A cold hard menace: A contaminated ice machine as a potential source for transmission of carbapenem-resistant...

Area of Science:

• Microbiology
• Infectious Diseases
• Hospital Epidemiology

Background:

• Multidrug-resistant gram-negative bacilli (MDR-GN) pose a significant threat in healthcare settings, particularly on specialized units like spinal cord injury (SCI) wards.
• Identifying reservoirs and transmission routes of MDR-GN is crucial for effective infection control.

Purpose of the Study:

• To investigate potential sources of transmission for multidrug-resistant gram-negative bacilli within a spinal cord injury unit.
• To determine if ice machines could act as a reservoir for the dissemination of these resistant bacteria.

Main Methods:

• Environmental and clinical sampling was conducted on an SCI unit.
• Bacterial isolates, specifically carbapenem-resistant Acinetobacter baumannii, were recovered from patient stool, healthcare worker hands, and an ice machine.
• Genetic relatedness of isolates was assessed to trace potential transmission pathways.

Main Results:

• Genetically similar carbapenem-resistant Acinetobacter baumannii isolates were identified in the stool samples of three patients.
• The same bacterial strain was also found on the hands of a nurse involved in patient care.
• Crucially, the identical isolates were recovered from the water outlet spout and drain of an ice machine.

Conclusions:

• The findings indicate that contaminated ice machines can serve as a potential environmental reservoir for multidrug-resistant gram-negative bacilli.
• This highlights the need to consider non-obvious sources, such as ice machines, in infection control strategies to prevent the spread of resistant organisms.
• Further research into the role of environmental fomites in MDR-GN transmission is warranted.