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Volume 26, Number 8—August 2020
Dispatch

Spread of Multidrug-Resistant Bacteria by Moth Flies from Hospital Waste Water System

Thomas Rupprecht1, Annette Moter, Alexandra Wiessener, Joerg Reutershan, Klaus Lang-Schwarz, Michael Vieth, Christian Rupprecht, Ruediger Wagner, and Thomas Bollinger1Comments to Author 
Author affiliations: Klinikum Bayreuth, Bayreuth, Germany (T. Rupprecht, J. Reutershan, K. Lang-Schwarz, M. Vieth, T. Bollinger); Friedrich-Alexander University, Erlangen, Germany (T. Rupprecht, M. Vieth); Charité-Universitätsmedizin, Berlin, Germany (A. Moter, A. Wiessener); Eberhard Karls University, Tübingen, Germany (J. Reutershan); University of Oxford, Oxford, UK (C. Rupprecht); Universität Kassel, Kassel, Germany (R. Wagner); University Hospital Schleswig-Holstein, Lübeck, Germany (T. Bollinger)

Main Article

Table 2

Multidrug resistant bacteria on moth flies and biofilm in a hospital, Germany*

No. Specimens tested Location found Species identified† Can produce biofilm? Resistance level‡ Macroscopic/
histologic findings
1
 Biofilm
 Sewage line
 Achromobacter xylosoxidans
 Yes
 Not classified
 Biofilm, Candida, mucin, eggs
2 Biofilm Sewage line Pseudomonas spp. Yes Potential XDR§ Biofilm, cocoons, eggs
Escherichia coli MDR
Lysinibacillus fusiformis
3
 Moth fly
 OR 7
 Bacillus spp., Citrobacter freundii
 Yes
 MDR
 NA
4 Biofilm Endoscopy of sewage lines in washroom, OR 7 Advenella species Yes Potential XDR§ Extensive biofilm in all sewage lines, mucin, Candida
Bacillus spp. Yes
Pseudomonas aeuginosa Yes
Stenotrophomonas maltophilia
Moth fly
 Washroom OR 7
 Sterile
 NA
 ND
 NA
5
 Moth fly
 Corridor OR 7
 P. mosselii
S. maltophilia
 Yes
 Potential XDR§
 NA
7
 Moth fly
 Corridor OR 1-6
 Bacillus spp.
B. megatariume
 Yes
Yes
 ND
 NA
8
 Moth fly
 Corridor ICU CS
 Bacillus spp.
 Yes
NA
9 Moth fly Toilet (A3-40) S. maltophilia Potential XDR§
2 moth flies
 Toilet (A3-40)
 Sterile
 NA
 ND
 NA
10 Moth fly Doctors room (A3-43) Bacillus spp.
P. nitroreducens Yes
Yes ND NA
Moth fly
 Doctors room (A3-43)
 B. cereus
B. thuringienses
 Yes
Yes
 ND
 NA
14
 Moth fly
 Toilet (A3-06)
 Bacillus spp.
B. cereus
Chryseobacterium indologenses
 Yes
 ND
 NA
16 Biofilm Shower drain B. cereus
Bacillus spp.
P. putida Yes ND Biofilm, eggs, Candida albicans
Moth fly Shower (F3-07) Bacillus cereus
L. sphaericus
Staphylococcus epidermidis Yes ND NA
2 moth flies
 Shower (F3-07)
 S. maltophilia
B. thuringiensis
 Yes
 Potential XDR
 NA
17 Moth fly Shower (F3-31) Enterococcus faecium (vanA)
Bacillus spp.
S. maltophilia Yes Possible XDR¶
Potential XDR§ NA
Moth fly
 Shower (F3-31)
 E. faecium
 Yes
 MDR
 NA
24 Moth fly ICU floor C Sterile NA ND NA

*Numbers at left are patient numbers, which correspond to the numbers in Table 1 and Figure 1, panel C. CS, cardiosurgery; C, cardiology; ICU, intensive care unit; MDR, multidrug resistant; OR, operating room; NA, not applicable; ND, not detected; XDR, extensively drug resistant.
†Microbiology, histology, and fluorescence in situ hybridization findings in the investigated specimens. Note that not every moth fly from the Table 1 count column was analyzed.
‡Resistance levels defined in Magiorakos et al. (13).
§Potential XDR means that the international standards have not been applied to the bacterium S. maltophilia. Additional details are available in the Appendix.
¶Possible XDR means that it could be XDR but not all antimicrobial categories were tested. Additional details are available in the Appendix.

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References
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1These authors were co–principal investigators.

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Page updated: July 18, 2020
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