title: The combined use of VIGI@ct (bioMérieux) and fluorescent amplified length fragment polymorphisms in the investigation of potential outbreaks.
abstract: Even with good surveillance programmes, hospital-acquired infections (HAIs) are not always recognized and this may lead to an outbreak. In order to reduce this risk, we propose a model for prompt detection of HAIs, based on the use of a real-time epidemiological information system called VIGI@ct (bioMèrieux, Las Balmas, France) and on the rapid confirmation or exclusion of the genetic relationship among pathogens using fluorescent amplified length fragment polymorphism (f-AFLP) microbial fingerprinting. We present the results of one year's experience with the system, which identified a total of 306 suspicious HAIs. Of these, 281 (92%) were 'confirmed' by clinical evidence, 16 (5%) were considered to be simple colonization and the latter nine (3%) were archived as 'not answered' because of the absence of the physician's cooperation. There were seven suspected outbreaks; of these, f-AFLP analysis confirmed the clonal relationship among the isolates in four cases: outbreak 1 (four isolates of Pseudomonas aeruginosa), outbreak 2 (three Escherichia coli isolates), outbreak 6 (two Candida parapsilosis isolates) and outbreak 7 (30 ESbetaL-producing Klebsiella pneumoniae subsp. pneumoniae). Based on our results, we conclude that the combination of VIGI@ct and f-AFLP is useful in the rapid assessment of an outbreak due to Gram-positive or Gram-negative bacteria and yeasts.
authors.affiliation: Department of Experimental Medicine and Biochemical Sciences, Tor Vergata University of Rome, Rome, Italy. carla.fontana@uniroma2.it
authors.forename: C
authors.initials: C
authors.lastname: Fontana
authors.forename: M
authors.initials: M
authors.lastname: Favaro
authors.forename: E S
authors.initials: ES
authors.lastname: Pistoia
authors.forename: S
authors.initials: S
authors.lastname: Minelli
authors.forename: M C
authors.initials: MC
authors.lastname: Bossa
authors.forename: A
authors.initials: A
authors.lastname: Altieri
authors.forename: G P
authors.initials: GP
authors.lastname: Testore
authors.forename: F
authors.initials: F
authors.lastname: Leonardis
authors.forename: S
authors.initials: S
authors.lastname: Natoli
authors.forename: C
authors.initials: C
authors.lastname: Favalli
mesh_terms: D015373:Bacterial Typing Techniques / Q000379:methods*; D003428:Cross Infection / Q000175:diagnosis* / Q000517:prevention & control; D004196:Disease Outbreaks / Q000517:prevention & control*; D005838:Genotype; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units; D007558:Italy; D016347:Medical Records Systems, Computerized; D012150:Polymorphism, Restriction Fragment Length; D018571:Sentinel Surveillance