A study revealed that the risk of spreading multidrug-resistant bacteria is most pronounced in hospital sinks. These conclusions stem from an investigation into a multispecies outbreak of the superbug carbapenemase-producing Enterobacterales (CPE), which occurred in a pediatric ward at the Toho University Omori Medical Center in Tokyo in 2017. (1✔ ✔Trusted Source
Outbreak of multispecies carbapenemase-producing Enterobacterales associated with pediatric ward sinks: IncM1 plasmids act as vehicles for cross-species transmission
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Outbreak Investigation: Tracing the Spread of CPE in a Pediatric Ward
In the paper, published in the American Journal of Infection Control (AJIC), the team detailed that the first case of CPE was detected in a one-year-old boy hospitalized with cardiac disease in June 2016. Nine months later in March 2017, a 15-year-old boy became the second to be infected with the deadly superbug. Subsequently, the outbreak spread to 19 pediatric patients. On investigation, 9 sinks were identified to be contaminated with CPE. Of these, 6 were from hospital rooms with CPE-positive patients, and 3 from a nurse centre, a waste room, and an ice machine. Genomic analysis identified bacterial strains such as “Klebsiella variicola, Klebsiella quasipneumoniae, and Escherichia coli.”
Further, DNA sequences showed that the resistance mechanism could have been passed from one bacterial species to another within the hospital, the team said.
“The discovery of the same bacterial species in sinks in adjoining rooms indicates that pathogen transmission may be possible from one sink to another via the drains and connected plumbing,” the team said.
Preventive measures included recommending hand disinfection after using sinks, introducing disposable tools for cleaning sinks, prohibiting mouth-washing with sink water, enacting disinfection and drying procedures for any items exposed to sink water, and more. The outbreak was finally controlled in October 2017.
“After months of intense infection control protocols, we were at last able to declare an end to this outbreak,” said Sadako Yoshizawa, Associate Professor in the Department of Microbiology and Infectious Diseases at Toho University. “Our experience highlights the importance of focusing on sinks and other water-related areas in hospital wards, as these are critical for CPE transmission and therefore major fronts in the fight against antibiotic resistance,” Yoshizawa added.
Reference:
- Outbreak of multispecies carbapenemase-producing Enterobacterales associated with pediatric ward sinks: IncM1 plasmids act as vehicles for cross-species transmission – (https://linkinghub.elsevier.com/retrieve/pii/S0196655324001019)
Source-IANS
