ArticleFrontiers in microbiology2016
Outbreak of Extended-Spectrum Beta-Lactamase Producing Enterobacter cloacae with High MICs of Quaternary Ammonium Compounds in a Hematology Ward Associated with Contaminated Sinks.
Article in Frontiers in microbiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 45 citations in OpenAlex.
- The Role of Neonatal Ward Environment as a Reservoir for the Dissemination of Multidrug-Resistant Klebsiella pneumoniae in Algeria.MicrobiologyOpen · 2026Article
- Patterns of pathogenic microbial contamination of handwashing sinks change over time following new installations.Infection prevention in practice · 2026Article
- Genomic analysis of non-carbapenem drug-resistant Gram-negative bacteria from advanced chronic liver disease (ACLD) patients suggests no evidence for in-house transmissions.Frontiers in microbiology · 2025Article
- Investigation of an outbreak of metallo-β-lactamase producingAntimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Containment of a Verona Integron-Encoded Metallo-Beta-Lactamase-ProducingOpen forum infectious diseases · 2023Article
- Quaternary ammonium disinfectants and antiseptics: tolerance, resistance and potential impact on antibiotic resistance.Antimicrobial resistance and infection control · 2023Review
- Genomic Investigation and Successful Containment of an Intermittent Common Source Outbreak of OXA-48-Producing Enterobacter cloacae Related to Hospital Shower Drains.Microbiology spectrum · 2021Article
- Are Sink Drainage Systems a Reservoir for Hospital-Acquired Gammaproteobacteria Colonization and Infection? A Systematic Review.Open forum infectious diseases · 2021Review
- Article
- Colonization of a hand washing sink in a veterinary hospital by an Enterobacter hormaechei strain carrying multiple resistances to high importance antimicrobials.Antimicrobial resistance and infection control · 2020Article
- Article
- Wide Spread ofFrontiers in microbiology · 2020Article
- Droplet- Rather than Aerosol-Mediated Dispersion Is the Primary Mechanism of Bacterial Transmission from Contaminated Hand-Washing Sink Traps.Applied and environmental microbiology · 2019Article
- Osteoarticular Infections Following Open or Penetrating Trauma in Children in the Post-Community-Acquired Methicillin-resistant Staphylococcus aureus Era: The Impact of Enterobacter cloacae.The Pediatric infectious disease journal · 2018Article
- Sink-Related Outbreaks and Mitigation Strategies in Healthcare Facilities.Current infectious disease reports · 2018Review
- Spread from the Sink to the Patient:Applied and environmental microbiology · 2017Article
- Molecular Characteristics of First IMP-4-ProducingFrontiers in microbiology · 2017Article
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate an outbreak of extended-spectrum beta-lactamase (ESBL) producing Enterobacter cloacae that occurred in the Hematology ward (24-bed unit) of the François Mitterrand University Hospital (Dijon, France) between January 2011 and December 2013. The outbreak involved 43 patients (10 infected and 33 colonized).
designWe performed environmental analysis to detect multiresistant E. cloacae for comparison with clinical isolates (genotyping by pulsed-field gel electrophoresis and MLST as well as ESBL-typing) and determined the MICs of the quaternary ammonium compounds (QACs) alkyldimethylbenzylammonium chloride (ADBAC) and didecyldimethylammonium chloride (DDAC). A bleach-based cleaning-disinfection program was implemented in December 2012 after mechanical removal of the biofilm in all sinks.
resultsWe have detected 17 ESBL-producing E. cloacae in patients sink drains, shower drains and medical sink drains. Sequencing of the bla genes performed on 60 strains recovered from patients and environment (n = 43 clinical and n = 17 environmental) revealed that bla CTX-M15 was predominant (37 isolates) followed by bla CTX-M9 plus bla SHV-12 (20 isolates). We observed a great diversity among the isolates: 14 pulsotypes (11 STs) in clinical isolates and 9 pulsotypes (7 STs) in environmental isolates. Six pulsotypes were identical between clinical and environmental isolates. MICs of the quaternary ammonium compounds widely used for disinfection were very high in clinical and environmental isolates. Immediately after the implementation of the disinfection program we noticed a substantial fall in cases number. Our findings demonstrate the role of drains as important reservoir of ESBL-producing E. cloacae and highlight the necessity to settle drains accessible to achieve correct cleaning as well as to use disinfectant with proved activity against nosocomial pathogens.
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