Emergence of a pandrug-resistant VIM-1-producing Providencia stuartii clonal strain causing an outbreak in a Greek intensive care unit.
Here we describe an outbreak caused by a pandrug-resistant Providencia stuartii strain involving 15 critically ill patients in a Greek intensive care unit (ICU) during September-November 2011. All isolates harboured the blaVIM-1 gene and a class 1 integron structure of 1913 bp as well as blaSHV-5 and blaTEM-1. Pulsed-field gel electrophoresis (PFGE) demonstrated that isolates from all 15 patients belonged to a single P. stuartii clonal type. As all of the infected patients were hospitalised during overlapping time periods, horizontal intra-ICU transmission was considered as the main route for the dissemination of the outbreak strain. The outbreak ended following reinforcement of infection control measures, including implementation of additional barrier precautions for infected patients.
First Department of Critical Care, Medical School, University of Athens, Evangelismos Hospital, 45-47 Ipsilantou Street, Athens 106 76, Greece.
Evangelia
E
Douka
Department of Clinical Microbiology, Evangelismos Hospital, Athens, Greece.
Efstathia
E
Perivolioti
Department of Clinical Microbiology, Evangelismos Hospital, Athens, Greece.
Elena
E
Kraniotaki
Department of Clinical Microbiology, Evangelismos Hospital, Athens, Greece.
Kimon
K
Fountoulis
First Department of Critical Care, Medical School, University of Athens, Evangelismos Hospital, 45-47 Ipsilantou Street, Athens 106 76, Greece.
Foteini
F
Economidou
Department of Microbiology, Medical School, University of Athens, Athens, Greece.
Athanassios
A
Tsakris
Fifth Department of Internal Medicine, Evangelismos Hospital, Athens, Greece.
Athanassios
A
Skoutelis
First Department of Critical Care, Medical School, University of Athens, Evangelismos Hospital, 45-47 Ipsilantou Street, Athens 106 76, Greece. Electronic address: chroutsi@hotmail.com.
Christina
C
Routsi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D004269:DNA, Bacterial / Q000235:genetics; D004196:Disease Outbreaks; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission; D005260:Female; D005838:Genotype; D006115:Greece / Q000453:epidemiology; D006801:Humans; D017053:Infection Control / Q000379:methods; D032023:Integrons; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D058889:Molecular Typing; D011532:Providencia / Q000145:classification / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D055815:Young Adult; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism
D004269:DNA, Bacterial; C417264:VIM-1 metallo-beta-lactamase; D001618:beta-Lactamases
ICU; Outbreak; PFGE Pandrug-resistant; Providencia stuartii