ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Transmission of Mobile Colistin Resistance (mcr-1) by Duodenoscope.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 41 citations in OpenAlex.
- Microbiological surveillance result of endoscopes after INTERCEPT Foam Spray: a quasi-experimental pilot study in Singapore.Clinical endoscopy · 2024Article
- Impact of Borescope Inspections on Endoscope Repair Frequency and Costs.Biomedical instrumentation & technology · 2024Article
- Comparison of Sampling Methods for Detecting Protein in Gastrointestinal Endoscopes.Biomedical instrumentation & technology · 2024Article
- Pathogenic Drug Resistant Fungi: A Review of Mitigation Strategies.International journal of molecular sciences · 2023Review
- Comprehensive Surveillance and Sampling Reveal Carbapenem-Resistant Organism Spreading in Tertiary Hospitals in China.Infection and drug resistance · 2022Article
- A narrative review on current duodenoscope reprocessing techniques and novel developments.Antimicrobial resistance and infection control · 2021Review
- Investigation of possible transmission of a susceptible microorganism through a contaminated duodenoscope; a case report.Antimicrobial resistance and infection control · 2021Article
- Duodenoscope-associated infection prevention: A call for evidence-based decision making.Endoscopy international open · 2020Review
- The Centers for Disease Control and Prevention Guidance on Flexible Gastrointestinal Endoscopes: Lessons Learned from Outbreaks, Infection Control.Gastrointestinal endoscopy clinics of North America · 2020Review
- Sepsis Attributed to Bacterial Contamination of Platelets Associated with a Potential Common Source - Multiple States, 2018.MMWR. Morbidity and mortality weekly report · 2019Article
- Article
- Phylogenetic Analysis of Multi-Drug ResistantFrontiers in public health · 2019Article
- Use of ethylene-oxide gas sterilisation to terminate multidrug-resistant bacterial outbreaks linked to duodenoscopes.BMJ open gastroenterology · 2019Review
Corrections and comments
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Authors and funding
18 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundClinicians increasingly utilize polymyxins for treatment of serious infections caused by multidrug-resistant gram-negative bacteria. Emergence of plasmid-mediated, mobile colistin resistance genes creates potential for rapid spread of polymyxin resistance. We investigated the possible transmission of Klebsiella pneumoniae carrying mcr-1 via duodenoscope and report the first documented healthcare transmission of mcr-1-harboring bacteria in the United States.
methodsA field investigation, including screening targeted high-risk groups, evaluation of the duodenoscope, and genome sequencing of isolated organisms, was conducted. The study site included a tertiary care academic health center in Boston, Massachusetts, and extended to community locations in New England.
resultsTwo patients had highly related mcr-1-positive K. pneumoniae isolated from clinical cultures; a duodenoscope was the only identified epidemiological link. Screening tests for mcr-1 in 20 healthcare contacts and 2 household contacts were negative. Klebsiella pneumoniae and Escherichia coli were recovered from the duodenoscope; neither carried mcr-1. Evaluation of the duodenoscope identified intrusion of biomaterial under the sealed distal cap; devices were recalled to repair this defect.
conclusionsWe identified transmission of mcr-1 in a United States acute care hospital that likely occurred via duodenoscope despite no identifiable breaches in reprocessing or infection control practices. Duodenoscope design flaws leading to transmission of multidrug-resistant organsisms persist despite recent initiatives to improve device safety. Reliable detection of colistin resistance is currently challenging for clinical laboratories, particularly given the absence of a US Food and Drug Administration-cleared test; improved clinical laboratory capacity for colistin susceptibility testing is needed to prevent the spread of mcr-carrying bacteria in healthcare settings.
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Registered trials
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