Routes of transmission of VIM-positive Pseudomonas aeruginosa in the adult intensive care unit-analysis of 9 years of surveillance at a university hospital using a mathematical model
Background Hospital outbreaks of multidrug resistant Pseudomonas aeruginosa are often caused by Pseudomonas aeruginosa clones which produce metallo-β-lactamases, such as Verona Integron-encoded Metallo-β-lactamase (VIM). Although different sources have been identified, the exact transmission routes often remain unknown. However, quantifying the role of different transmission routes of VIM-PA is important for tailoring infection prevention and control measures. The aim of this study is to quantify the relative importance of different transmission routes by applying a mathematical transmission model using admission and discharge dates as well as surveillance culture data of patients. Methods We analyzed VIM-PA surveillance data collected between 2010 and 2018 of two intensive-care unit (ICU) wards for adult patients of the Erasmus University Medical Center Rotterdam using a mathematical transmission model. We distinguished two transmission routes: direct cross-transmission and a persistent environmental route. Based on admission, discharge dates, and surveillance cultures, we estimated the proportion of transmissions assigned to each of the routes. Results Our study shows that only 13.7% (95% CI 1.4%, 29%) of the transmissions that occurred in these two ICU wards were likely caused by cross-transmission, leaving the vast majority of transmissions (86.3%, 95% CI 71%, 98.6%) due to persistent environmental contamination. Conclusions Our results emphasize that persistent contamination of the environment may be an important driver of nosocomial transmissions of VIM-PA in ICUs. To minimize the transmission risk from the environment, potential reservoirs should be regularly and thoroughly cleaned and disinfected, or redesigned..
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:11 |
|---|---|
| Enthalten in: |
Antimicrobial resistance and infection control - 11(2022), 1 vom: 04. Apr. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Pham, Thi Mui [VerfasserIn] |
|---|
| Links: |
Volltext [kostenfrei] |
|---|
| BKL: | |
|---|---|
| Themen: |
Critical care |
| Anmerkungen: |
© The Author(s) 2022 |
|---|
| doi: |
10.1186/s13756-022-01095-x |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
OLC2130035078 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | OLC2130035078 | ||
| 003 | DE-627 | ||
| 005 | 20240408092124.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 230506s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1186/s13756-022-01095-x |2 doi | |
| 035 | |a (DE-627)OLC2130035078 | ||
| 035 | |a (DE-He213)s13756-022-01095-x-e | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 082 | 0 | 4 | |a 610 |q VZ |
| 084 | |a 15,3 |2 ssgn | ||
| 084 | |a PHARM |q DE-84 |2 fid | ||
| 084 | |a 44.38 |2 bkl | ||
| 084 | |a 44.75 |2 bkl | ||
| 100 | 1 | |a Pham, Thi Mui |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Routes of transmission of VIM-positive Pseudomonas aeruginosa in the adult intensive care unit-analysis of 9 years of surveillance at a university hospital using a mathematical model |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a © The Author(s) 2022 | ||
| 520 | |a Background Hospital outbreaks of multidrug resistant Pseudomonas aeruginosa are often caused by Pseudomonas aeruginosa clones which produce metallo-β-lactamases, such as Verona Integron-encoded Metallo-β-lactamase (VIM). Although different sources have been identified, the exact transmission routes often remain unknown. However, quantifying the role of different transmission routes of VIM-PA is important for tailoring infection prevention and control measures. The aim of this study is to quantify the relative importance of different transmission routes by applying a mathematical transmission model using admission and discharge dates as well as surveillance culture data of patients. Methods We analyzed VIM-PA surveillance data collected between 2010 and 2018 of two intensive-care unit (ICU) wards for adult patients of the Erasmus University Medical Center Rotterdam using a mathematical transmission model. We distinguished two transmission routes: direct cross-transmission and a persistent environmental route. Based on admission, discharge dates, and surveillance cultures, we estimated the proportion of transmissions assigned to each of the routes. Results Our study shows that only 13.7% (95% CI 1.4%, 29%) of the transmissions that occurred in these two ICU wards were likely caused by cross-transmission, leaving the vast majority of transmissions (86.3%, 95% CI 71%, 98.6%) due to persistent environmental contamination. Conclusions Our results emphasize that persistent contamination of the environment may be an important driver of nosocomial transmissions of VIM-PA in ICUs. To minimize the transmission risk from the environment, potential reservoirs should be regularly and thoroughly cleaned and disinfected, or redesigned. | ||
| 650 | 4 | |a Drug Resistance, multiple | |
| 650 | 4 | |a Pseudomonas aeruginosa | |
| 650 | 4 | |a Critical care | |
| 650 | 4 | |a Epidemiological monitoring | |
| 650 | 4 | |a Models, statistical | |
| 700 | 1 | |a Büchler, Andrea C. |4 aut | |
| 700 | 1 | |a Voor in ‘t holt, Anne F. |4 aut | |
| 700 | 1 | |a Severin, Juliëtte A. |4 aut | |
| 700 | 1 | |a Bootsma, Martin C. J. |4 aut | |
| 700 | 1 | |a Gommers, Diederik |4 aut | |
| 700 | 1 | |a Kretzschmar, Mirjam E. |4 aut | |
| 700 | 1 | |a Vos, Margreet C. |0 (orcid)0000-0002-0496-7038 |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Antimicrobial resistance and infection control |d BioMed Central, 2012 |g 11(2022), 1 vom: 04. Apr. |h Online-Ressource |w (DE-627)718716140 |w (DE-600)2666706-X |w (DE-576)366995383 |x 2047-2994 |7 nnns |
| 773 | 1 | 8 | |g volume:11 |g year:2022 |g number:1 |g day:04 |g month:04 |
| 856 | 4 | 0 | |u https://dx.doi.org/10.1186/s13756-022-01095-x |z kostenfrei |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a SYSFLAG_A | ||
| 912 | |a GBV_OLC | ||
| 912 | |a FID-PHARM | ||
| 912 | |a SSG-OLC-PHA | ||
| 912 | |a SSG-OPC-PHA | ||
| 912 | |a SSG-OPC-DE-84 | ||
| 912 | |a GBV_ILN_11 | ||
| 912 | |a GBV_ILN_20 | ||
| 912 | |a GBV_ILN_22 | ||
| 912 | |a GBV_ILN_23 | ||
| 912 | |a GBV_ILN_24 | ||
| 912 | |a GBV_ILN_39 | ||
| 912 | |a GBV_ILN_40 | ||
| 912 | |a GBV_ILN_60 | ||
| 912 | |a GBV_ILN_62 | ||
| 912 | |a GBV_ILN_63 | ||
| 912 | |a GBV_ILN_65 | ||
| 912 | |a GBV_ILN_69 | ||
| 912 | |a GBV_ILN_73 | ||
| 912 | |a GBV_ILN_74 | ||
| 912 | |a GBV_ILN_95 | ||
| 912 | |a GBV_ILN_105 | ||
| 912 | |a GBV_ILN_110 | ||
| 912 | |a GBV_ILN_151 | ||
| 912 | |a GBV_ILN_161 | ||
| 912 | |a GBV_ILN_170 | ||
| 912 | |a GBV_ILN_206 | ||
| 912 | |a GBV_ILN_213 | ||
| 912 | |a GBV_ILN_230 | ||
| 912 | |a GBV_ILN_285 | ||
| 912 | |a GBV_ILN_293 | ||
| 912 | |a GBV_ILN_602 | ||
| 912 | |a GBV_ILN_2003 | ||
| 912 | |a GBV_ILN_2005 | ||
| 912 | |a GBV_ILN_2009 | ||
| 912 | |a GBV_ILN_2014 | ||
| 912 | |a GBV_ILN_2055 | ||
| 912 | |a GBV_ILN_2111 | ||
| 912 | |a GBV_ILN_2446 | ||
| 912 | |a GBV_ILN_4012 | ||
| 912 | |a GBV_ILN_4037 | ||
| 912 | |a GBV_ILN_4112 | ||
| 912 | |a GBV_ILN_4125 | ||
| 912 | |a GBV_ILN_4126 | ||
| 912 | |a GBV_ILN_4249 | ||
| 912 | |a GBV_ILN_4305 | ||
| 912 | |a GBV_ILN_4306 | ||
| 912 | |a GBV_ILN_4307 | ||
| 912 | |a GBV_ILN_4313 | ||
| 912 | |a GBV_ILN_4322 | ||
| 912 | |a GBV_ILN_4323 | ||
| 912 | |a GBV_ILN_4324 | ||
| 912 | |a GBV_ILN_4325 | ||
| 912 | |a GBV_ILN_4338 | ||
| 912 | |a GBV_ILN_4367 | ||
| 912 | |a GBV_ILN_4700 | ||
| 936 | b | k | |a 44.38 |j Pharmakologie |j Pharmakologie |q VZ |
| 936 | b | k | |a 44.75 |j Infektionskrankheiten |j parasitäre Krankheiten |j Infektionskrankheiten |j parasitäre Krankheiten |x Medizin |q VZ |
| 951 | |a AR | ||
| 952 | |d 11 |j 2022 |e 1 |b 04 |c 04 | ||