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NDM-producing Enterobacteriaceae responsible for environmental contamination of internal medicine wards in a Portuguese Hospital

2016-12Conference object Restricted access
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dc.contributor.authorManageiro, Vera
dc.contributor.authorFerreira, Eugénia
dc.contributor.authorRomão, Raquel
dc.contributor.authorRodrigues, João
dc.contributor.authorPereira, Patrícia
dc.contributor.authorCano, Manuela
dc.contributor.authorRodrigues, Paulo
dc.contributor.authorPalos, Carlos
dc.contributor.authorCaniça, Manuela
dc.date.accessioned2017-02-15T13:26:10Z
dc.date.available2017-02-15T13:26:10Z
dc.date.issued2016-12
dc.description.abstractObjective: The hospital environment plays a role in the cross-transmission of multidrug-resistant bacteria. The aim of this study was to identify potential carbapenemase-producing Enterobacteriaceae (CPE) reservoirs that might be responsible for a NDM-1 outbreak at a hospital in Portugal. Methods: An environmental investigation was instituted in a Portuguese hospital, after the occurrence of NDM-1-producing Providencia stuartii in five patients characterized by whole-genome sequencing. CPE screening was performed in critical infection sites of internal medicine wards and intensive care units where the patients stayed during hospitalization, by using MacConkey agar supplemented with ertapenem. Air samples were also obtained for the same locations. Antimicrobial susceptibility was determined by the disk diffusion method according to EUCAST guidelines. PCR and sequencing were applied to detect and identify carbapenemase-encoding genes. PCR-based replicon typing was used to characterize the plasmids. The genetic relationship between CPE was evaluated by PFGE. Results: Sixty-three Gram-negative isolates (Acinetobacter baumannii, Burkholderia cepacia, Klebsiella pneumoniae, Providentia stuartii and Pseudomonas spp.) were obtained from the 91 surface samples collected. A total of 17 NDM-1-producers were found: 9 K. pneumoniae and 8 P. stuartii in flush handles, bathroom door handles, dinamap monitors and/or hygiene cars from internal medicine wards. No CPE were obtained from air samples. The five NDM-1-producing P. stuartii clinical strains obtained during the outbreak were all genetically indistinguishable from those collected in the hospital environment. Regarding NDM-1-producing K. pneumoniae, no clinical cases were described. However, PFGE analysis identified two clusters, one of them indistinguishable, consisting of 7 NDM-1-K. pneumoniae producers and 7 K. pneumoniae non-CPE. PCR-based replicon typing revealed the presence of the same plasmid type among NDM-1-producers, suggesting horizontal transfer within the hospital surfaces. Conclusion: These results showed the importance of the hospital environment as a potential reservoir and source of CPE. This study also emphasizes the need of early environmental screening to interrupt the transmission of CPE.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationManageiro, V., Ferreira, E., Romão, R., Rodrigues, J., Pereira, P., Cano, M., Rodrigues, P., Palos, C., Caniça, M. 2016. NDM-producing Enterobacteriaceae responsible for environmental contamination of internal medicine wards in a Portuguese Hospital. RICAI 2016: 36e Réunion interdisciplinaire de chimiothérapie anti-infectieuse, Paris, France. P036.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.18/4179
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectNDM-1pt_PT
dc.subjectP. stuartiipt_PT
dc.subjectEnvironmental contaminationpt_PT
dc.subjectAntibiotic resistancept_PT
dc.subjectResistência aos Antimicrobianospt_PT
dc.subjectAr e Saúde Ocupacionalpt_PT
dc.titleNDM-producing Enterobacteriaceae responsible for environmental contamination of internal medicine wards in a Portuguese Hospitalpt_PT
dc.typeconference object
dspace.entity.typePublication
oaire.citation.conferencePlaceParis, Francept_PT
oaire.citation.titleRICAI 2016: 36e Réunion interdisciplinaire de chimiothérapie anti-infectieuse, 12-13 décembre 2016pt_PT
rcaap.rightsclosedAccesspt_PT
rcaap.typeconferenceObjectpt_PT

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