Effective prevention of Pseudomonas aeruginosa cross-infection at a cystic fibrosis centre – Results of a 10-year prospective study

Wiehlmann, Lutz; Cramer, Nina; Ulrich, Jutta; Hedtfeld, Silke; Weißbrodt, H.; Tümmler, Burkhard

doi:10.1016/j.ijmm.2011.11.001

Cited by 33 publications

(27 citation statements)

References 40 publications

(51 reference statements)

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“…For ex-ample, there is a separate clinic for people infected with MRSA or a separate clinic for people infected with an epidemic strain of P. aeruginosa. 1,161,185,374,375,[444][445][446] While cohort segregation has been associated with a reduced incidence of LES of P. aeruginosa 185,373,375,444 and a decrease in the incidence and prevalence of Burkholderia spp. in the United States, 44 additional IP&C practices were also implemented at the same time.…”

Section: Ivf1 Cohort Segregation Versus All-patient Separationmentioning

confidence: 99%

“…Concurrent practices included recommending no socialization among people with CF in nonhealthcare settings, alternatives to common waiting rooms, removal of common toys and books, an emphasis on hand hygiene, single-use mouthpieces for PFT equipment, and aggressive eradication protocols for P. aeruginosa. 375,[444][445][446] Therefore, it is difficult to conclude which IP&C practices were most important for successfully decreasing transmission.…”

Section: Ivf1 Cohort Segregation Versus All-patient Separationmentioning

confidence: 99%

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Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Saiman

Siegel

LiPuma

et al. 2014

Infect. Control Hosp. Epidemiol.

345

382

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The 2013 Infection Prevention and Control (IP&C) Guideline for Cystic Fibrosis (CF) was commissioned by the CF Foundation as an update of the 2003 Infection Control Guideline for CF. During the past decade, new knowledge and new challenges provided the following rationale to develop updated IP&C strategies for this unique population:1. The need to integrate relevant recommendations from evidence-based guidelines published since 2003 into IP&C practices for CF. These included guidelines from the Centers for Disease Control and Prevention (CDC)/Healthcare Infection Control Practices Advisory Committee (HICPAC), the World Health Organization (WHO), and key professional societies, including the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). During the past decade, new evidence has led to a renewed emphasis on source containment of potential pathogens and the role played by the contaminated healthcare environment in the transmission of infectious agents. Furthermore, an increased understanding of the importance of the application of implementation science, monitoring adherence, and feedback principles has been shown to increase the effectiveness of IP&C guideline recommendations.2. Experience with emerging pathogens in the non-CF population has expanded our understanding of droplet transmission of respiratory pathogens and can inform IP&C strategies for CF. These pathogens include severe acute respiratory syndrome coronavirus and the 2009 influenza A H1N1. Lessons learned about preventing transmission of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant gram-negative pathogens in non-CF patient populations also can inform IP&C strategies for CF.

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Section: Ivf1 Cohort Segregation Versus All-patient Separationmentioning

confidence: 99%

Section: Ivf1 Cohort Segregation Versus All-patient Separationmentioning

confidence: 99%

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Saiman

Siegel

LiPuma

et al. 2014

Infect. Control Hosp. Epidemiol.

345

382

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

“…aeruginosa infection, as well as, the onset of chronic infection in several settings (Frederiksen et al 1999;Wiehlmann et al 2012). …”

Section: Introductionmentioning

confidence: 99%

“…Acquisition of P. aeruginosa from environmental sources has historically been considered the primary route of acquisition; however, person-to-person transmission and nosocomial acquisition have also been identified as potential infection sources (Jones et al 2003; Kidd et al. 2015;Knibbs et al 2014;Ranganathan et al 2013; Saiman et al 2014;Wiehlmann et al 2012).To reduce the risk of cross-infection infection control guidelines recommend the implementation of numerous practices including hand hygiene, rigorous cleaning of equipment and facilities designated areas for airway clearance and nebuliser use and single rooms for hospital admissions (Saiman et al 2014). Improved infection control has been shown to reduce the incidence and prevalence of P.…”

mentioning

confidence: 99%

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Diversity of environmental and clinical Pseudomonas aeruginosa isolates

Ramsay¹

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Background and AimsThe bacterium Pseudomonas aeruginosa is a versatile environmental organism which is capable of persisting within a diverse range of habitats. For people with cystic fibrosis (CF), P. aeruginosa is the most common bacterial species isolated from respiratory secretions and infection is associated with poor health outcomes and decreased life expectancy.Molecular-based epidemiological studies have shown that patients with CF can harbour indistinguishable genotypes (shared strains) of P. aeruginosa that have not been isolated from natural or commonly encountered environments sources. It is speculated that these shared strains are acquired by person-to-person transmission and have become highly niche-adapted to the CF airway. However, the specific mechanisms relating to the transmission, host adaptation and persistence of these strains remain uncertain.By thoroughly characterising P. aeruginosa isolates from a defined cohort of patients this thesis aims to determine the prevalence and diversity of strains among adults with CF, and using phenotypic and genomic methods, to explore the key differences pertaining to adaptation between shared and unique strains of P. aeruginosa strains sourced from a range of ecological settings. MethodsLongitudinal analysis of respiratory pathogens from adults with CF was undertaken to determine the prevalence of P. aeruginosa and other major CF pathogens. Univariate analysis was conducted to determine change in prevalence over time.P. aeruginosa isolates at two time points from adults with CF underwent single nucleotide polymorphism (SNP) based genotyping to assess the incidence and prevalence of shared strains. Statistical analyses was undertaken to find associations between acquisition of shared strains and health outcomes.Bacterial motility and adhesion was determined for clinical (CF, non-CF and animal) and environmental P. aeruginosa isolates. Each assay was performed under varied atmospheric conditions. Regression analysis was performed to assess an association between genotype and phenotype.iii CF and environmental P. aeruginosa isolates were grown a dynamic flow cell system to allow for the development and visualisation of biofilm structures. Following incubation and staining, three dimensional images were captured and resulting data analysed using Comstat software.Mixed effects models were used to compare relevant biofilm parameters.Bioinformatic analysis was performed on CF and environmental P. aeruginosa isolates.Genetic variants associated with phenotypic characteristics were identified. ResultsThe prevalence of significant airway pathogens declined over the study period. For paediatric patients at the time of transition, this decline was correlated with an improvement in lung function. Interestingly, the prevalence of chronic P. aeruginosa infection remained stable.While the proportion of patients harbouring the shared strain AUST-02 declined over time, there was a marked increase in those infected with the AUST-06 strain. In contrast, the prevale...

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Decreased Pseudomonas aeruginosa detection in children after separation of pediatric from adult cystic fibrosis clinics: A single center experience

Barnes

Gaillard

Menk

et al. 2018

Pediatric Pulmonology

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Background The impact of separating the adult from pediatric patients on Pseudomonas aeruginosa (P. aeriginosa) detection in the respiratory cultures of patients was examined at the University of Minnesota CF Center. Methods This study was a retrospective review using data recorded in the University of Minnesota CF Database between 1995 and 2010. Respiratory culture results obtained during routine University of Minnesota Cystic Fibrosis (CF) Center. CF clinic encounters of two cohorts of pediatric and adult CF patients (pre‐ and post‐separation) were analyzed for presence of P. aeruginosa. Results The odds of a pediatric patient having P. aeruginosa were significantly less if the first culture was obtained after separation of pediatric and adult clinics. Being diagnosed by newborn screening or introduction of inhaled tobramycin did not affect this outcome. This reduction in P. aeruginosa was not detected in the adult cohort. Conclusions Separation of pediatric and adult CF clinics has contributed to decrease in P. aeruginosa detection in pediatric patients.

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Effective prevention of Pseudomonas aeruginosa cross-infection at a cystic fibrosis centre – Results of a 10-year prospective study

Cited by 33 publications

References 40 publications

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Diversity of environmental and clinical Pseudomonas aeruginosa isolates

Decreased Pseudomonas aeruginosa detection in children after separation of pediatric from adult cystic fibrosis clinics: A single center experience

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