Abstract

During June 2017–November 2019, a total 36 patients with carbapenem-resistant Pseudomonas aeruginosa harboring Verona-integron–encoded metallo-β-lactamase were identified in a city in western Texas, USA. A faucet contaminated with the organism, identified through environmental sampling, in a specialty care room was the likely source for infection in a subset of patients.

Verona-integron–encoded metallo-β-lactamase–producing carbapenem-resistant Pseudomonas aeruginosa (VIM-CRPA) and other carbapenemase-producing organisms (CPOs) are emerging public health threats. CPOs cause infections that are often extensively drug-resistant and associated with substantial rates of illness and death. By colonizing faucet aerators and wastewater plumbing systems, CPOs can spread rapidly within healthcare facilities, including to patients (1–9). VIM is a carbapenemase, a type of enzyme that inactivates carbapenems and other β-lactam antimicrobial drugs that are frequently encoded on mobile genetic elements, which in turn can lead to horizontal spread.

VIM-CRPA is uncommon in the United States; <150 isolates are reported to CDC annually (10). During June 2017–November 2019, in a city of 250,000 residents in western Texas, USA (city A), 36 patients with VIM-CRPA were identified. Most were hospitalized for >1 night at an acute-care hospital (hospital A) in the 6 months before VIM-CRPA was isolated, but patients did not have overlapping hospital stays or common procedures. We assessed water sources and plumbing in hospital A to identify potential VIM-CRPA reservoirs.

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