Identifying and controlling a multiresistant pseudomonas aeruginosa outbreak in a latin-american cancer centre and its associated risk factors

Abstract

Pseudomonas aeruginosa is an important and frightening microorganism for patients suffering from cancer. Multiresistant P. aeruginosa (MRPA) may appear as a consequence of exposure to multiple antibiotics or from a breakdown in infection control practices. This article reports an MRPA outbreak in a cancer treatment centre and the consequent case control study. Mechanical ventilation was identified as being the main risk factor for developing MRPA colonisation or infection; molecular analysis confirmed the outbreak. A multifaceted strategy was adopted, involving reinforcing hand-washing practices, contact isolation, antibiotic restriction and suction devices for mechanically-ventilated patients. MRPA was controlled and the outbreak ended. Such strategy may be effective in controlling MRPS in low-resource environments amongst high risk cancer patients.

Outbreaks, persistence, and high mortality rates of multiresistant Pseudomonas aeruginosa infections in a hospital with AIDS-predominant admissions

“…21 However, a multifaceted infection control program can temporarily control the transmission of this infection. 3,5 To the best of our knowledge, this is the first report to describe the epidemiological characteristics of MDR-PA/XDR-PA infection outbreaks that were temporarily controlled but not eradicated in patients with AIDS, in whom persistent MR-PA infections likely increase the risk of transmission.…”

“…5,12 We used several educational activities and resources such as posters, folders, and signs during the study period. Continuous education is important even in hospitals specialized in treating infectious diseases, where all health care workers have some knowledge about the risk of nosocomial infections.…”

“…[1][2][3][4][5][6][7][8] These infections are usually associated with high mortality rates. [1][2][3][4][5][6] Also, in patients with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS), authors have described persistent and recurrent infections caused by non-MR-PA strains. 9,10 Pulsed-field gel electrophoresis (PFGE) is the recommended technique for determining the genotypes of nosocomial pathogens.…”

“…11 Researchers have used it in several studies to confirm the similarity of P. aeruginosa strains, suggesting the importance of cross-colonization, 11,12 and as a tool to control nosocomial infections. 3,12 Multifaceted strategies using molecular epidemiology approach for controlling MR-PA infection outbreaks in immunocompromised patients, especially those with cancer or admitted to intensive care units (ICUs), 3,5 have been adopted but none were described in patients with AIDS. In this report, we describe the surveillance and intervention measures used for controlling MR-PA infections over five years in an infectious disease hospital in Rio de Janeiro, Brazil, in which the majority of admitted patients have AIDS.…”

Pseudomonas aeruginosa resistente a antimicrobianos en hospitales colombianos

“…Las altas tasas de resistencia, y especialmente de multi-resistencia observadas en este estudio, podrían ser secundarias a la presencia de brotes en diversos hospitales, los cuales se han documentado ocasionalmente en Colombia y Venezuela 21,22 .…”