Giuseppe
Emeritus
Extented measures for controlling an outbreak of VIM-1 producing imipenem-resistant Klebsiella pneumoniae in a liver transplant centre in France, 2003?2004 (Euro Surveill., abstract, edited)
[Source: Eurosurveillance, full text: <cite cite="http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19713">Eurosurveillance - View Article</cite>. Abstract, edited.]
Eurosurveillance, Volume 15, Issue 46, 18 November 2010
Surveillance and outbreak reports
Extented measures for controlling an outbreak of VIM-1 producing imipenem-resistant Klebsiella pneumoniae in a liver transplant centre in France, 2003?2004
N Kassis-Chikhani 1,2, F Saliba 3, A Carbonne 4, S Neuville 5, D Decre 6,7,8, C Sengelin 1,2, C Guerin 1, N Gastiaburu 3, A Lavigne-Kriaa 3, C Boutelier 1, G Arlet 7,8,9, D Samuel 3,10, D Castaing 3,10, E Dussaix 2,10, V Jarlier 5,7,11
1. Assistance Publique?H?pitaux de Paris, hospital Paul Brousse, Infection Control Unit, Villejuif, France
2. Assistance Publique?H?pitaux de Paris, hospital Paul Brousse, Microbiology Laboratory, Villejuif, France
3. Assistance Publique?H?pitaux de Paris, hospital Paul Brousse, Centre H?pato-Biliaire, Villejuif, France
4. Centre de Coordination de la Lutte contre les Infections Nosocomiales (CCLIN, Coordinating centre in the fight against nosocomial infections) Paris-Nord, France
5. Assistance Publique?H?pitaux de Paris, Central Infection Control Team, Paris, France
6. Assistance Publique?H?pitaux de Paris, hospital Saint-Antoine, Bacteriology, Paris, France
7. Universit? Pierre et Marie Curie, Paris 6, France
8. ER8 Antibiotiques et Flore digestive, Universit? Paris 6, Paris, France
9. Assistance Publique?H?pitaux de Paris, hospital Tenon, Bacteriology, Paris, France
10. Universit? Paris-Sud, UMR 785, Villejuif, France
11. Assistance Publique?H?pitaux de Paris, hospital Piti?-Salp?tri?re, Paris, France
Citation style for this article: Kassis-Chikhani N, Saliba F, Carbonne A, Neuville S, Decre D, Sengelin C, Guerin C, Gastiaburu N, Lavigne-Kriaa A, Boutelier C, Arlet G, Samuel D, Castaing D, Dussaix E, Jarlier V. Extented measures for controlling an outbreak of VIM-1 producing imipenem-resistant Klebsiella pneumoniae in a liver transplant centre in France, 2003?2004. Euro Surveill. 2010;15(46)
ii=19713. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19713
Date of submission: 16 June 2010
We report the successful control of an outbreak caused by imipenem-resistant VIM-1-producing Klebsiella pneumoniae (IR-Kp) in France. This outbreak occurred in a care centre for abdominal surgery that includes a 15-bed liver intensive care unit and performs more than 130 liver transplantations per year. The index case was a patient with acute liver failure transferred from a hospital in Greece for urgent liver transplantation who was carrying IR-Kp at admission as revealed by routine culture of a rectal swab. Infection control measures were undertaken and included contact isolation and promotion of hand hygiene with alcohol-based hand rub solution. Nevertheless, secondary IR-Kp cases were identified during the six following months from 3 December 2003 to 2 June 2004. From 2 June to 21 October, extended infection control measures were set up, such as cohorting IR-Kp carriers, contact patients and new patients in distinct sections with dedicated staff, limiting ward admission, and strict control of patient transfer. They led to a rapid control of the outbreak. The global attack rate of the IR-Kp outbreak was 2.5%, 13% in liver transplant patients and 0.4% in the other patients in the care centre (p<0.005). Systematic screening for IR-Kp of all patients admitted to the care centre is still maintained to date and no secondary IR-Kp case has been detected since 2 June 2004.
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[Source: Eurosurveillance, full text: <cite cite="http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19713">Eurosurveillance - View Article</cite>. Abstract, edited.]
Eurosurveillance, Volume 15, Issue 46, 18 November 2010
Surveillance and outbreak reports
Extented measures for controlling an outbreak of VIM-1 producing imipenem-resistant Klebsiella pneumoniae in a liver transplant centre in France, 2003?2004
N Kassis-Chikhani 1,2, F Saliba 3, A Carbonne 4, S Neuville 5, D Decre 6,7,8, C Sengelin 1,2, C Guerin 1, N Gastiaburu 3, A Lavigne-Kriaa 3, C Boutelier 1, G Arlet 7,8,9, D Samuel 3,10, D Castaing 3,10, E Dussaix 2,10, V Jarlier 5,7,11
1. Assistance Publique?H?pitaux de Paris, hospital Paul Brousse, Infection Control Unit, Villejuif, France
2. Assistance Publique?H?pitaux de Paris, hospital Paul Brousse, Microbiology Laboratory, Villejuif, France
3. Assistance Publique?H?pitaux de Paris, hospital Paul Brousse, Centre H?pato-Biliaire, Villejuif, France
4. Centre de Coordination de la Lutte contre les Infections Nosocomiales (CCLIN, Coordinating centre in the fight against nosocomial infections) Paris-Nord, France
5. Assistance Publique?H?pitaux de Paris, Central Infection Control Team, Paris, France
6. Assistance Publique?H?pitaux de Paris, hospital Saint-Antoine, Bacteriology, Paris, France
7. Universit? Pierre et Marie Curie, Paris 6, France
8. ER8 Antibiotiques et Flore digestive, Universit? Paris 6, Paris, France
9. Assistance Publique?H?pitaux de Paris, hospital Tenon, Bacteriology, Paris, France
10. Universit? Paris-Sud, UMR 785, Villejuif, France
11. Assistance Publique?H?pitaux de Paris, hospital Piti?-Salp?tri?re, Paris, France
Citation style for this article: Kassis-Chikhani N, Saliba F, Carbonne A, Neuville S, Decre D, Sengelin C, Guerin C, Gastiaburu N, Lavigne-Kriaa A, Boutelier C, Arlet G, Samuel D, Castaing D, Dussaix E, Jarlier V. Extented measures for controlling an outbreak of VIM-1 producing imipenem-resistant Klebsiella pneumoniae in a liver transplant centre in France, 2003?2004. Euro Surveill. 2010;15(46)
ii=19713. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19713Date of submission: 16 June 2010
We report the successful control of an outbreak caused by imipenem-resistant VIM-1-producing Klebsiella pneumoniae (IR-Kp) in France. This outbreak occurred in a care centre for abdominal surgery that includes a 15-bed liver intensive care unit and performs more than 130 liver transplantations per year. The index case was a patient with acute liver failure transferred from a hospital in Greece for urgent liver transplantation who was carrying IR-Kp at admission as revealed by routine culture of a rectal swab. Infection control measures were undertaken and included contact isolation and promotion of hand hygiene with alcohol-based hand rub solution. Nevertheless, secondary IR-Kp cases were identified during the six following months from 3 December 2003 to 2 June 2004. From 2 June to 21 October, extended infection control measures were set up, such as cohorting IR-Kp carriers, contact patients and new patients in distinct sections with dedicated staff, limiting ward admission, and strict control of patient transfer. They led to a rapid control of the outbreak. The global attack rate of the IR-Kp outbreak was 2.5%, 13% in liver transplant patients and 0.4% in the other patients in the care centre (p<0.005). Systematic screening for IR-Kp of all patients admitted to the care centre is still maintained to date and no secondary IR-Kp case has been detected since 2 June 2004.
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