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Background <p><i>Pseudomonas aeruginosa</i> is frequently responsible for hospital-acquired infections. It may be isolated in healthcare environment where it can survive. Between January 2018 and June 2024, a growing number of VIM-producing <i>Pseudomonas aeruginosa</i> (PA-VIM) were isolated from patients hospitalized in our surgical intensive care unit (SICU). The aim of this study was to investigate SICU long-term PA-VIM outbreaks involving a persistent environmental reservoir.</p> Methods <p>Investigations included an active case finding, a matched case–control study to identify factors associated with PA-VIM acquisition, the identification of environmental reservoirs, a whole-genome sequencing analysis of patient and environmental strains, and the implementation of control measures.</p> Results <p>During these outbreaks, 32 patients were colonized or identified with at least one PA-VIM positive clinical sample during their SICU stay. Factors significantly associated with the PA-VIM acquisition in the conditional univariate analysis included exposure to antibiotics (e.g., carbapenem) and antifungals, and the use of a nasogastric tube and enteral nutrition. Among 342 environmental samples collected in the SICU (including sink drains, syringes and glasses containing syringes used for enteral nutrition), 67 (19.6%) were found positive for PA-VIM. Core-genome Multi-Locus Sequence Typing analysis identified 2 major clones, each including patients and environmental strains.</p> Conclusions <p>These long-lasting outbreaks of PA-VIM were associated to a persistent environmental contamination of sink drains. All the strategies aiming at eradicating PA-VIM reservoirs (disinfection, descaling, or replacement of sink drains) failed or only showed a temporary effect.</p>

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Protracted outbreaks of VIM-producing Pseudomonas aeruginosa in a surgical intensive care unit in France, January 2018 to June 2024

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  • 发表日期：

    2025年8月4日

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  • Benjamin Querin,
  • Maxime Danjean,
  • Sarah Jolivet,
  • Jeanne Couturier,
  • Soumaya Oubbéa,
  • Claire Jouans,
  • Christelle Lazare,
  • Théo Montagne,
  • Aurélia Chamming’s,
  • Solweig Luce,
  • Gil Dhenin,
  • Nathalie Audrain,
  • Fabienne Fieux,
  • Franck Verdonk,
  • Jean-Winoc Decousser,
  • Florence Stordeur,
  • Frédéric Barbut

摘要

Background

Pseudomonas aeruginosa is frequently responsible for hospital-acquired infections. It may be isolated in healthcare environment where it can survive. Between January 2018 and June 2024, a growing number of VIM-producing Pseudomonas aeruginosa (PA-VIM) were isolated from patients hospitalized in our surgical intensive care unit (SICU). The aim of this study was to investigate SICU long-term PA-VIM outbreaks involving a persistent environmental reservoir.

Methods

Investigations included an active case finding, a matched case–control study to identify factors associated with PA-VIM acquisition, the identification of environmental reservoirs, a whole-genome sequencing analysis of patient and environmental strains, and the implementation of control measures.

Results

During these outbreaks, 32 patients were colonized or identified with at least one PA-VIM positive clinical sample during their SICU stay. Factors significantly associated with the PA-VIM acquisition in the conditional univariate analysis included exposure to antibiotics (e.g., carbapenem) and antifungals, and the use of a nasogastric tube and enteral nutrition. Among 342 environmental samples collected in the SICU (including sink drains, syringes and glasses containing syringes used for enteral nutrition), 67 (19.6%) were found positive for PA-VIM. Core-genome Multi-Locus Sequence Typing analysis identified 2 major clones, each including patients and environmental strains.

Conclusions

These long-lasting outbreaks of PA-VIM were associated to a persistent environmental contamination of sink drains. All the strategies aiming at eradicating PA-VIM reservoirs (disinfection, descaling, or replacement of sink drains) failed or only showed a temporary effect.