Extended measures for controlling an outbreak of VIM-1 producing imipenem-resistant Klebsiella pneumoniae in a liver transplant centre in France, 2003-2004
We report the successful control of an outbreak caused by imipenem-resistant VIM-1-producing Klebsiella pneumoniae (IR-Kp) in France. This outbreak occurred in a care centre for abdominal surgery that includes a 15-bed liver intensive care unit and performs more than 130 liver transplantations per y...
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| Veröffentlicht in: | Euro surveillance : bulletin européen sur les maladies transmissibles 2010-11, Vol.15 (46), p.40 |
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| creator | Kassis-Chikhani, N Saliba, F Carbonne, A Neuville, S Decre, D Sengelin, C Guerin, C Gastiaburu, N Lavigne-Kriaa, A Boutelier, C Arlet, G Samuel, D Castaing, D Dussaix, E Jarlier, V |
| description | We report the successful control of an outbreak caused by imipenem-resistant VIM-1-producing Klebsiella pneumoniae (IR-Kp) in France. This outbreak occurred in a care centre for abdominal surgery that includes a 15-bed liver intensive care unit and performs more than 130 liver transplantations per year. The index case was a patient with acute liver failure transferred from a hospital in Greece for urgent liver transplantation who was carrying IR-Kp at admission as revealed by routine culture of a rectal swab. Infection control measures were undertaken and included contact isolation and promotion of hand hygiene with alcohol-based hand rub solution. Nevertheless, secondary IR-Kp cases were identified during the six following months from 3 December 2003 to 2 June 2004. From 2 June to 21 October, extended infection control measures were set up, such as cohorting IR-Kp carriers, contact patients and new patients in distinct sections with dedicated staff, limiting ward admission, and strict control of patient transfer. They led to a rapid control of the outbreak. The global attack rate of the IR-Kp outbreak was 2.5%, 13% in liver transplant patients and 0.4% in the other patients in the care centre (p |
| doi_str_mv | 10.2807/ese.15.46.19713-en |
| format | Article |
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This outbreak occurred in a care centre for abdominal surgery that includes a 15-bed liver intensive care unit and performs more than 130 liver transplantations per year. The index case was a patient with acute liver failure transferred from a hospital in Greece for urgent liver transplantation who was carrying IR-Kp at admission as revealed by routine culture of a rectal swab. Infection control measures were undertaken and included contact isolation and promotion of hand hygiene with alcohol-based hand rub solution. Nevertheless, secondary IR-Kp cases were identified during the six following months from 3 December 2003 to 2 June 2004. From 2 June to 21 October, extended infection control measures were set up, such as cohorting IR-Kp carriers, contact patients and new patients in distinct sections with dedicated staff, limiting ward admission, and strict control of patient transfer. They led to a rapid control of the outbreak. The global attack rate of the IR-Kp outbreak was 2.5%, 13% in liver transplant patients and 0.4% in the other patients in the care centre (p<0.005). 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The global attack rate of the IR-Kp outbreak was 2.5%, 13% in liver transplant patients and 0.4% in the other patients in the care centre (p<0.005). 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This outbreak occurred in a care centre for abdominal surgery that includes a 15-bed liver intensive care unit and performs more than 130 liver transplantations per year. The index case was a patient with acute liver failure transferred from a hospital in Greece for urgent liver transplantation who was carrying IR-Kp at admission as revealed by routine culture of a rectal swab. Infection control measures were undertaken and included contact isolation and promotion of hand hygiene with alcohol-based hand rub solution. Nevertheless, secondary IR-Kp cases were identified during the six following months from 3 December 2003 to 2 June 2004. From 2 June to 21 October, extended infection control measures were set up, such as cohorting IR-Kp carriers, contact patients and new patients in distinct sections with dedicated staff, limiting ward admission, and strict control of patient transfer. They led to a rapid control of the outbreak. The global attack rate of the IR-Kp outbreak was 2.5%, 13% in liver transplant patients and 0.4% in the other patients in the care centre (p<0.005). Systematic screening for IR-Kp of all patients admitted to the care centre is still maintained to date and no secondary IR-Kp case has been detected since 2 June 2004.</abstract><cop>Sweden</cop><pub>Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS)</pub><pmid>21144428</pmid><doi>10.2807/ese.15.46.19713-en</doi><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1560-7917 |
| ispartof | Euro surveillance : bulletin européen sur les maladies transmissibles, 2010-11, Vol.15 (46), p.40 |
| issn | 1560-7917 1025-496X 1560-7917 |
| language | eng |
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| subjects | Anti-Bacterial Agents - pharmacology Anti-Bacterial Agents - therapeutic use beta-Lactamases - metabolism Cross Infection - epidemiology Cross Infection - microbiology Cross Infection - prevention & control Disease control Disease Outbreaks - prevention & control Drug Resistance, Bacterial Epidemics Female France - epidemiology Gram-negative bacteria Hospital Bed Capacity, 500 and over Humans Imipenem - pharmacology Imipenem - therapeutic use Infection Control - methods Intensive care Intensive Care Units Klebsiella Infections - drug therapy Klebsiella Infections - epidemiology Klebsiella Infections - microbiology Klebsiella Infections - prevention & control Klebsiella pneumoniae - classification Klebsiella pneumoniae - enzymology Klebsiella pneumoniae - isolation & purification Liver Transplantation Male Microbial Sensitivity Tests Nosocomial infections Transplants & implants |
| title | Extended measures for controlling an outbreak of VIM-1 producing imipenem-resistant Klebsiella pneumoniae in a liver transplant centre in France, 2003-2004 |
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