Outbreak of New Delhi Metallo-β-lactamase Carbapenemase-producing Pseudomonas Aeruginosa Infections in a Southern California Hospital.

Details

• Alternative Title:
  American Journal of Infection Control, 2025, v. 53, no. 9: Outbreak of New Delhi Metallo-β-lactamase Carbapenemase-producing Pseudomonas Aeruginosa Infections in a Southern California Hospital.
• Journal Article:
  American Journal of Infection Control
• Personal Author:
  Garrigues, Jacob M. ; Gray, Hannah K. ; Ison, Ricardo P. ; Uslan, Daniel Z. ; Lima, Amorce ; Gonzalez-Ferrer, Shekina ; Trejo, Marisol ; Zhuo, Ran ; Matysiak Match, Colette J. ; Ulloa, Erlinda R. ; Bhaurla, Sandeep ; Lewis, Vanessa ; Parti, Urvashi ; Sandoval, Tessa ; Turay, Sebora ; Walton, Shaunté ; Prabaker, Kavitha ; Garner, Omai B. ; Chandrasekaran, Sukantha ; Green, Nicole M. ; Yang, Shangxin
• Description:
  Carbapenemase-producing carbapenem-resistant Pseudomonas aeruginosa (CP-CRPA) is a major public health threat due to limited treatment options and high transmissibility. Though widespread globally, few instances of locally transmitted New Delhi metallo-β-lactamase (NDM)-producing CP-CRPA have been documented in the United States. Here, a cluster of locally transmitted NDM-1 CP-CRPA infections in Southern California is reported.
  
  Epidemiologic investigations involving both patient screening and environmental surveillance by microbiological culture, carbapenemase testing, and bacterial whole-genome sequencing were conducted.
  
  Through extensive epidemiologic investigations, a sink environmental reservoir was identified. A genetically unique strain of NDM-CRPA was identified to be transmitted among seven patients in a single hospital over the course of 1.5 years. Changes in antimicrobial resistance genes harbored by a mobile genetic element were identified between the index and later cases, and the gene encoding NDM-1 resided within a mobile genetic element on the chromosome displaying evidence of widespread transmission between different species. Several interventions were implemented, including sink P-trap replacement and disinfectant against Pseudomonas biofilms. No additional cases were identified after the interventions.
  
  Implementation of real-time pathogen surveillance enabled effective response to an ongoing outbreak that involved environmental sampling, microbiological testing, whole-genome sequencing, facility management, and updated infection prevention policies.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • beta-Lactamases
  • Pseudomonas Infections
  • Pseudomonas aeruginosa
  • California
  • Disease Outbreaks
  • Cross Infection
  • Male
  • Female
  • Hospitals
  More +
• Keywords:
  • NDM
  • Sink
  • P-trap
  • Genomic surveillance
  • Whole-genome sequencing
• Source:
  American Journal of Infection Control, 2025, v. 53, no. 9
• DOI:
  https://doi.org/10.1016/j.ajic.2025.06.005
• ISSN:
  0196-6553 ; 1527-3296
• Pubmed ID:
  40518051
• Pubmed Central ID:
  PMC13464689
• Document Type:
  Text
• Funding:
  NU51CK000357/CK/NCEZID CDC HHSUnited States/ ; UM1 TR004927/TR/NCATS NIH HHSUnited States/ ; U01 CK000357/CK/NCEZID CDC HHSUnited States/ ; NU50CK000495/CK/NCEZID CDC HHSUnited States/ ; K08 AI151253/AI/NIAID NIH HHSUnited States/
• Genre:
  Journal Article
• Pages in Document:
  977-984 (17 pdf pages)
• Volume:
  53
• Issue:
  9
• Download URL:
  https://stacks.cdc.gov/view/cdc/261335/cdc_261335_DS1.pdf
• File Type:
  [PDF - 1.09 MB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:952e3f9ce421d35c48ec86b7bcf7425dfc078aa036fc0bfbf68e80732f77c82cb70242d914f65ac6714d2adda333c840712e93f56d60f6ce0d2aa518a66f95ce