{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:14:39Z","timestamp":1790806479661,"version":"4.1.0"},"reference-count":16,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2018,2,8]],"date-time":"2018-02-08T00:00:00Z","timestamp":1518048000000},"content-version":"unspecified","delay-in-days":7,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec id=\"S0899823X1700304X_abs1\" sec-type=\"general\"><jats:title>OBJECTIVE<\/jats:title><jats:p>To describe an outbreak of multidrug-resistant <jats:italic>Pseudomonas aeruginosa<\/jats:italic> in which the hospital waste-pipe system was the likely source of contamination and to report the bundle of measures that facilitated the long-term control of the outbreak.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X1700304X_abs2\" sec-type=\"general\"><jats:title>DESIGN<\/jats:title><jats:p>Outbreak investigation.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X1700304X_abs3\" sec-type=\"general\"><jats:title>SETTING<\/jats:title><jats:p>The hematology unit of a tertiary-care referral center.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X1700304X_abs4\" sec-type=\"general\"><jats:title>PATIENTS<\/jats:title><jats:p>Patients who were colonized or infected with <jats:italic>P. aeruginosa<\/jats:italic> belonging to the clonal outbreak.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X1700304X_abs5\" sec-type=\"methods\"><jats:title>METHODS<\/jats:title><jats:p>Patients admitted to our 15-bed stem-cell transplantation hematology unit were screened for <jats:italic>P. aeruginosa<\/jats:italic> carriage. <jats:italic>Pseudomonas aeruginosa<\/jats:italic> isolates were also obtained from diagnostic samples. We assessed the microbiological contamination of P-traps, water and toilets for 42 months. Extended-spectrum \u03b2-lactamases (ESBLs) and metallo-\u03b2-lactamases (MBLs) were screened and identified by polymerase chain reaction (PCR) and sequencing. Molecular typing of ESBL- or MBL-producing isolates was carried out using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X1700304X_abs6\" sec-type=\"results\"><jats:title>RESULTS<\/jats:title><jats:p>From 2009 to 2013, a biclonal outbreak of IMP-19\u2013producing ST235 (11 cases) and IMP-29\u2013producing ST111 (10 cases) of <jats:italic>P. aeruginosa<\/jats:italic> occurred. The environmental investigation strongly suggested that P-traps were the reservoirs for the outbreak strains. A bundle of infection control measures, including engineering interventions on water outlets and disinfection of P-traps, controlled the outbreak.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X1700304X_abs7\" sec-type=\"conclusions\"><jats:title>CONCLUSIONS<\/jats:title><jats:p>We report a prolonged outbreak of IMP-producing high-risk clones of <jats:italic>P. aeruginosa<\/jats:italic>, for which P-traps seems to play a major role in cross-transmission. It appears essential to implement proactive measures to limit the bacterial load in water fittings of high-risk units.<\/jats:p><jats:p><jats:italic>Infect Control Hosp Epidemiol<\/jats:italic> 2018;39:164\u2013169<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2017.304","type":"journal-article","created":{"date-parts":[[2018,2,8]],"date-time":"2018-02-08T05:40:10Z","timestamp":1518068410000},"page":"164-169","source":"Crossref","is-referenced-by-count":51,"title":["A Bundle of Measures to Control an Outbreak of <i>Pseudomonas aeruginosa<\/i> Associated With P-Trap Contamination"],"prefix":"10.1017","volume":"39","author":[{"given":"Houssein","family":"Gbaguidi-Haore","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Am\u00e9lie","family":"Varin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Cholley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Thouverez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Hocquet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Bertrand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2018,2,8]]},"reference":[{"key":"S0899823X1700304X_ref16","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.05838-11"},{"key":"S0899823X1700304X_ref15","doi-asserted-by":"publisher","DOI":"10.3201\/eid2302.160649"},{"key":"S0899823X1700304X_ref10","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.03327-16"},{"key":"S0899823X1700304X_ref3","doi-asserted-by":"publisher","DOI":"10.1002\/mbo3.391"},{"key":"S0899823X1700304X_ref9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0049300"},{"key":"S0899823X1700304X_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2015.03.001"},{"key":"S0899823X1700304X_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2009.04.020"},{"key":"S0899823X1700304X_ref8","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01646-09"},{"key":"S0899823X1700304X_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2013.09.010"},{"key":"S0899823X1700304X_ref12","doi-asserted-by":"publisher","DOI":"10.1086\/592700"},{"key":"S0899823X1700304X_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2016.05.009"},{"key":"S0899823X1700304X_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2014.06.018"},{"key":"S0899823X1700304X_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.drup.2015.08.002"},{"key":"S0899823X1700304X_ref6","unstructured":"European Committee on Antimicrobial Susceptibility Testing (EUCAST 2013). 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