New Delhi metallo-β-lactamase-producing carbapenem-resistant Escherichia coli associated with exposure to duodenoscopes.

Importance: Carbapenem-resistant Enterobacteriaceae (CRE) producing the New Delhi metallo-β-lactamase (NDM) are rare in the United States, but have the potential to add to the increasing CRE burden. Previous NDM-producing CRE clusters have been attributed to person-to-person transmission in health care facilities.

Objective: To identify a source for, and interrupt transmission of, NDM-producing CRE in a northeastern Illinois hospital.

Investigation and control of an outbreak of Achromobacter xylosoxidans bacteremia.

Objective: To define the extent of an outbreak of Achromobacter xylosoxidans bacteremia, determine the source of the outbreak, and implement control measures.

Design: An outbreak investigation, including environmental and infection control assessment, and evaluation of hypotheses using the binomial distribution and case control studies.

Setting: A 50-bed medical surgical unit in a hospital in Illinois during the period January 1-July 15, 2006.