Routes of transmission of VIM-positive Pseudomonas aeruginosa in the adult intensive care unit-analysis of 9 years of surveillance at a university hospital using a mathematical model

• DOI: 10.1186/s13756-022-01095-x
• Publication Date: 2022-04-04T13:03:52Z
• Authors: Thi Mui Pham; Andrea C. Büchler; Anne F. Voor in ‘...; Juliëtte A. Severin; Martin C. J. Bootsma; Diederik Gommers; Mirjam E. Kretzsc...; Margreet C. Vos
• Keywords: Erasmus+

Abstract Background Hospital outbreaks of multidrug resistant Pseudomonas aeruginosa are often caused by clones which produce metallo-β-lactamases, such as Verona Integron-encoded Metallo-β-lactamase (VIM). Although different sources have been identified, the exact transmission routes remain unknown. However, quantifying role VIM-PA is important for tailoring infection prevention and control measures. The aim this study to quantify relative importance applying a mathematical model using admission discharge dates well surveillance culture data patients. Methods We analyzed collected between 2010 2018 two intensive-care unit (ICU) wards adult patients Erasmus University Medical Center Rotterdam model. distinguished routes: direct cross-transmission persistent environmental route. Based on admission, dates, cultures, we estimated proportion transmissions assigned each routes. Results Our shows that only 13.7% (95% CI 1.4%, 29%) occurred in these ICU were likely cross-transmission, leaving vast majority (86.3%, 95% 71%, 98.6%) due contamination. Conclusions results emphasize contamination environment may be an driver nosocomial ICUs. To minimize risk from environment, potential reservoirs should regularly thoroughly cleaned disinfected, or redesigned.