Section of Epidemiology and Preventative Medicine, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906, Tel-Aviv, Israel.
Antimicrob Resist Infect Control. 2021 Nov 29;10(1):166. doi: 10.1186/s13756-021-01036-0.
BACKGROUND: To describe the course and intervention of an hospital-wide IMI-Producing Enterobacter ludwigii outbreak.
This was an outbreak interventional study, done at a tertiary care center in Tel-Aviv, Israel. Data was collected on the course of the outbreak and the demographic and clinical characteristics of all patients involved in the outbreak. The intervention measures included patients' cohorting, contact isolation precautions, environmental cleaning and screening of contacts. The molecular features and phylogeny of outbreak-related isolates were studied by whole-genome based analysis.
The outbreak included 34 patients that were colonized by IMI-Producing E. ludwigii and were identified in 24 wards throughout the hospital. Colonization was identified in the first 72 h of admission in 13/34 patients (38.2%). Most patients (91.2%) were admitted from home and had relatively low level of comorbidities. The majority of them (88%) had no recent use of invasive catheters and none had previous carriage of other multi-drug resistant bacteria. All available isolates harbored the bla allele and belonged to Sequence-Type 385. With the exception of two isolates, all isolates were closely related with less than a 20-SNP difference between them.
This outbreak had most likely originated in the community and subsequently disseminated inside our institution. More studies are required in order to elucidate the epidemiology of IMI-Producing E. ludwigii and the possible role of environmental sources in its dissemination.
背景：描述一次产碳青霉烯酶肠杆菌属 ludwigii（简称 IMI-Producing E. ludwigii）全院感染暴发的过程和干预措施。
这是一项在以色列特拉维夫的一家三级保健中心进行的暴发干预研究。收集了暴发的过程以及所有参与暴发的患者的人口统计学和临床特征的数据。干预措施包括患者分组、接触隔离预防措施、环境清洁和接触者筛查。通过全基因组分析研究暴发相关分离株的分子特征和系统发育。
暴发涉及 34 名被产 IMI-Producing E. ludwigii 定植的患者，这些患者分布在医院的 24 个病房中。34 名患者中有 13 名（38.2%）在入院的前 72 小时被定植。大多数患者（91.2%）来自家庭，合并症相对较少。他们中的大多数（88%）最近没有使用过侵入性导管，也没有人携带过其他多药耐药菌。所有可用的分离株都携带 bla 基因，属于序列型 385。除了两个分离株外，所有分离株之间的差异小于 20-SNP，密切相关。
此次暴发很可能起源于社区，随后在我们的机构内传播。需要进一步研究以阐明产碳青霉烯酶肠杆菌属 ludwigii 的流行病学以及环境来源在其传播中的可能作用。
