P-365. Outbreak of Carbapenemase-Producing Organisms in the Cardiovascular ICU Linked to "Hoppers"
Bibliographic record
Abstract
Abstract Background Between June and October 2023, a Canadian cardiac centre recognized a growing number of carbapenemase producing organisms (CPO) in patients in the cardiovascular intensive care unit (CVICU). The organisms were mainly KPC-producing Enterobacterales. Following declaration of an outbreak in the CVICU at the Mazankowski Heart Institute, we investigated the sources of CPO across the unit and in patient rooms to determine environmental reservoirs and mechanisms of patient transmission. Methods We employed prevalence screening to identify cases, environmental sampling to identify source, and comparison of patient strains utilizing whole genome sequencing (WGS) during the investigation. Results Between June and October 2023, five patients were identified as being colonized or infected with CPO-KPC. WGS of patient samples confirmed clonality with less than 10 SNV differences in the plasmid . Environmental sampling revealed drains in the hand-hygiene sinks and medical sinks used for disposal of liquid clinical waste (“hoppers”) harboured CPO. Using GlowGermTM, we found that the faucets of the hoppers resulted in a ∼30cm splash zone causing contamination of medical supplies and health care workers. GlowGermTM did not reveal splash from drains of hand hygiene sinks. Because the hoppers were the only temperature controlled water source on the unit, the majority of faucet use was to collect warm water for bathing patients. As a solution, the unit was equipped with single-use packages of chlorhexidine wipes in warmers for patient bathing. To prevent accidental use of the hoppers, the faucet handles were removed. Since implementing these changes, prevalence screening has not identified any further cases of CPO carriage or infection over 5 months. Conclusion A CPO-KPC outbreak in CVICU was linked to splashback from faucets of hoppers primarily used to collect warm water for sponge-bathing. The outbreak was ended by cessation of faucet use and transition to chlorhexidine wipes for patient bathing. Disclosures All Authors: No reported disclosures
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".