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Journal of Medical Microbiology logo Journal of Medical Microbiology

Volume 44, Issue 2

Investigation of outbreaks of colonisation and infection in intensive care units by random amplification of polymorphic DNA No Access

Abstract

During a 4-month period, 41 isolates of were cultured from different specimens from a 14-bed intensive care unit (ICU1). These were obtained from 12 patients out of a total of 187 patients admitted to the ICU. Sixteen isolates were cultured from another ICU (ICU2) 6 months later. Six non-outbreak-associated strains were included as controls and all the isolates were compared by random amplification of polymorphic DNA (RAPD), with three different 10-mer oligonucleotide primers. The six non-outbreak-associated strains were distinguishable by RAPD with two of the three primers. RAPD fingerprinting with primer AP12h was as discriminatory as the combined results from all three primers and defined 22 different patterns for the 41 isolates from the ICU1. In nine instances, isolates with indistinguishable RAPD patterns were detected in two-to-five patients over a 3–15-day period, suggesting patient-to-patient transmission. During their stay in ICU1, patients harboured one-to-12 distinguishable isolates. Isolates from ICU2 were indistinguishable by RAPD analysis with the three different primers. These findings suggest that the cluster of colonisations and infections in ICU1 was a “false outbreak”, consisting of successive patient-to-patient transmission of different strains. In contrast, the outbreak on ICU2 probably involved the extensive spread of a single strain.

  • Received:
  • Accepted:
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  • Published Online:
© J. MED. MICROBIOL. 1996
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1996-02-01
2025-01-20
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References

  1. Schaberg D. R., Culver D. H., Gaynes R. P. Major trends in the microbial etiology of nosocomial infection. Am J Med 1991; 91:72S–75S
     [Google Scholar]
  2. Burchard K. W., Barrall D. T., Reed M., Slotman G. J. Enterobacter bacteremia in surgical patients. Surgery 1986; 100:857–862
     [Google Scholar]
  3. Gaston M. A. Enterobacter: an emerging nosocomial pathogen. J Hosp Infect 1988; 11:197–208
     [Google Scholar]
  4. Watanakunakom C., Weber J. Enterobacter bacteremia: a review of 58 episodes. Scand J Infect Dis 1989; 21:1–8
     [Google Scholar]
  5. Weischer M., Kolmos H. J. Retrospective 6-year study of Enterobacter bacteraemia in a Danish university hospital. J Hosp Infect 1992; 20:15–24
     [Google Scholar]
  6. De Champs C., Sauvant M. P., Chanal C. Prospective survey of colonization and infection caused by expanded-spectrum-beta-lactamase-producing members of the family Enterobacteriaceae in an intensive care unit. J Clin Microbiol 1989; 27:2887–2890
     [Google Scholar]
  7. De Champs C., Sirot D., Chanal C., Poupart, M-C, Dumas, M-P, Sirot J. Concomitant dissemination of three extended-spectrum beta-lactamases among different Enterobacteriaceae isolated in a French hospital. J Antimicrob Chemother 1991; 27:441–457
     [Google Scholar]
  8. Fawcett C., Chawla J. C., Quoraishi A., Stickler D. J. A study of the skin flora of spinal cord injured patients. J Hosp Infect 1986; 8:149–158
     [Google Scholar]
  9. Ehrhardt A. F., Sanders C. C., Thomson K.S., Watanakunakom C., Trujillano-Martin I. Emergence of resistance to imipenem in Enterobacter isolates masquerading as Klebsiella pneumoniae during therapy with imipenem/cilastatin. Clin Infect Dis 1993; 17:120–122
     [Google Scholar]
  10. Gallagher P. G. Enterobacter bacteremia in pediatric patients. Rev Infect Dis 1990; 12:808–12
     [Google Scholar]
  11. Gaston M. A., Strickland M. A., Ayling-Smith B. A., Pitt T. L. Epidemiological typing of Enterobacter aerogenes . J Clin Microbiol 1989; 27:564–565
     [Google Scholar]
  12. Weinstein R. A. Endemic emergence of cephalosporin-resistant Enterobacter: relation to prior therapy. Infect Control 1986; 7: Suppl 120–123
     [Google Scholar]
  13. Chow J. W., Fine M. J., Shlaes D. M. Enterobacter bacteremia: clinical features and emergence of antibiotic resistance during therapy. Ann Intern Med 1991; 115:585–590
     [Google Scholar]
  14. Flynn D. M., Weinstein R. A., Nathan C., Gaston M. A., Kabins S. A. Patients’ endogenous flora as the source of “nosocomial” Enterobacter in cardiac surgery. J Infect Dis 1987; 156:363–368
     [Google Scholar]
  15. De Champs C., Henquell C., Guelon D., Sirot D., Gazuy N., Sirot J. Clinical and bacteriological study of nosocomial infections due to Enterobacter aerogenes resistant to imipenem. J Clin Microbiol 1993; 31:123–127
     [Google Scholar]
  16. Markowitz S. M., Smith S. M., Williams D. S. Retrospective analysis of plasmid patterns in a study of bum unit outbreaks of infection due to Enterobacter cloacae . J Infect Dis 1983; 148:18–23
     [Google Scholar]
  17. Bingen E., Denamur E., Lambert-Zechovsky N., Brahimi N., El Lakany M., Elion J. Rapid genotyping shows the absence of cross-contamination in Enterobacter cloacae nosocomial infections. J Hosp Infect 1992; 21:95–101
     [Google Scholar]
  18. Haertl R., Bandlow G. Epidemiological fingerprinting of Enterobacter cloacae by small-fragment restriction endonuclease analysis and pulsed-field gel electrophoresis of genomic restriction fragments. J Clin Microbiol 1993; 31:128–133
     [Google Scholar]
  19. Williams J. G. K., Kubelik A. R., Livak K. J., Rafalski J. A., Tingey S. V. DNA polymorphisms amplified by arbitrary primers are useful as genetic markers. Nucleic Acids Res 1990; 18:6531–6535
     [Google Scholar]
  20. van Belkum A. DNA Fingerprinting of medically important microorganisms by use of PCR. Clin Microbiol Rev 1994; 7:174–184
     [Google Scholar]
  21. Bollet C., Elkouby A., Pietri P., de Micco P. Isolation of Enterobacter amnigenus from a heart transplant recipient. Eur J Clin Microbiol Infect Dis 1991; 10:1071–1073
     [Google Scholar]
  22. Philippon A., Labia R., Jacoby G. Extended-spectrum beta-lactamases. Antimicrob Agents Chemother 1989; 33:1131–1136
     [Google Scholar]
  23. Bassam B. J., Caetano-Anollés G., Gresshoff P. M. DNA amplification fingerprinting of bacteria. Appl Microbiol Biotechnol 1992; 38:70–76
     [Google Scholar]
  24. Olson B., Weinstein R. A., Nathan C., Kabins S. A. Broad-spectrum beta-lactam resistance in Enterobacter: emergence during treatment and mechanisms of resistance. J Antimicrob Chemother 1983; 11:299–310
     [Google Scholar]
  25. Chow J. W., Shlaes D. M. Imipenem resistance associated with the loss of a 40 kDa outer membrane protein in Enterobacter aerogenes . J Antimicrob Chemother 1991; 28:499–504
     [Google Scholar]
  26. Hopkins J. M., Towner K. sJ. Enhanced resistance to cefotaxine and imipenem associated with outer membrane protein alterations in Enterobacter aerogenes . J Antimicrob Chemother 1990; 25:49–55
     [Google Scholar]
  27. Leying H., Cullmann W., Dick W. Carbapenem resistance in Enterobacter aerogenes is due to lipopolysaccharide alterations. Chemotherapy 1991; 37:106–113
     [Google Scholar]
/content/journal/jmm/10.1099/00222615-44-2-89
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Investigation of outbreaks of Enterobacter aerogenes colonisation and infection in intensive care units by random amplification of polymorphic DNA
J. Med. Microbiol. 44, 89 (1996); https://doi.org/10.1099/00222615-44-2-89
/content/journal/jmm/10.1099/00222615-44-2-89
/content/journal/jmm/10.1099/00222615-44-2-89
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