1887

Abstract

A prolonged outbreak of carbapenem-resistant in a German university medical centre in 2006 was investigated; the investigation included a descriptive epidemiological analysis, a case–control study, environmental sampling, molecular typing of isolates using PFGE and repetitive-sequence-based PCR (rep-PCR) typing, and detection of OXA-type carbapenemases by multiplex PCR. Thirty-two patients acquired the outbreak strain in five intensive care units (ICUs) and two regular wards at a tertiary care hospital within 10 months. The outbreak strain was resistant to penicillins, cephalosporins, ciprofloxacin, gentamicin, tobramycin, imipenem and meropenem, and carried the -like gene. Based on PFGE and rep-PCR typing, it was shown to be related to the pan-European clone II. The most likely mode of transmission was cross-transmission from colonized or infected patients via the hands of health-care workers, with the severity of disease and intensity of care (therapeutic intervention scoring system 28 score >median) being independently associated with acquisition of the outbreak strain (odds ratio 6.67, 95 % confidence interval 1.55–36.56). Control of the outbreak was achieved by enforcement of standard precautions, education of personnel, screening of ICU patients for carbapenem-resistant and cohorting of patients. This is believed to be the first report of an outbreak of carrying the carbapenemase OXA-23 in Germany.

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2009-11-01
2019-10-22
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