Shiloh
Editor, Senior Moderator
Source: http://www.cidrap.umn.edu/news-perspective/2017/04/stewardship-resistance-scan-apr-14-2017
Stewardship / Resistance Scan for Apr 14, 2017
MRSA hospital outbreak in LA; NDM findings in Ireland
Filed Under:
Antimicrobial Stewardship; MRSA
[h=3]MRSA outbreak reported among infants at LA hospital[/h] Ten infants in the neonatal intensive care unit (NICU) at a Los Angeles hospital have been infected with a strain of methicillin-resistant Staphylococcus aureus (MRSA) over the past several months, the Los Angeles Times reported yesterday.
According to the paper, lab tests confirmed that five infants at UC Irvine Hospital had been infected with the same strain of MRSA in the middle of December. Two more babies became infected later that month, followed by another positive test in February and two more in late March. In addition, four hospital employees have been colonized with the same strain.
None of the 10 infants, who were already critically ill when they tested positive, have active infections.
This is the first the public is hearing of the outbreak. The Times learned about the infections after a member of a state advisory committee on hospital-acquired infections filed a complaint with the state, arguing that hospital officials should have informed pregnant women who were preparing to give birth at the hospital.
Hospital officials tell the paper they didn't believe it was necessary to inform expecting families about the outbreak, and county health officials say notifying the public was unnecessary because they had no evidence that infants treated in the UC Irvine NICU were at higher risk of MRSA than infants being treated at other hospitals. But since last month, the hospital has been disclosing the outbreak in a letter to parents of all infants in the unit.
Hospital officials tell the paper they have not yet found the source of the MRSA infections, but are working aggressively to prevent further infections.
Apr 13 Los Angeles Times story
[h=3]Researchers find NDM-producing Enterobacteriaceae at Irish beach[/h] Researchers in Ireland are reporting the identification of carbapenemase-producing Enterobacteriaceae (CPE) in Irish recreational waters and sewage.
In a report published yesterday in Eurosurveillance, the researchers say they isolated New Delhi metallo-beta-lactamase (NDM)-producing Escherichia coli and Klebsiella pneumoniae from fresh water and seawater samples collected at two beaches located near an untreated human sewage ocean discharge pump and two fresh water streams that flow into the ocean. The samples were collected from May 2016 to January 2017 from the two streams (Stream A and Stream B) and from seawater at the two beaches (Beach A and Beach B), and additional samples were collected from the sewage collection system, the sewage storage tank, and the sewage outflow. Genetic analysis of the isolates was performed using pulsed-field gel electrophoresis (PFGE).
NDM-producing E coli was isolated from samples from Stream B, the sewage collection system, the sewage storage tank, and from the sewage outflow. All isolates were resistant to ampicillin, cefotaxime, cefoxitin, cefpodoxime, ceftazidime, ciprofloxacin, ertapenem, meropenem, and nalidixic acid, and were genetically indistinguishable from a human isolate submitted to the National Carbapenemase Producing Enterobacteriaceae Reference Laboratory Service (CPERLS).
NDM-producing K pneumoniae was isolated from samples from the sewage collection system and storage tank and from seawater at the two beaches. The isolates were resistant to ampicillin, cefotaxime, cefoxitin, cefpodoxime, ceftazidime, ciprofloxacin, ertapenem, gentamicin, kanamycin, meropenem, nalidixic acid, and tetracycline, and were 83% and 97% similar to a human isolate from CPERLS.
The researchers say they believe human sewage outflow is the source of the NDM-producing Enterobacteriaceae in the seawater, and that the fresh water streams were contaminated by backwash of sewage during high tide. To their knowledge, this is the first identification of CPE in bathing seawater in Europe. Their concern is that people using the beach may be intermittently exposed to the multidrug-resistant bacteria.
"It appears therefore that there is potential for environmental contamination to contribute to a transition of CPE from largely healthcare-associated organisms, to organisms affecting the general population and the veterinary sector," the authors write. "From a public health perspective, the findings focus attention on the need to accelerate programmes to cease discharge of untreated sewage into the environment."
Apr 13 Euro Surveill rapid communication
Stewardship / Resistance Scan for Apr 14, 2017
MRSA hospital outbreak in LA; NDM findings in Ireland
Filed Under:
Antimicrobial Stewardship; MRSA
[h=3]MRSA outbreak reported among infants at LA hospital[/h] Ten infants in the neonatal intensive care unit (NICU) at a Los Angeles hospital have been infected with a strain of methicillin-resistant Staphylococcus aureus (MRSA) over the past several months, the Los Angeles Times reported yesterday.
According to the paper, lab tests confirmed that five infants at UC Irvine Hospital had been infected with the same strain of MRSA in the middle of December. Two more babies became infected later that month, followed by another positive test in February and two more in late March. In addition, four hospital employees have been colonized with the same strain.
None of the 10 infants, who were already critically ill when they tested positive, have active infections.
This is the first the public is hearing of the outbreak. The Times learned about the infections after a member of a state advisory committee on hospital-acquired infections filed a complaint with the state, arguing that hospital officials should have informed pregnant women who were preparing to give birth at the hospital.
Hospital officials tell the paper they didn't believe it was necessary to inform expecting families about the outbreak, and county health officials say notifying the public was unnecessary because they had no evidence that infants treated in the UC Irvine NICU were at higher risk of MRSA than infants being treated at other hospitals. But since last month, the hospital has been disclosing the outbreak in a letter to parents of all infants in the unit.
Hospital officials tell the paper they have not yet found the source of the MRSA infections, but are working aggressively to prevent further infections.
Apr 13 Los Angeles Times story
[h=3]Researchers find NDM-producing Enterobacteriaceae at Irish beach[/h] Researchers in Ireland are reporting the identification of carbapenemase-producing Enterobacteriaceae (CPE) in Irish recreational waters and sewage.
In a report published yesterday in Eurosurveillance, the researchers say they isolated New Delhi metallo-beta-lactamase (NDM)-producing Escherichia coli and Klebsiella pneumoniae from fresh water and seawater samples collected at two beaches located near an untreated human sewage ocean discharge pump and two fresh water streams that flow into the ocean. The samples were collected from May 2016 to January 2017 from the two streams (Stream A and Stream B) and from seawater at the two beaches (Beach A and Beach B), and additional samples were collected from the sewage collection system, the sewage storage tank, and the sewage outflow. Genetic analysis of the isolates was performed using pulsed-field gel electrophoresis (PFGE).
NDM-producing E coli was isolated from samples from Stream B, the sewage collection system, the sewage storage tank, and from the sewage outflow. All isolates were resistant to ampicillin, cefotaxime, cefoxitin, cefpodoxime, ceftazidime, ciprofloxacin, ertapenem, meropenem, and nalidixic acid, and were genetically indistinguishable from a human isolate submitted to the National Carbapenemase Producing Enterobacteriaceae Reference Laboratory Service (CPERLS).
NDM-producing K pneumoniae was isolated from samples from the sewage collection system and storage tank and from seawater at the two beaches. The isolates were resistant to ampicillin, cefotaxime, cefoxitin, cefpodoxime, ceftazidime, ciprofloxacin, ertapenem, gentamicin, kanamycin, meropenem, nalidixic acid, and tetracycline, and were 83% and 97% similar to a human isolate from CPERLS.
The researchers say they believe human sewage outflow is the source of the NDM-producing Enterobacteriaceae in the seawater, and that the fresh water streams were contaminated by backwash of sewage during high tide. To their knowledge, this is the first identification of CPE in bathing seawater in Europe. Their concern is that people using the beach may be intermittently exposed to the multidrug-resistant bacteria.
"It appears therefore that there is potential for environmental contamination to contribute to a transition of CPE from largely healthcare-associated organisms, to organisms affecting the general population and the veterinary sector," the authors write. "From a public health perspective, the findings focus attention on the need to accelerate programmes to cease discharge of untreated sewage into the environment."
Apr 13 Euro Surveill rapid communication