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

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

PIs: Prof. Dr. Axel Hamprecht, Dr. Corinna Glasner

For other languages, see Nederlands and Deutsch.

About the project

Antimicrobialresistance (AMR) is considered among the top 10 threats to global health. Without further action, AMR could cause 39.1 million direct deaths and 169 million associated deaths by 2050.
“Global Action Plan on AMR” by the World Health Organisation urges international action and cross-border collaboration to address AMR spread.

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

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