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“Down the drain”: carbapenem-resistant bacteria in intensive care unit patients and handwashing sinks

One of the most concerning emerging resistance traits among gram-negative bacteria is the ability of these organisms to produce carbapenem-hydrolysing β-lactamases, which confer resistance to almost all β-lactams.1 Carbapenem-resistant Enterobacteriaceae (CRE) are increasing in prevalence worldwide, causing growing concern, as they are often combined with non-β-lactam resistance to produce isolates that are multidrug resistant, have few treatment options available and are associated with high mortality rates.2

Although multiple resistance mechanisms have been identified, carbapenem resistance is often plasmid-encoded, allowing gene dissemination and a propensity to cause nosocomial outbreaks.36

We describe a CRE outbreak due to the presence of the metallo-β-lactamase gene blaIMP-4 in an intensive care unit (ICU) associated with contaminated sinks. This report highlights the key role of bacterial…