Epidemiology of Pseudomonas aeruginosa and risk factors for carriage acquisition in an intensive care unit

Thuong, Marie; Arvaniti, Kostoula; Ruimy, Raymond; Salmonière, Pauline de La; Scanvic-Hameg, A.; Lucet, J.‐C.; Régnier, B.

doi:10.1053/jhin.2002.1370

Cited by 105 publications

(61 citation statements)

References 20 publications

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“…In an 18-bed ICU in France, 26% of the admitted patients acquired P. aeruginosa carriage or colonization. Of those with P. aeruginosa carriage, 23% ended with infection, that is almost 6% of all admitted patients during the study time [21].…”

Section: Discussionmentioning

confidence: 99%

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

Cortés¹,

Cuervo²,

Urdaneta³

et al. 2009

Braz J Infect Dis

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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.

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Section: Discussionmentioning

confidence: 99%

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

Cortés¹,

Cuervo²,

Urdaneta³

et al. 2009

Braz J Infect Dis

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“…22,23 Many authors have advocated the use of surveillance cultures to improve the control of infections with multiresistant pathogens in high-risk settings, but the benefit of this strategy remains to be evaluated. 24 We agree with previous observation that surveillance of patients with MR-PA infections must be accompanied by an early implementation of an intervention program whenever required.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, gastrointestinal carriage appears to Gomes be a prerequisite for P. aeruginosa colonization and/or infection at other sites, and the intestinal tract is considered the most important reservoir of P. aeruginosa. 22,25 However, the sensitivity of rectal swabs in detecting small inocula is suboptimal, 22 and patients with colonization at sites other than the intestinal tract may have been missed. 25,26 Our intention was to perform surveillance of patients with MR-PA infections in a real-life hospital setting with limited resources so that the surveillance program would be easy to accomplish.…”

Section: Discussionmentioning

confidence: 99%

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

Gomes¹,

Machado²,

Conceição³

et al. 2011

Braz J Infect Dis

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Introduction: Authors have reported increased incidence of multiresistant Pseudomonas aeruginosa (MR-PA) infections worldwide over the last decade. Researchers have proposed multifaceted approaches to control MR-PA infections, but none have been reported in the acquired immunodeficiency syndrome (AIDS) setting. Objective and Methods: Herein we report the impact of a multifaceted intervention for controlling MR-PA over five years in a hospital with AIDS-predominant admissions and describe the clinical characteristics of MR-PA infection in our patient population. The clinical outcomes of infected patients and molecular characteristics of the isolated strains were used as tools for controlling MR-PA infection rates. Results: Significant temporary decrease of new infections was achieved after intervention, although a high level of diagnostic suspicion of nosocomial infection was maintained. We obtained 35 P. aeruginosa isolates with multiresistant profiles from 13 infected and 3 colonized patients and 2 environmental samples. Most of the patients (94%) were immunocompromised with AIDS (n = 10) or HTLV-1 infections (n = 5). Of the followed patients, 67% had persistent and/or recurrent infections, and 92% died. We observed differences in the antibiotic-resistance pattern of MR-PA infection/colonization during two outbreaks, although the genetic profiles of the tested strains were identical. Conclusions: Therefore, we concluded that early multidisciplinary interventions are essential for reducing the burden caused by this microorganism in patients with AIDS. Prolonged or suppressive antibiotic-based therapy should be considered for MR-PA infections in patients with AIDS because of the persistence characteristic of MR-PA in these patients.

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“…PFGE has been shown to be an excellent epidemiological tool for the discrimination of related and unrelated isolates of P. aeruginosa. 6,7 Tenover et al defined categories of genetic and epidemiological relatedness of isolates using PFGE. 8 However, they suggested that these guidelines should be used to examine relatively small sets of isolates (typically %30) related to putative outbreaks of disease.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological analysis of carbapenem-sensitive and -resistant Pseudomonas aeruginosa

Walsh

Bracher

Turner

et al. 2005

Journal of Hospital Infection

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Summary Pseudomonas aeruginosa with decreased levels of meropenem susceptibility were identified in the Royal Infirmary Edinburgh in 2002. Within the affected group of patients, none had meropenem-resistant P. aeruginosa when they arrived in the intensive care unit (ICU). Seven isolates from the ICU were collected five months after the decreased susceptibility to meropenem was identified. In order to investigate if resistance was a problem in P. aeruginosa throughout Edinburgh, both in hospital-and community-acquired isolates, a prospective study was performed. The susceptibilities of 104 P. aeruginosa to imipenem, meropenem, ceftazidime, piperacillin/tazobactam and ciprofloxacin were investigated. Meropenem had the highest activity against these isolates and the lowest MIC 90 (2 mg/L), followed by imipenem (4 mg/L), ciprofloxacin (8 mg/L), piperacillin/tazobactam (16 mg/L) and ceftazidime (32 mg/L). These isolates were also analysed genotypically by pulsed-field gel electrophoresis. Five of the seven ICU isolates were identified, one isolate was 98% similar and the other was 85% similar to the ICU isolates. One isolate from the prospective study had approximately 90% genotype similarity to the six ICU isolates with R98% similarity. There was no clonality within the strains from the prospective study and clusters with O90% similarity comprised at five or less isolates. Isolates with the same resistance patterns did not necessarily have the same genotypic profile. Strains isolated from different patients on the same day were also not necessarily related. The conclusions of this study were that while the seven ICU isolates were clonal or highly related, they were not widespread throughout Edinburgh and the P. aeruginosa within Edinburgh were highly varied.

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Epidemiology of Pseudomonas aeruginosa and risk factors for carriage acquisition in an intensive care unit

Cited by 105 publications

References 20 publications

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

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

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

Epidemiological analysis of carbapenem-sensitive and -resistant Pseudomonas aeruginosa

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