In a startling discovery, an ICU patient in Southern California was found to have contracted a rare strain of Pseudomonas aeruginosa that was resistant to antibiotics—a strain carrying the dangerous NDM-1 gene. This gene, notorious for breaking down powerful antibiotics, raised immediate alarms among medical staff at UCLA Health.

Dr. Shangxin Yang, the director of the Molecular Microbiology and Pathogen Genomics Laboratory at UCLA Health, noted, "This strain was concerning, especially since it was found in a patient with no history of international travel. While NDM-1 is common in places like Asia and Europe, seeing it in the U.S. was alarming—the implications could be dire."

A Mysterious Spread

Over the following year and a half, six more patients tested positive for the same strain, but these cases appeared scattered and unrelated, complicating the investigation and defying typical outbreak patterns. After diligent investigation, the infection control teams traced the source back to a singular, unexpected location: an ICU sink that was contaminated.

The Hunt for Answers

When the NDM-1 strain was discovered, Dr. Yang reached out to Dr. Dan Uslan, UCLA Health's Chief Infection Prevention Officer. His team began an exhaustive search to uncover the origins of the infection, investigating everything from shared equipment to environmental surfaces. However, no clear connections emerged immediately.

Advanced Tracking Technology

To determine if the infections were interlinked, Dr. Yang's lab utilized whole-genome sequencing (WGS). This sophisticated technology analyzes the complete DNA makeup of the bacteria, allowing the team to pinpoint genetic similarities. The results were revealing—seven of the eight cases shared nearly identical DNA signatures, linking them directly to the contaminated sink.

The Sink: An Unlikely Culprit

The breakthrough discovery came from environmental testing, which revealed that the sink's drain and plumbing held the same resistant strain found in the patients. The bacteria thrived in biofilms—layers that protect them from cleaning agents—making it extremely difficult to eradicate.

A Multilayered Response

To combat the outbreak, the hospital introduced a series of aggressive interventions, including: weekly treatments with a specialized disinfectant known as Virasept™, which can effectively break down bacterial biofilms; replacing entire sections of plumbing; and adjusting faucets to minimize water splashing into the sink and onto medical supplies.

Additionally, hospital staff received training on the importance of keeping patient care items away from the sink’s splash zone, further reducing the risk of cross-contamination.

A Proven Strategy

Since these measures were implemented, there have been no new cases reported, showcasing the effectiveness of proactive pathogen management and environmental hygiene.

Important Lessons for Hospitals

This incident highlights critical takeaways for healthcare facilities everywhere: the necessity for continuous pathogen surveillance, real-time testing, and the importance of collaboration among teams. Dr. Uslan remarked, "Our success was a result of teamwork across infection prevention, microbiology, and facilities management—a true community effort to eliminate a hidden threat."

The fight against superbugs like Pseudomonas aeruginosa is ongoing, but this remarkable case demonstrates how vigilance, technology, and cooperation can thwart even the most challenging outbreaks.