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Molecular characterization of a suspected IMP-type carbapenemase-producing Pseudomonas aeruginosa outbreak reveals two simultaneous outbreaks in a tertiary-care hospital

Published online by Cambridge University Press:  04 May 2023

Ana Gual-de-Torrella*
Affiliation:
Servicio de Microbiología, Hospital Universitario Usansolo-Galdakao, Galdakao, Bizkaia, Spain
Carla López-Causape
Affiliation:
Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, Illes Balears, Spain CIBER Enfermedades Infecciosas (CIBERINFEC), Madrid, Copmunidad de Madrid, Spain
Izaskun Alejo-Cancho
Affiliation:
Servicio de Microbiología, Hospital Universitario Usansolo-Galdakao, Galdakao, Bizkaia, Spain
Estrella Rojo-Molinero
Affiliation:
Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, Illes Balears, Spain CIBER Enfermedades Infecciosas (CIBERINFEC), Madrid, Copmunidad de Madrid, Spain
Gonzalo Sanchez-García
Affiliation:
Servicio de Medicina Preventiva, Hospital Universitario Usansolo-Galdakao, Galdakao, Bizkaia, Spain Universidad del País Vasco/Euskal Herriko Unibertsitatea, Leioa, Bizkaia, Spain
Sara Cortés-Lara
Affiliation:
Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, Illes Balears, Spain CIBER Enfermedades Infecciosas (CIBERINFEC), Madrid, Copmunidad de Madrid, Spain
María B. Rodríguez Moral
Affiliation:
Servicio de Medicina Preventiva, Hospital Universitario Usansolo-Galdakao, Galdakao, Bizkaia, Spain
Pilar Berdonces-Gonzalez
Affiliation:
Servicio de Microbiología, Hospital Universitario Usansolo-Galdakao, Galdakao, Bizkaia, Spain
María J. Lopez de Goikoetxea
Affiliation:
Servicio de Microbiología, Hospital Universitario Usansolo-Galdakao, Galdakao, Bizkaia, Spain
Antonio Oliver
Affiliation:
Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, Illes Balears, Spain CIBER Enfermedades Infecciosas (CIBERINFEC), Madrid, Copmunidad de Madrid, Spain
*
Corresponding author: Ana Gual de Torrella Bennasar; Email: gualdetorrella.ana@gmail.com

Abstract

Objective:

To describe IMP-type carbapenemase-producing Pseudomonas aeruginosa outbreaks at Galdakao University Hospital between March 2021 to December 2021.

Design:

Outbreak report.

Setting:

Galdakao University Hospital is a tertiary-care hospital in the Basque Country (northern Spain).

Patients:

All patients with a positive IMP-type carbapenemase producing Pseudomonas aeruginosa (IMP-PA) culture were included in this study, both colonization and infection cases.

Methods:

An outbreak investigation was conducted, in which molecular epidemiology analysis [pulsed-field gel electrophoresis and whole-genome sequencing (WGS)] and environmental screenings were performed.

Results:

Between March and December 2021, 21 cases of IMP-PA were detected in Galdakao University Hospital: 18 infection cases and 3 colonization cases. In total, 4 different pulsotypes were detected belonging to 4 clones according to WGS: ST175 (n = 14), ST633 (n = 3), ST179 (n = 3), and ST348 (n = 1). IMP-13 was detected in most isolates belonging to the ST175 clone and in all ST179 and ST348 clones, whereas IMP-29 was detected in isolates belonging to the ST633 clone. Clinical isolates belonging to the ST175 clone were isolated mainly from patients admitted to the respiratory ward, and isolates belonging to the ST633 clone from patients admitted to the ICU. Two environmental isolates belonging to the ST175 clone were detected in the respiratory ward.

Conclusions:

Molecular and genomic epidemiology revealed that there had been 2 independent IMP-PA outbreaks, one of long duration in the respiratory ward and the other more limited in the ICU.

Type
Original Article
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

a

Both authors contributed equal.

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