus-Sequence-Typing} {(MLST)} and screened for known {Metallo-Beta-Lactamase} {(MBL)} genes with {PCR.} Environmental sources of transmission were tested for bacterial contamination using surveillance cultures. Furthermore, a matched case-control study was performed in search of medical procedures significantly associated with case status. Typing of recovered strains confirmed {VIM-2} {Metallo-Beta-Lactamase} producing P. aeruginosa of Sequence Type {(ST)} 175 in all cases. Surveillance cultures failed to verify an environmental source of the outbreak strain. Case-control analysis revealed retrograde urography as the only exposure significantly associated with case status. Our analyses suggest the transmission of a single clone of {VIM-2} {MBL} producing P. aeruginosa leading to the infection of 11 patients within 47 days. Events in temporal proximity to retrograde urographies seem to have facilitated infection in the majority of cases. Department-specific infection control measures including reinforced hygienic procedures during retrograde urographies quickly terminated the outbreak.},
added-at = {2011-03-11T10:05:34.000+0100},
author = {Elias, Johannes and Schoen, Christoph and Heinze, Georg and Valenza, Giuseppe and Gerharz, Elmar and Riedmiller, Hubertus and Vogel, Ulrich},
biburl = {https://www.bibsonomy.org/bibtex/230b52abb7b17ed0953ee3a0edf954f51/jelias},
doi = {10.1111/j.1469-0691.2009.03146.x},
interhash = {8cce1a8bf6aa5e6ca3c3f5d23e655ffb},
intrahash = {30b52abb7b17ed0953ee3a0edf954f51},
issn = {1469-0691},
journal = {Clinical Microbiology and Infection: The Official Publication of the European Society of Clinical Microbiology and Infectious Diseases},
keywords = {imported},
month = dec,
note = {{PMID:} 20041895},
timestamp = {2011-03-11T10:06:33.000+0100},
title = {Nosocomial Outbreak of {VIM-2} {Metallo-Beta-Lactamase} Producing Pseudomonas aeruginosa Associated With Retrograde Urography},
url = {http://www.ncbi.nlm.nih.gov/pubmed/20041895},
year = 2009
}