Epidemiology of Pseudomonas aeruginosa Infections in a Neonatal Intensive Care Unit

Abstract

During the 19-month study period, 48 (2 per cent) of the 2177 neonates admitted to the neonatal intensive care unit (NICU) yielded Pseudomonas aeruginosa growths in blood cultures. All these neonates had clinical and haematological evidences of sepsis. Prominent clinical features included sclerema, violaceus necrotic patches, necrotizing enterocolitis (NEC), conjugated hyperbilirubinaemia, and DIC. Over all mortality was 23 per cent, distinctly higher in premature neonates with RDS. The mean gestational age and birth weights (+/- SD) of these neonates were 36.42 (+/- 2.73) weeks and 2173.34 (+/- 567.33) g, respectively. Approximately half of the total cases had low birth weight. Other adverse perinatal events before the development of sepsis included birth asphyxia (60 per cent), neonatal resuscitation (67 per cent), meconium aspiration syndrome (29 per cent), hyaline membrane disease (8 per cent), prolonged hospitalization (44 per cent), closed incubator care (17 per cent), prolonged intravenous fluids (42 per cent), repeated blood sampling (63 per cent), and umbilical catheterization (4 per cent). Analysis of the trend of Pseudomonas sepsis in our NICU revealed six definite outbreaks (more than two cases) interspersed with occasional (one or two) cases. Six study months, however, remained free of Pseudomonas sepsis. Index case was demonstrable on seven occasions. Bacteriological surveillance of the NICU after onset of initial case/cases revealed statistically significant colonization of resuscitation equipment, baby placement sites, and various cleansing solutions by the same bacterial species (P < 0.05). It is possible that Pseudomonas was introduced to our NICU from transfer admissions from other hospitals since on four occasions index case was the one transferred from outside.(ABSTRACT TRUNCATED AT 250 WORDS)

Pseudomonas aeruginosaType III secretion system interacts with phagocytes to modulate systemic infection of zebrafish embryos

“…We have not observed this phenomenon in either S. arizonae or M. marinum infection, suggesting that it is specific to certain bacteria, including PA. The consistent occurrence of this phenomenon intrigued us, because thrombotic complications are associated with PA infections in humans (Gupta et al ., 1993). While these cellular aggregates are comprised principally of erythrocytes and proerythroblasts, we also noted the presence of phagocytes within them.…”

Branched Chain Fatty Acids Reduce the Incidence of Necrotizing Enterocolitis and Alter Gastrointestinal Microbial Ecology in a Neonatal Rat Model

“…In addition, P. aeruginosa levels were similar in the DF group and the Control group, despite the lack of NEC in the DF group. Reports of P. aeruginosa association with NEC are mixed [61], [62]. Recent data show that BCFA, specifically iso -14:0, anteiso -15:0 iso -16:0, and anteiso -17:0, repress motility in P. aeruginosa without significantly inhibiting its growth in liquid cultures [63].…”

Pseudomonas aeruginosain a neonatal intensive care unit: molecular epidemiology and infection control measures

“…Pseudomonas aeruginosa , a non-fermentative, gram-negative rod, is responsible for a wide variety of clinical syndromes in NICU patients, including sepsis, pneumonia, meningitis, diarrhea, conjunctivitis and skin infections [6]. Nevertheless, if compared to other gram-negative bacteria, outbreaks by P. aeruginosa in NICU settings have been much less reported up-to-date and have been associated with both environmental reservoirs and healthcare workers' carriage [7-10].…”