Outbreak of NDM-1-Producing Escherichia coli in a Coronavirus Disease 2019 Intensive Care Unit in a Mexican Tertiary Care Center
ABSTRACT Emergency department areas were repurposed as intensive care units (ICUs) for patients with acute respiratory distress syndrome during the initial months of the coronavirus disease 2019 (COVID-19) pandemic. We describe an outbreak of New Delhi metallo-β-lactamase 1 (NDM-1)-producing Escheri...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
American Society for Microbiology
2022-02-01
|
| Series: | Microbiology Spectrum |
| Subjects: | |
| Online Access: | https://journals.asm.org/doi/10.1128/spectrum.02015-21 |
| _version_ | 1818323352155062272 |
|---|---|
| author | Oscar A. Fernández-García María F. González-Lara Marco Villanueva-Reza Nereyda de-León-Cividanes Luis F. Xancal-Salvador Verónica Esteban-Kenel Ayleen Cárdenas-Ochoa Axel Cervantes-Sánchez Areli Martínez-Gamboa Eric Ochoa-Hein Arturo Galindo-Fraga Miriam Bobadilla-del-Valle José Sifuentes-Osornio Alfredo Ponce-de-León |
| author_facet | Oscar A. Fernández-García María F. González-Lara Marco Villanueva-Reza Nereyda de-León-Cividanes Luis F. Xancal-Salvador Verónica Esteban-Kenel Ayleen Cárdenas-Ochoa Axel Cervantes-Sánchez Areli Martínez-Gamboa Eric Ochoa-Hein Arturo Galindo-Fraga Miriam Bobadilla-del-Valle José Sifuentes-Osornio Alfredo Ponce-de-León |
| author_sort | Oscar A. Fernández-García |
| collection | DOAJ |
| description | ABSTRACT Emergency department areas were repurposed as intensive care units (ICUs) for patients with acute respiratory distress syndrome during the initial months of the coronavirus disease 2019 (COVID-19) pandemic. We describe an outbreak of New Delhi metallo-β-lactamase 1 (NDM-1)-producing Escherichia coli infections in critically ill COVID-19 patients admitted to one of the repurposed units. Seven patients developed infections (6 ventilator-associated pneumonia [VAP] and 1 urinary tract infection [UTI]) due to carbapenem-resistant E. coli, and only two survived. Five of the affected patients and four additional patients had rectal carriage of carbapenem-resistant E. coli. The E. coli strain from the affected patients corresponded to a single sequence type. Rectal screening identified isolates of two other sequence types bearing blaNDM-1. Isolates of all three sequence types harbored an IncFII plasmid. The plasmid was confirmed to carry blaNDM-1 through conjugation. An outbreak of clonal NDM-1-producing E. coli isolates and subsequent dissemination of NDM-1 through mobile elements to other E. coli strains occurred after hospital conversion during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. This emphasizes the need for infection control practices in surge scenarios. IMPORTANCE The SARS-CoV-2 pandemic has resulted in a surge of critically ill patients. Hospitals have had to adapt to the demand by repurposing areas as intensive care units. This has resulted in high workload and disruption of usual hospital workflows. Surge capacity guidelines and pandemic response plans do not contemplate how to limit collateral damage from issues like hospital-acquired infections. It is vital to ensure quality of care in surge scenarios. |
| first_indexed | 2024-12-13T11:11:19Z |
| format | Article |
| id | doaj.art-65957b7f407047409251a3396db773a2 |
| institution | Directory Open Access Journal |
| issn | 2165-0497 |
| language | English |
| last_indexed | 2024-12-13T11:11:19Z |
| publishDate | 2022-02-01 |
| publisher | American Society for Microbiology |
| record_format | Article |
| series | Microbiology Spectrum |
| spelling | doaj.art-65957b7f407047409251a3396db773a22022-12-21T23:48:45ZengAmerican Society for MicrobiologyMicrobiology Spectrum2165-04972022-02-0110110.1128/spectrum.02015-21Outbreak of NDM-1-Producing Escherichia coli in a Coronavirus Disease 2019 Intensive Care Unit in a Mexican Tertiary Care CenterOscar A. Fernández-García0María F. González-Lara1Marco Villanueva-Reza2Nereyda de-León-Cividanes3Luis F. Xancal-Salvador4Verónica Esteban-Kenel5Ayleen Cárdenas-Ochoa6Axel Cervantes-Sánchez7Areli Martínez-Gamboa8Eric Ochoa-Hein9Arturo Galindo-Fraga10Miriam Bobadilla-del-Valle11José Sifuentes-Osornio12Alfredo Ponce-de-León13Infectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoClinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoInfectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoInfectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoClinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoClinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoClinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoClinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoClinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoHospital Epidemiology and Healthcare Quality Control, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoHospital Epidemiology and Healthcare Quality Control, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoClinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoInfectious Diseases Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoABSTRACT Emergency department areas were repurposed as intensive care units (ICUs) for patients with acute respiratory distress syndrome during the initial months of the coronavirus disease 2019 (COVID-19) pandemic. We describe an outbreak of New Delhi metallo-β-lactamase 1 (NDM-1)-producing Escherichia coli infections in critically ill COVID-19 patients admitted to one of the repurposed units. Seven patients developed infections (6 ventilator-associated pneumonia [VAP] and 1 urinary tract infection [UTI]) due to carbapenem-resistant E. coli, and only two survived. Five of the affected patients and four additional patients had rectal carriage of carbapenem-resistant E. coli. The E. coli strain from the affected patients corresponded to a single sequence type. Rectal screening identified isolates of two other sequence types bearing blaNDM-1. Isolates of all three sequence types harbored an IncFII plasmid. The plasmid was confirmed to carry blaNDM-1 through conjugation. An outbreak of clonal NDM-1-producing E. coli isolates and subsequent dissemination of NDM-1 through mobile elements to other E. coli strains occurred after hospital conversion during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. This emphasizes the need for infection control practices in surge scenarios. IMPORTANCE The SARS-CoV-2 pandemic has resulted in a surge of critically ill patients. Hospitals have had to adapt to the demand by repurposing areas as intensive care units. This has resulted in high workload and disruption of usual hospital workflows. Surge capacity guidelines and pandemic response plans do not contemplate how to limit collateral damage from issues like hospital-acquired infections. It is vital to ensure quality of care in surge scenarios.https://journals.asm.org/doi/10.1128/spectrum.02015-21COVID-19carbapenemaseE. colicarbapenem-resistant enterobacteriaNDM-1ventilator-associated pneumonia |
| spellingShingle | Oscar A. Fernández-García María F. González-Lara Marco Villanueva-Reza Nereyda de-León-Cividanes Luis F. Xancal-Salvador Verónica Esteban-Kenel Ayleen Cárdenas-Ochoa Axel Cervantes-Sánchez Areli Martínez-Gamboa Eric Ochoa-Hein Arturo Galindo-Fraga Miriam Bobadilla-del-Valle José Sifuentes-Osornio Alfredo Ponce-de-León Outbreak of NDM-1-Producing Escherichia coli in a Coronavirus Disease 2019 Intensive Care Unit in a Mexican Tertiary Care Center Microbiology Spectrum COVID-19 carbapenemase E. coli carbapenem-resistant enterobacteria NDM-1 ventilator-associated pneumonia |
| title | Outbreak of NDM-1-Producing Escherichia coli in a Coronavirus Disease 2019 Intensive Care Unit in a Mexican Tertiary Care Center |
| title_full | Outbreak of NDM-1-Producing Escherichia coli in a Coronavirus Disease 2019 Intensive Care Unit in a Mexican Tertiary Care Center |
| title_fullStr | Outbreak of NDM-1-Producing Escherichia coli in a Coronavirus Disease 2019 Intensive Care Unit in a Mexican Tertiary Care Center |
| title_full_unstemmed | Outbreak of NDM-1-Producing Escherichia coli in a Coronavirus Disease 2019 Intensive Care Unit in a Mexican Tertiary Care Center |
| title_short | Outbreak of NDM-1-Producing Escherichia coli in a Coronavirus Disease 2019 Intensive Care Unit in a Mexican Tertiary Care Center |
| title_sort | outbreak of ndm 1 producing escherichia coli in a coronavirus disease 2019 intensive care unit in a mexican tertiary care center |
| topic | COVID-19 carbapenemase E. coli carbapenem-resistant enterobacteria NDM-1 ventilator-associated pneumonia |
| url | https://journals.asm.org/doi/10.1128/spectrum.02015-21 |
| work_keys_str_mv | AT oscarafernandezgarcia outbreakofndm1producingescherichiacoliinacoronavirusdisease2019intensivecareunitinamexicantertiarycarecenter AT mariafgonzalezlara outbreakofndm1producingescherichiacoliinacoronavirusdisease2019intensivecareunitinamexicantertiarycarecenter AT marcovillanuevareza outbreakofndm1producingescherichiacoliinacoronavirusdisease2019intensivecareunitinamexicantertiarycarecenter AT nereydadeleoncividanes outbreakofndm1producingescherichiacoliinacoronavirusdisease2019intensivecareunitinamexicantertiarycarecenter AT luisfxancalsalvador outbreakofndm1producingescherichiacoliinacoronavirusdisease2019intensivecareunitinamexicantertiarycarecenter AT veronicaestebankenel outbreakofndm1producingescherichiacoliinacoronavirusdisease2019intensivecareunitinamexicantertiarycarecenter AT ayleencardenasochoa outbreakofndm1producingescherichiacoliinacoronavirusdisease2019intensivecareunitinamexicantertiarycarecenter AT axelcervantessanchez outbreakofndm1producingescherichiacoliinacoronavirusdisease2019intensivecareunitinamexicantertiarycarecenter AT arelimartinezgamboa outbreakofndm1producingescherichiacoliinacoronavirusdisease2019intensivecareunitinamexicantertiarycarecenter AT ericochoahein outbreakofndm1producingescherichiacoliinacoronavirusdisease2019intensivecareunitinamexicantertiarycarecenter AT arturogalindofraga outbreakofndm1producingescherichiacoliinacoronavirusdisease2019intensivecareunitinamexicantertiarycarecenter AT miriambobadilladelvalle outbreakofndm1producingescherichiacoliinacoronavirusdisease2019intensivecareunitinamexicantertiarycarecenter AT josesifuentesosornio outbreakofndm1producingescherichiacoliinacoronavirusdisease2019intensivecareunitinamexicantertiarycarecenter AT alfredoponcedeleon outbreakofndm1producingescherichiacoliinacoronavirusdisease2019intensivecareunitinamexicantertiarycarecenter |