Effective mitigation of an outbreak of New Delhi metallo-β-lactamase–producing Escherichia coli infections in a small animal veterinary teaching hospital

• DOI: 10.2460/javma.24.09.0572
• Publication Date: 2025-02-26T17:12:56Z
• Authors: Ian DeStefano; Claire L. Fellman; Alicia C. Bergeron; Lauren M. Golato; Shira Doron; Melissa Cumming; Catherine M. Brown; Jessica Leaf; Jaclyn Dietrich; Regina Wagner; Stephen D. Cole

Abstract OBJECTIVE To describe infection prevention and control (IPC) interventions implemented in response to an outbreak of New Delhi metallo-β-lactamase (NDM)–producing carbapenem-resistant Enterobacterales (CRE) infections a veterinary teaching hospital. METHODS A multimodal intervention was introduced that included environmental surveillance, point-prevalence surveillance hospitalized dogs cats, mandatory education/training about CRE, alterations personal protective equipment protocols, increased cleaning/disinfection, workflow modifications, expert consultation. RESULTS The highest point prevalence for all-type carbapenemase-producing CRE (CP-CRE) or NDM Escherichia coli samples 59.4% (19 32) 37.5% (12 32), respectively. patient colonization with CP-CRE (4 13 [30.8%]) E (3 [23.1%]) occurred at the same time point. Following interventions, environment rapidly declined, no further clinical were documented subsequent 7 months. However, rates took several months decline. CONCLUSIONS Both declined by use IPC strategy. inpatient more slowly, suggesting ongoing intrafacility transmission and/or unidentified reservoirs longer resolve. CLINICAL RELEVANCE This study described feasible can be applied small animal settings help mitigate acquisition asymptomatic colonization. Monitoring alone is insensitive indicator patients. Substantial expenses associated outbreak. Improved early are recommended prevent within hospitals.