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Handwashing sinks as the source of transmission of ST16 carbapenem-resistant Klebsiella pneumoniae, an international high-risk clone, in an intensive care unit.

Abstract

Carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates (carrying the carbapenemase gene blaNDM-5) of sequence type 16 caused hospital-acquired bloodstream infection or gut colonization in two patients in an intensive care unit (ICU). It was hypothesized that handwashing sinks were the source, and all handwashing sinks in the ICU were sampled. Whole-genome sequencing and analysis revealed that one sink was the source of CRKP colonization/infection in both patients, instead of direct transmission of a common clone between the patients. This study highlights handwashing sinks as an important source of multi-drug-resistant organisms. Sink management, including prohibition of disposal of body fluids and daily disinfection with chlorine, curbed the transmission.

Authors+Show Affiliations

Centre of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China; Division of Infectious Diseases, State Key Laboratory of Biotherapy, Chengdu, China; Centre for Pathogen Research, West China Hospital, Sichuan University, Chengdu, China.Department of Infection Control, West China Hospital, Sichuan University, Chengdu, China.Department of Infection Control, West China Hospital, Sichuan University, Chengdu, China.Department of Infection Control, West China Hospital, Sichuan University, Chengdu, China.Centre of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China; Division of Infectious Diseases, State Key Laboratory of Biotherapy, Chengdu, China; Centre for Pathogen Research, West China Hospital, Sichuan University, Chengdu, China.Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China.Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China.Laboratory of Clinical Microbiology, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.Institute of Microbiology and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.Centre of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China; Division of Infectious Diseases, State Key Laboratory of Biotherapy, Chengdu, China; Centre for Pathogen Research, West China Hospital, Sichuan University, Chengdu, China; Department of Infection Control, West China Hospital, Sichuan University, Chengdu, China. Electronic address: zongzhiy@scu.edu.cn.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31606433

Citation

Feng, Y, et al. "Handwashing Sinks as the Source of Transmission of ST16 Carbapenem-resistant Klebsiella Pneumoniae, an International High-risk Clone, in an Intensive Care Unit." The Journal of Hospital Infection, 2019.
Feng Y, Wei L, Zhu S, et al. Handwashing sinks as the source of transmission of ST16 carbapenem-resistant Klebsiella pneumoniae, an international high-risk clone, in an intensive care unit. J Hosp Infect. 2019.
Feng, Y., Wei, L., Zhu, S., Qiao, F., Zhang, X., Kang, Y., ... Zong, Z. (2019). Handwashing sinks as the source of transmission of ST16 carbapenem-resistant Klebsiella pneumoniae, an international high-risk clone, in an intensive care unit. The Journal of Hospital Infection, doi:10.1016/j.jhin.2019.10.006.
Feng Y, et al. Handwashing Sinks as the Source of Transmission of ST16 Carbapenem-resistant Klebsiella Pneumoniae, an International High-risk Clone, in an Intensive Care Unit. J Hosp Infect. 2019 Oct 10; PubMed PMID: 31606433.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Handwashing sinks as the source of transmission of ST16 carbapenem-resistant Klebsiella pneumoniae, an international high-risk clone, in an intensive care unit. AU - Feng,Y, AU - Wei,L, AU - Zhu,S, AU - Qiao,F, AU - Zhang,X, AU - Kang,Y, AU - Cai,L, AU - Kang,M, AU - McNally,A, AU - Zong,Z, Y1 - 2019/10/10/ PY - 2019/09/01/received PY - 2019/10/30/revised PY - 2019/10/01/accepted PY - 2019/10/14/pubmed PY - 2019/10/14/medline PY - 2019/10/14/entrez KW - Carbapenem resistance KW - Carbapenemases KW - Klebsiella pneumoniae KW - Sinks JF - The Journal of hospital infection JO - J. Hosp. Infect. N2 - Carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates (carrying the carbapenemase gene blaNDM-5) of sequence type 16 caused hospital-acquired bloodstream infection or gut colonization in two patients in an intensive care unit (ICU). It was hypothesized that handwashing sinks were the source, and all handwashing sinks in the ICU were sampled. Whole-genome sequencing and analysis revealed that one sink was the source of CRKP colonization/infection in both patients, instead of direct transmission of a common clone between the patients. This study highlights handwashing sinks as an important source of multi-drug-resistant organisms. Sink management, including prohibition of disposal of body fluids and daily disinfection with chlorine, curbed the transmission. SN - 1532-2939 UR - https://www.unboundmedicine.com/medline/citation/31606433/Handwashing_sinks_as_the_source_of_transmission_of_ST16_carbapenem-resistant_Klebsiella_pneumoniae,_an_international_high-risk_clone,_in_ICU L2 - https://linkinghub.elsevier.com/retrieve/pii/S0195-6701(19)30438-4 DB - PRIME DP - Unbound Medicine ER -