Imipenemase-producing carbapenem-resistant Enterobacteriaceae transmission in a long-term-care facility during a community-wide multidrug resistant organism outbreak-North Carolina, 2017

Am J Infect Control. 2020 Mar;48(3):320-323. doi: 10.1016/j.ajic.2019.05.022. Epub 2019 Jul 19.

Abstract

We describe an outbreak of imipenemase metallo-β-lactamase-producing organisms in a long-term-care facility (LTCF) amid a larger community outbreak of extended-spectrum β-lactamase-producing organisms. Transmission was propagated by inadequate infection prevention practices. We provided infection prevention recommendations and education, facilitated colonization screening, and increased interfacility communication. This outbreak demonstrates the unmet need for infection prevention education in long-term-care facilities and the importance of prompt public health response to ensure appropriate identification, containment, and prevention of emerging resistance.

Keywords: Antimicrobial resistance; Carbapenemase-producing carbapenem-resistant Enterobacteriaceae; Health care–associated; Infection prevention.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology
  • Bacterial Proteins / metabolism
  • Carbapenem-Resistant Enterobacteriaceae / drug effects*
  • Carbapenem-Resistant Enterobacteriaceae / metabolism
  • Carbapenem-Resistant Enterobacteriaceae / pathogenicity*
  • Carbapenems / pharmacology*
  • Case-Control Studies
  • Cross Infection / drug therapy
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Disease Outbreaks / statistics & numerical data*
  • Drug Resistance, Multiple, Bacterial / physiology
  • Enterobacteriaceae Infections / drug therapy
  • Enterobacteriaceae Infections / epidemiology*
  • Enterobacteriaceae Infections / microbiology
  • Female
  • Humans
  • Long-Term Care / statistics & numerical data*
  • Male
  • Middle Aged
  • North Carolina / epidemiology
  • Nursing Homes / statistics & numerical data
  • Young Adult
  • beta-Lactamases / metabolism

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Carbapenems
  • beta-Lactamases