Oh, the fun you can have with a urinary catheter and a drain

We have blogged a fair bit recently about the risk of antibiotic-resistant Gram-negative bacterial contamination of sinks and drains. A new study offers a novel approach to this problem: by repurposing a balloon catheter to extend the duration of contact between a disinfectant and the sink-end of the pipe.

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21 is the magic number (for defining CPE person-to-person transmission using WGS)

A fascinating study from a European research group has unravelled the molecular epidemiology of a large European collection of carbapenem-resistant Klebsiella pneumoniae clinical isolates. Most carbapenem resistance was due to an acquired carbapenemases, transmission clusters were common within and between hospitals, carbapenemase-producing isolates are more likely to spread in hospitals, and 21 SNPs is the magic number for defining CPE person-to-person transmission using WGS.

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The challenges of detecting colistin resistance in CPE

Colistin resistance in CPE is bad news. Colistin is an older antibiotic that has been effectively brought out of retirement to tackle CPE infections. We have first-hand experience of witnessing the emergence and spread of colistin resistance in CPE – and it’s not a pretty sight. Colistin susceptibility testing is very tricky from a diagnostic laboratory viewpoint – and so I was interested in this recently published paper from colleagues at Imperial evaluating a rapid MALDI-TOF based approach to detecting colistin resistance, which looks very promising indeed.

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CPE in drains: a light at the end of the drain pipe?

We have been posting for a while about the emerging recognition of CPE contamination of drains in clinical settings, which seems to be fueling some CPE transmission. Until now, there’s been plenty of publications identifying the problem, but very few presenting a solution. In fact, attempts to tackle CPE contamination of drains have had moderate impact, at best. A new short study in ICHE illustrates the potential of a foaming hydrogen-peroxide based disinfectant to tackle contamination with resistant Gram-negative bacteria in drains.

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Mcr-1 plasmid-mediated colistin resistance genes in environmental Enterobacteriaceae

An interesting new Italian study has identified the mcr-1 gene, a plasmid-mediated colistin resistance gene, in 8% of environmental Enterobacteriaceae isolates. This suggests that environmental Enterobacteriaceae and perhaps even environmental surfaces themselves could be important reservoirs in the spread of mcr-1 and colistin resistance.

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No CPE but a lot of VRE

Addenbrookes hospital in Cambridge (UK) have recently performed a point prevalence survey for antibiotic resistant bacteria. None of 540 patient samples grew CPE, but 130 (24%) grew VRE. So, why no CPE but so much VRE?

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