Genotypes and infection sites in an outbreak of multidrug-resistant Pseudomonas aeruginosa

• Published in: The Journal of hospital infection Vol. 78; no. 4; pp. 317 - 322
• Main Authors: Tsutsui, A, Suzuki, S, Yamane, K, Matsui, M, Konda, T, Marui, E, Takahashi, K, Arakawa, Y
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.08.2011; Elsevier
• Subjects: Aged; Biological and medical sciences; Cluster Analysis; Cross Infection - epidemiology; Cross Infection - microbiology; Disease Outbreaks; Drug Resistance, Multiple, Bacterial; Electrophoresis, Gel, Pulsed-Field; Female; Genotype; Humans; Infectious Disease; Infectious diseases; Japan - epidemiology; Male; Medical sciences; Molecular Epidemiology; Molecular Typing; Multidrug resistance; Outbreak; Pseudomonas aeruginosa; Pseudomonas aeruginosa - classification; Pseudomonas aeruginosa - drug effects; Pseudomonas aeruginosa - isolation & purification; Pseudomonas Infections - epidemiology; Pseudomonas Infections - microbiology; Pulsed-field gel electrophoresis; Respiratory Tract Infections - epidemiology; Respiratory Tract Infections - microbiology; Urinary Tract Infections - epidemiology; Urinary Tract Infections - microbiology; VIM-2; Japan; VIM-2; Pseudomonas aeruginosa; Pulsed-field gel electrophoresis; Outbreak; Multidrug resistance; Pseudomonadales; Epidemic; Typing; Genotype; Infection; Pulsed field electrophoresis; Microbiological investigation; Multiple resistance; Bacteria; Pseudomonadaceae; Public health
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2011.04.013

Summary An outbreak of multidrug-resistant (MDR) Pseudomonas aeruginosa occurred in an acute care hospital in Japan, which lasted for more than three years. During January 2006 to June 2009, 59 hospitalised patients with MDR P. aeruginosa were mainly detected by urine culture in the first half, whereas isolation from respiratory tract samples became dominant in the latter half of the outbreak. Non-duplicate MDR P. aeruginosa isolates were available from 51 patients and all isolates were positive for blaVIM-2 . Pulsed-field gel electrophoresis (PFGE) analysis categorised the isolates into three major clusters; types A, B and C with eight, 19 and 21 isolates, respectively. The outbreak started with patients harbouring PFGE type A strains, followed by type B, and type C strains. Multivariate analysis demonstrated that patients with PFGE type C strains were more likely to be detected by respiratory tract samples (odds ratio: 11.87; 95% confidence interval: 1.21–116.86). Improved aseptic urethral catheter care controlled PFGE type A and type B strains and improvement in respiratory care procedures finally contained the transmission of PFGE type C strains.