Rapid control of hyper-virulent Serratia marcesans outbreak in the neonatal intensive care unit facilitated by whole genome sequencing (WGS) and optimised infection control measures

Pathology ◽  
2019 ◽  
Vol 51 ◽  
pp. S140
Author(s):  
Harsha Samarasekara ◽  
Catherine Janto ◽  
Zoe Jennings ◽  
Vitali Sintchenko ◽  
James Branley
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Neonatal Intensive Care Unit ◽  
Genome Sequencing ◽  
Neonatal Intensive Care ◽  
Control Measures ◽  
Whole Genome ◽  
Infection Control Measures ◽  
Rapid Control

Nosocomial Ringworm in a Neonatal Intensive Care Unit: A Nurse and Her Cat

2000 ◽  
Vol 21 (9) ◽  
pp. 605-607 ◽  
Author(s):  
Lewis M. Drusin ◽  
Barbara G. Ross ◽  
Karen Helton Rhodes ◽  
Alfred N. Krauss ◽  
Rachelle A. Scott
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Index Case ◽  
Control Measures ◽  
Microsporum Canis ◽  
Professional Collaboration ◽  
Infection Control Measures

AbstractAn outbreak of nosocomial ringworm involved five infants in a neonatal intensive care unit. The index case was a nurse infected with Microsporum canis by her cat. After standard infection control measures were initiated, the outbreak was resolved successfully by an interdisciplinary professional collaboration of physician and veterinary dermatologists and infection control personnel.

scholarly journals Transmission of Listeriosis in a Neonatal Intensive Care Unit Supported by Whole-Genome Sequencing

2020 ◽  
Vol 41 (S1) ◽  
pp. s53-s53
Author(s):  
Janice Kim ◽  
Hilary Rosen ◽  
Kristen Angel ◽  
Azarnoush Maroufi ◽  
Samantha Tweeten ◽  
...  
Keyword(s):  
Public Health ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Neonatal Intensive Care Unit ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Neonatal Intensive Care ◽  
Blood Cultures ◽  
Whole Genome

Background: Listeriosis is a rare but serious infectious disease caused by Listeria monocytogenes (LM) and predominantly transmitted through contaminated food. Moreover, 15% of listeriosis cases in the United States are pregnancy associated; nosocomial neonatal transmission in hospitals is extremely rare. In July 2018, the California Department of Public Health (CDPH) was notified of 4 patients, a mother–neonate pair and twin neonates, with listeriosis at the same hospital. The CDPH and San Diego County Health and Human Services Agency initiated an investigation to determine transmission and prevent additional infections. Methods: We reviewed medical records of the neonates and their mothers, interviewed the mothers with a detailed food exposure questionnaire, interviewed healthcare personnel (HCP), and performed an infection control assessment of the neonatal intensive care unit (NICU). CDPH performed whole-genome sequencing (WGS) on LM isolates that were then analyzed by whole-genome multilocus sequence typing (wgMLST) by the Centers for Diseases Control and Prevention (CDC) to assess relatedness in PulseNet, a public health laboratory database. The CDC also performed testing for LM on formalin-fixed placentas from the mother of the twins. Results: During a 1-week period, 4 patients with LM were identified at the hospital. A mother was admitted at 31 weeks gestation with acute abdominal and back pain that progressed with precipitous vaginal delivery and postpartum sepsis. Her neonate was resuscitated, transported to the NICU, underwent a sepsis evaluation, received antibiotics, and was transferred to another hospital within 6 hours. Maternal blood, placenta, and neonatal blood cultures grew LM. Twin neonates, born to an asymptomatic mother and present in the NICU during the index neonate’s stay, developed acute infection 4 and 6 days after the index neonate’s transfer; blood cultures confirmed LM. The LM isolates from the 4 patients were indistinguishable by wgMLST and were not related to other PulseNet isolates. LM was not detected in the twin placentas. There were no common food exposures between the mothers. At least 1 common HCP cared for all 3 neonates. Infection control lapses included lack of proper hand hygiene during the index neonate’s resuscitation and potentially after cleaning and disinfection of the neonate’s incubator. Conclusions: This report provides supportive evidence that nosocomial transmission of LM can occur during a brief NICU stay due to lapses in infection control practices. Strict adherence to standard precautions in the delivery room and NICU is imperative to prevent cross transmission.Disclosures: NoneFunding: None

Whole Genome Sequencing in Real-Time Investigation and Management of a Pseudomonas aeruginosa Outbreak on a Neonatal Intensive Care Unit

2015 ◽  
Vol 36 (9) ◽  
pp. 1058-1064 ◽  
Author(s):  
Rebecca J. Davis ◽  
Slade O. Jensen ◽  
Sebastiaan Van Hal ◽  
Björn Espedido ◽  
Adrienne Gordon ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Infection Control ◽  
Neonatal Intensive Care Unit ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Neonatal Intensive Care ◽  
Neonatal Unit ◽  
Whole Genome

OBJECTIVETo use whole genome sequencing to describe the likely origin of an outbreak of Pseudomonas aeruginosa in a neonatal unit.DESIGNOutbreak investigation.SETTINGThe neonatal intensive care unit service of a major obstetric tertiary referral center.PATIENTSInfants admitted to the neonatal unit who developed P. aeruginosa colonization or infection.METHODSWe undertook whole genome sequencing of P. aeruginosa strains isolated from colonized infants and from the neonatal unit environment.RESULTSEighteen infants were colonized with P. aeruginosa. Isolates from 12 infants and 7 environmental samples were sequenced. All but one of the clinical isolates clustered in ST253 and no differences were detected between unmapped reads. The environmental isolates revealed a variety of sequence types, indicating a large diverse bioburden within the unit, which was subsequently confirmed via enterobacterial repetitive intergenic consensus–polymerase chain reaction typing of post-outbreak isolates. One environmental isolate, obtained from a sink in the unit, clustered within ST253 and differed from the outbreak strain by 9 single-nucleotide polymorphisms only. This information allowed us to focus infection control activities on this sink.CONCLUSIONSWhole genome sequencing can provide detailed information in a clinically relevant time frame to aid management of outbreaks in critical patient management areas. The superior discriminatory power of this method makes it a powerful tool in infection control.Infect. Control Hosp. Epidemiol. 2015;36(9):1058–1064

scholarly journals Carbapenemase-Producing Enterobacteriaceae (CPE) Newborn Colonization in a Portuguese Neonatal Intensive Care Unit (NICU): Epidemiology and Infection Prevention and Control Measures

2021 ◽  
Vol 13 (2) ◽  
pp. 411-417
Author(s):  
Teresa L. Almeida ◽  
Tânia Mendo ◽  
Raquel Costa ◽  
Cristina Novais ◽  
Mónica Marçal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Infection Control Measures ◽  
Gut Colonization

Infections due to carbapenemase-producing Enterobacterales (CPE) are increasing worldwide and are especially concerning in a neonatal intensive care unit (NICU). Risk factors for CPE gut colonization in neonates need to be clarified. In this work, we describe the epidemiological and clinical features of CPE-colonized newborns and the infection control measures in a Portuguese NICU. We performed a prospective, observational, longitudinal, cohort study for surveillance of CPE colonization. Maternal and neonatal features of colonized newborns and surveillance strategy were described. A statistical analysis was performed with SPSS23.0, and significance was indicated by p-value ≤ 0.05. Between March and November 2019, CPE was isolated in 5.8% of 173 admitted neonates. Carbapenemase-producing Klebsiella pneumoniae were the most frequently isolated. There was no associated infection. Birth weight, gestational age, length of stay, and days of central line were the identified risk factors for CPE colonization (bivariate analysis with Student’s t-test or Mann–Whitney U test, according to normality). No independent risk factors for CPE colonization were identified in the logistic regression analysis. CPE colonization risk factors are still to be determined accurately in the neonatal population. Active surveillance and continuous infection control measures restrained the current cluster of colonized newborns and helped to prevent infection and future outbreaks.

Use of whole-genome sequencing to detect an outbreak of Malassezia pachydermatis infection and colonization in a neonatal intensive care unit—California, 2015–2016

2020 ◽  
Vol 41 (7) ◽  
pp. 851-853 ◽  
Author(s):  
Nancy A. Chow ◽  
Raymond Chinn ◽  
Alice Pong ◽  
Kerry Schultz ◽  
Janice Kim ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Neonatal Intensive Care ◽  
Infection Prevention ◽  
Whole Genome ◽  
Prevention Measures ◽  
Malassezia Pachydermatis

AbstractWhole-genome sequencing confirmed the presence of a Malassezia pachydermatis outbreak among neonates in a neonatal intensive care unit. This technology supports the importance of adhering to infection prevention measures.

An Outbreak of Carbapenem-Resistant Acinetobacter baumannii Infection in a Neonatal Intensive Care Unit: Investigation and Control

2011 ◽  
Vol 32 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Eric J. McGrath ◽  
Teena Chopra ◽  
Nahed Abdel-Haq ◽  
Katherine Preney ◽  
Winston Koo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Neonatal Intensive Care Unit ◽  
Acinetobacter Baumannii ◽  
Neonatal Intensive Care ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Carbapenem Resistant ◽  
Surveillance Cultures

Objective.To investigate the mode of transmission of and assess control measures for an outbreak of carbapenem-resistant (multidrug-resistant) Acinetobacter baumannii infection involving 6 premature infants.Design.An outbreak investigation based on medical record review was performed for each neonate during the outbreak (from November 2008 through January 2009) in conjunction with an infection control investigation.Setting.A 36-bed, level 3 neonatal intensive care unit in a university-affiliated teaching hospital in Detroit, Michigan.Interventions.Specimens were obtained for surveillance cultures from all infants in the unit. In addition, geographic cohorting of affected infants and their nursing staff, contact isolation, re-emphasis of adherence to infection control practices, environmental cleaning, and use of educational modules were implemented to control the outbreak.Results.Six infants (age, 10-197 days) with multidrug-resistant A. baumannii infection were identified. All 6 infants were premature (gestational age, 23-30 weeks) and had extremely low birth weights (birth weight, 1000 g or less). Conditions included conjunctivitis (2 infants), pneumonia (4 infants), and bacteremia (1 infant). One infant died of causes not attributed to infection with the organism; the remaining 5 infants were discharged home. All surveillance cultures of unaffected infants yielded negative results.Conclusions.The spread of multidrug-resistant A. baumannii infection was suspected to be due to staff members who spread the pathogen through close contact with infants. Clinical staff recognition of the importance of multidrug-resistant A. baumannii recovery from neonatal intensive care unit patients, geographic cohorting of infected patients, enhanced infection control practices, and staff education resulted in control of the spread of the organism.

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