Evidence map›Paper›PMID 39468652›Full record

ArticleAntimicrobial resistance and infection control2024

Successful control of an environmental reservoir of NDM-producing Klebsiella pneumoniae associated with nosocomial transmissions in a low-incidence setting.

Estelle Moulin, Paraskevas Filippidis, Corinne Aymon Paire-Ficout, Dominique S Blanc, Bruno Grandbastien, Laurence Senn

Abstract read
In one paragraph

Article in Antimicrobial resistance and infection control, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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  3. Plasmid diversity ofMicrobiology spectrum · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Estelle Moulin *Infection Prevention and Control Unit, Infectious Diseases Service, Lausanne University Hospital, University of Lausanne, Lausanne, 1011, Switzerland. Estelle.Moulin@chuv.ch.
Paraskevas Filippidis *Infection Prevention and Control Unit, Infectious Diseases Service, Lausanne University Hospital, University of Lausanne, Lausanne, 1011, Switzerland.
Corinne Aymon Paire-FicoutInfection Prevention and Control Unit, Infectious Diseases Service, Lausanne University Hospital, University of Lausanne, Lausanne, 1011, Switzerland.
Dominique S BlancInfection Prevention and Control Unit, Infectious Diseases Service, Lausanne University Hospital, University of Lausanne, Lausanne, 1011, Switzerland.
Bruno GrandbastienInfection Prevention and Control Unit, Infectious Diseases Service, Lausanne University Hospital, University of Lausanne, Lausanne, 1011, Switzerland.
Laurence SennInfection Prevention and Control Unit, Infectious Diseases Service, Lausanne University Hospital, University of Lausanne, Lausanne, 1011, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe hospital wastewater system has been reported as a source of nosocomial acquisition of carbapenemase producing Enterobacteriaceae (CPE) in various settings. Cleaning and disinfection protocols or replacement of contaminated equipment often fail to eradicate these environmental reservoirs, which can lead to long-term transmission of CPE. We report a successful multimodal approach to control a New Delhi metallo-beta-lactamase positive Klebsiella pneumoniae (NDM-KP) nosocomial outbreak implicating contamination of sink traps in a low-incidence setting.

methodsFollowing the incidental identification of NDM-KP in a urine culture of an inpatient, we performed an epidemiological investigation, including patient and environmental CPE screening, and whole genome sequencing (WGS) of strains. We also implemented multimodal infection prevention and control (IPC) measures, namely the isolation of cases, waterless patient care, replacement of contaminated P-traps and connecting pieces, and bleach and steam disinfection of sinks for 6 months, followed by patient and environmental screenings for eradication.

resultsBetween February and May 2022, five NDM-KP cases were identified in an eight-bed neurosurgical intermediate care unit. Among the eight sink traps of the unit, three were positive for NDM-KP. Patient and environmental isolates belonged to multilocus sequence typing ST-268. All isolate genomes were genetically very similar suggesting cross-transmission and a potential role of the environment as the source of transmissions. Following the introduction of combined IPC measures, no new case was subsequently detected and sink traps remained negative for NDM-KP within 6 months after the intervention.

conclusionThe implementation of multimodal IPC measures, including waterless patient care combined with the replacement and disinfection of P-traps and connecting pieces, was successful in the control of NDM-KP after eight months. In a low-incidence setting, this approach has made it possible to pursue the objective of zero transmission of carbapenemase-producing Enterobacteriaceae (CPE).

Indexed as

beta-LactamasesCross InfectionKlebsiella InfectionsKlebsiella pneumoniaeBacterial ProteinsCarbapenem-Resistant EnterobacteriaceaeDisease OutbreaksDisinfectionFemaleHumansIncidenceInfection ControlMaleMiddle AgedWastewaterWhole Genome SequencingBacterial Proteinsbeta-lactamase NDM-1beta-LactamasesWastewaterCarbapenemaseNDMNosocomial outbreakSink trapsWastewater drains reservoirWhole genome sequencing

Identifiers

PMID39468652
PMCPMC11520856

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.