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Volume 28, Number 10—October 2022
Dispatch

Dialysis Water Supply Faucet as Reservoir for Carbapenemase-Producing Pseudomonas aeruginosa

Christopher PrestelComments to Author , Heather Moulton-Meissner, Paige Gable, Richard A. Stanton, Janet Glowicz, Lauren Franco, Mary McConnell, Tiffany Torres, Dijo John, Gillian Blackwell, Renae Yates, Chavela Brown, Kristina Reyes, Gillian A. McAllister, Jasen Kunz, Erin E. Conners, Katharine M. Benedict, Amy Kirby, Mia Mattioli, Kerui Xu, Nicole Gualandi, Stephanie Booth, Shannon Novosad, Matthew Arduino, Alison Laufer Halpin, Katherine Wells, and Maroya Spalding Walters
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (C. Prestel, H. Moulton-Meissner, P. Gable, R.A. Stanton, J. Glowicz, L. Franco, G.A. McAllister, J. Kunz, E.E. Conners, K.M. Benedict, A. Kirby, M. Mattioli, K. Xu, N. Gualandi, S. Booth, S. Novosad, M. Arduino, A. Laufer Halpin, M.S. Walters); City of Lubbock Health Department, Lubbock, Texas, USA (M. McConnell, T. Torres, D. John, K. Wells); Texas Department of State Health Services, Austin, Texas (G. Blackwell); University Medical Centers, Lubbock (R. Yates, C. Brown, K. Reyes)

Main Article

Figure 1

Environmental sampling scheme at hospital A from a study of CRPA in acute-care hospital specialty care unit, Texas, USA. A) Collection location in hospital and number of each sample type (icons with numbers underneath) collected (N = 85). We selected units and rooms for environmental sampling on the basis of chart review, focusing on where patients who developed clinical infections were located; patient rooms were those where patients with VIM-CRPA had been previously located. Three patients developed clinical infections while in ICU 1 and 3 while in ICU 2. Thirteen other patients from several medical or surgical units also developed clinical infections. Samples from which we recovered >1 VIM-producing isolate are indicated in red. We identified VIM-CRPA from 3 sites related to a single sink in room A of ICU 1: the sink drain, the interior surface of the dialysis faucet, and bulk water from a dialysis faucet used as the water source for the reverse osmosis unit of portable dialysis machines. We identified VIM-producing Pseudomonas monteilii (†) in a single sink basin sample of 1 room in ICU 2. B) Schematic view and heatmap of colony forming units identified by culture at selected internal surface locations within the faucet and water supply used for portable dialysis in ICU 1, room A. CRPA, carbapenem-resistant Pseudomonas aeruginosa; ICU, intensive care unit; VIM, Verona-integron-encoded metallo-β-lactamase.

Figure 1. Environmental sampling scheme at hospital A from a study of CRPA in acute-care hospital specialty care unit, Texas, USA. A) Collection location in hospital and number of each sample type (icons with numbers underneath) collected (N = 85). We selected units and rooms for environmental sampling on the basis of chart review, focusing on where patients who developed clinical infections were located; patient rooms were those where patients with VIM-CRPA had been previously located. Three patients developed clinical infections while in ICU 1 and 3 while in ICU 2. Thirteen other patients from several medical or surgical units also developed clinical infections. Samples from which we recovered >1 VIM-producing isolate are indicated in red. We identified VIM-CRPA from 3 sites related to a single sink in room A of ICU 1: the sink drain, the interior surface of the dialysis faucet, and bulk water from a dialysis faucet used as the water source for the reverse osmosis unit of portable dialysis machines. We identified VIM-producing Pseudomonas monteilii (†) in a single sink basin sample of 1 room in ICU 2. B) Schematic view and heatmap of colony forming units identified by culture at selected internal surface locations within the faucet and water supply used for portable dialysis in ICU 1, room A. CRPA, carbapenem-resistant Pseudomonas aeruginosa; ICU, intensive care unit; VIM, Verona-integron-encoded metallo-β-lactamase.

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Page created: August 11, 2022
Page updated: September 21, 2022
Page reviewed: September 21, 2022
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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