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Resources » Paper

Fernandez-Cuenca F et al. (2020) Eur J Clin Microbiol Infect Dis "Nosocomial outbreak linked to a flexible gastrointestinal endoscope contaminated with an amikacin-resistant ST17 clone of Pseudomonas aeruginosa."

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  • Comments on Fernandez-Cuenca F et al. (2020) Eur J Clin Microbiol Infect Dis "Nosocomial outbreak linked to a flexible gastrointestinal endoscope contaminated with an amikacin-resistant ST17 clone of Pseudomonas aeruginosa." (0)

  • Overview

    PMID:
    32372127
    DOI:
    10.1007/s10096-020-03915-7
    Status:
    Publication type:
    Journal_article
    WormBase ID:
    WBPaper00059633

    Fernandez-Cuenca F, Lopez-Cerero L, Cabot G, Oliver A, Lopez-Mendez J, Recacha E, Portillo I, Rodriguez-Bano J, & Pascual A (2020). Nosocomial outbreak linked to a flexible gastrointestinal endoscope contaminated with an amikacin-resistant ST17 clone of Pseudomonas aeruginosa. Eur J Clin Microbiol Infect Dis. doi:10.1007/s10096-020-03915-7

    Endoscope contamination is infrequent but can be the source of nosocomial infections and outbreaks. In August 2016, an unexpected increase in the incidence of amikacin-resistant P. aeruginosa isolates (AK-Pae) was observed at a tertiary care center in the south of Spain. An epidemiological and microbiological investigation (August-October 2016) was performed to explain this finding. Isolates from clinical and environmental samples (2 endoscopes used for retrograde cholangiopancreatography; ERCP) were identified by MALDI-TOF. Antimicrobial susceptibility testing was performed using the MicroScan system. Whole-Genome-Sequencing (Miseq, Illumina) was performed to determine the resistome and virulome. Clonal relatedness among isolates was assessed by SpeI-PFGE and MLST. A Caenorhabditis elegans killing assay was performed for virulence testing. Biofilm formation was performed using a colorimetric assay. Four of the 5 patients infected and/or colonized with AK-Pae in August 2016 had undergone ERCP 5days before sample collection. Two endoscopes were contaminated with AK-Pae. Isolates from one endoscope showed an identical PFGE pattern to 9 isolates (cluster I) and differed (1-2 bands) to 5 isolates (cluster II). Isolates from these clusters belonged to the ST17 clone. This S17 clone was characterized by its low virulence in the C. elegans killing assay, and its biofilm-forming ability, slightly superior to that of high-risk clones of P. aeruginosa ST175 and ST235. This outbreak was caused by an endoscope used for ERCP contaminated with an invasive, moderately virulent, biofilm-forming AK-Pae ST17 clone, suggesting the possible emergence of a new high-risk lineage of this clone.

    Authors: Fernandez-Cuenca F, Lopez-Cerero L, Cabot G, Oliver A, Lopez-Mendez J, Recacha E, Portillo I, Rodriguez-Bano J, Pascual A


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