CHARE-GD II Subproject 4: Multidrug-Resistant Bacteria (MDR) - Analysis of Differences in Infection Prevention and Control Measures, Diagnostic Workup and MDR Prevalence in the Ems-Dollart Region
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CHARE-GD II Subproject 4: Multidrug-Resistant Bacteria (MDR) - Analysis of Differences in Infection Prevention and Control Measures, Diagnostic Workup and MDR Prevalence in the Ems-Dollart Region
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Project background
Vancomycin-resistant enterococci (VRE) in hospital settings across European borders: a scoping review comparing the epidemiology in the Netherlands and Germany.
Would you like to know more?
You can find this study here: https://aricjournal.biomedcentral.com/articles/10.1186/s13756-023-01278-0
Cimen, C., Berends, M. S., Bathoorn, E., Lokate, M., Voss, A., Friedrich, A. W., Glasner, C., & Hamprecht, A. (2023). Vancomycin-resistant enterococci (VRE) in hospital settings across European borders: a scoping review comparing the epidemiology in the Netherlands and Germany. Antimicrobial Resistance & Infection Control, 12(1), 78.
Surface water in Lower Saxony: A reservoir for multidrug-resistant Enterobacterales.
Would you like to know more?
You can find this study here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10424258/pdf/main.pdf
Cimen C, Noster J, Stelzer Y, Rump A, Sattler J, Berends M, Voss A, Hamprecht A. Surface water in Lower Saxony: A reservoir for multidrug-resistant Enterobacterales. One Health. 2023;17:100606. DOI: 10.1016/j.onehlt.2023.100606
Uncovering the spread of drug-resistant bacteria through next-generation sequencing based surveillance: transmission of extended-spectrum β-lactamase-producing Enterobacterales by a contaminated duodenoscope.
Purpose of the article
Contamination of duodenoscopes is a significant concern due to the transmission of multidrug-resistant organisms (MDROs) among patients who undergo endoscopic retrograde cholangiopancreatography (ERCP), resulting in outbreaks worldwide. The aim of the study was to demonstrate the effectiveness of routine-based Next-generation sequencing (NGS) in uncovering the source of an outbreak, by detection a contaminated ERCP duodenoscope as the origin of Extended-spectrum β-lactamase (ESBL)-producing Citrobacter freundii and Klebsiella pneumoniae in patients.
Key findings
With the outbreak investigation we conducted, three probable cases and three proven cases who were colonised or infected by ESBL-producing Citrobacter freundii and Klebsiella pneumoniae were identified.Despite intensive consecutive cultures of the duodenoscope failing to detect any microorganisms, guiding NGS analysis and dismantling of the duodenoscope revealed that ESBL-producing K. pneumoniae was transmitted by the suspected duodenoscope.
Implications
Our study underscores the role of routine NGS-based surveillance and accompanying extensive epidemiological investigation in the detection and management of MDRO outbreaks. The results of this study call for a review of existing protocols and a consensus on improved sampling methods to enhance the detection and prevention of duodenoscope associated infections, while also emphasizing the necessity for future research to systematically assess the cost-effectiveness of routine NGS typing.
Would you like to know more?
You can find this study here: https://aricjournal.biomedcentral.com/articles/10.1186/s13756-024-01386-5
Cimen C, Bathoorn E, Loeve AJ, Fliss M, Berends MS, Nagengast WB, Hamprecht A, Voss A, Lokate M. Uncovering the spread of drug-resistant bacteria through next-generation sequencing based surveillance: transmission of extended-spectrum β-lactamase-producing Enterobacterales by a contaminated duodenoscope. Antimicrob Resist Infect Control. 2024 Mar 8;13(1):31. doi: 10.1186/s13756-024-01386-5