title: Control of an outbreak of carbapenem-resistant Pseudomonas aeruginosa in a haemato-oncology unit.
abstract: An outbreak of a multidrug-resistant Pseudomonas aeruginosa producing metallo-β-lactamase (MBLPA) in a haemato-oncology unit was controlled using multidisciplinary interventions. The present study assesses the effects of these interventions by active surveillance of the incidence of MBLPA infection at the 1,240-bed tertiary care Kyoto University Hospital in Kyoto, Japan. Infection control strategies in 2004 included strengthening contact precautions, analysis of risk factors for MBLPA infection and cessation of urine collection. However, new MBLPA infections were identified in 2006, which prompted enhanced environmental cleaning, routine active surveillance, and restricting carbapenem usage. Between 2004 and 2010, 17 patients in the unit became infected with indistinguishable MBLPA strains. The final five infected patients were found by routine active surveillance, but horizontal transmission was undetectable. The MBLPA outbreak in the haemato-oncology unit was finally contained in 2008.
authors: Department of Infection Control and Prevention, Kyoto University Hospital, Kyoto, Japan. mnagao@kuhp.kyoto-u.ac.jp
authors: M
authors: M
authors: Nagao
authors: Y
authors: Y
authors: Iinuma
authors: J
authors: J
authors: Igawa
authors: T
authors: T
authors: Saito
authors: K
authors: K
authors: Yamashita
authors: T
authors: T
authors: Kondo
authors: A
authors: A
authors: Matsushima
authors: S
authors: S
authors: Takakura
authors: A
authors: A
authors: Takaori-Kondo
authors: S
authors: S
authors: Ichiyama
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015780:Carbapenems / Q000494:pharmacology*; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D019337:Hematologic Neoplasms / Q000150:complications; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods*; D007564:Japan; D011552:Pseudomonas Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification; D001618:beta-Lactamases / Q000096:biosynthesis
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D001618:beta-Lactamases