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Introduction of a Plasmid Encoding the OHIO-l β -Lactamase to an Intermediate Care Ward by Patient Transfer

Published online by Cambridge University Press:  07 February 2022

David M. Shlaes*
Infectious Diseases Section, Case Western Reserve University School of Medicine and Cleveland Veterans Administration Medical Center Research Service, Cleveland Veterans Administration Medical Center
Charlotte A. Currie-McCumber
Research Service, Cleveland Veterans Administration Medical Center
Mary-Helen Lehman
Nursing Service, Cleveland Veterans Administration Medical Center
Infectious Diseases and Microbiology, Cleveland VA Medical Center, 10701 East Boulevard, Cleveland, OH 44106


A prospective study of 147 intermediate care ward (ICW) patients for acquisition of gentamicin-resistant Enterobacteriaceae (GRE) was carried out. Fifty (34%) were colonized or infected with one or more strains of GRE. Fifteen of these patients and one nurse were colonized with 22 strains (including ten species) of GRE bearing identical 60 kb plasmids encoding a novel β-lactamase determinant, OHIO-l and ANT (2“). Analysis of the time course of colonized patients on the ICW revealed one probable episode of cross-transmission. Five colonized patients had been residing in the ICW from one to four months prior to study initiation. Eight patients were admitted to the ICW from other hospital areas already colonized and one additional patient acquired colonization on the ICW from an unknown source. Thus, eight of ten patients admitted to the ICW during the prospective study were already colonized on admission to the ICW. To control this level of colonization it would therefore be necessary to direct efforts at limiting admission of colonized patients or attempting to eliminate the strain from persistently colonized patients, rather than trying to limit transmission within the ward.

Original Articles
Copyright © The Society for Healthcare Epidemiology of America 1988

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