The combined use of VIGI@ct® (bioMérieux) and fluorescent amplified length fragment polymorphisms in the investigation of potential outbreaks

• Published in: The Journal of hospital infection 2007-07, Vol.66 (3), p.262-268
• Main Authors: Fontana, C, Favaro, M, Pistoia, E.S, Minelli, S, Bossa, M.C, Altieri, A, Testore, G.P, Leonardis, F, Natoli, S, Favalli, C
• Format: Article
• Language: English
• Subjects: Bacterial Typing Techniques - methods; Biological and medical sciences; Cross Infection - diagnosis; Cross Infection - prevention & control; Disease Outbreaks - prevention & control; F-AFLP; General aspects; Genotype; Human infectious diseases. Experimental studies and models; Humans; Infection Control - methods; Infectious Disease; Infectious diseases; Intensive Care Units; Italy; Medical Records Systems, Computerized; Medical sciences; Polymorphism, Restriction Fragment Length; Sentinel Surveillance; Surveillance of hospital infections; Typing methods
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2007.04.004

Summary Even with good surveillance programmes, hospital-acquired infections (HAIs) are not always recognized and this may lead to an outbreak. In order to reduce this risk, we propose a model for prompt detection of HAIs, based on the use of a real-time epidemiological information system called VIGI@ct® (bioMèrieux, Las Balmas, France) and on the rapid confirmation or exclusion of the genetic relationship among pathogens using fluorescent amplified length fragment polymorphism (f-AFLP) microbial fingerprinting. We present the results of one year's experience with the system, which identified a total of 306 suspicious HAIs. Of these, 281 (92%) were ‘confirmed’ by clinical evidence, 16 (5%) were considered to be simple colonization and the latter nine (3%) were archived as ‘not answered’ because of the absence of the physician's cooperation. There were seven suspected outbreaks; of these, f-AFLP analysis confirmed the clonal relationship among the isolates in four cases: outbreak 1 (four isolates of Pseudomonas aeruginosa ), outbreak 2 (three Escherichia coli isolates), outbreak 6 (two Candida parapsilosis isolates) and outbreak 7 (30 ESβL-producing Klebsiella pneumoniae subsp. pneumoniae ). Based on our results, we conclude that the combination of VIGI@ct® and f-AFLP is useful in the rapid assessment of an outbreak due to Gram-positive or Gram-negative bacteria and yeasts.