“…The epidemiological importance of P. aeruginosa from water systems has been debated because it could be argued that patients contaminate their environment directly or indirectly rather than vice versa. However, prospective studies in ICUs, including isolate typing, confirmed that contaminated water systems can be a source of infection; this finding was supported by the fact that corrective actions on water systems led to a significant decrease in P. aeruginosa infections caused by water isolates (Petignat et al., ; Rogues et al., ; Romano et al., ; Vallés et al., ). Furthermore, a correlation was observed between high prevalence of faucet contamination and number of cases of patients who harbor a genotype that is identical to one isolated from the water (Cuttelod et al., ).…”
Pseudomonas aeruginosa is an opportunistic bacterial pathogen that is widely occurring in the environment and is recognized for its capacity to form or join biofilms. The present review consolidates current knowledge on P. aeruginosa ecology and its implication in healthcare facilities premise plumbing. The adaptability of P. aeruginosa and its capacity to integrate the biofilm from the faucet and the drain highlight the role premise plumbing devices can play in promoting growth and persistence. A meta‐analysis of P. aeruginosa prevalence in faucets (manual and electronic) and drains reveals the large variation in device positivity reported and suggest the high variability in the sampling approach and context as the main reason for this variation. The effects of the operating conditions that prevail within water distribution systems (disinfection, temperature, and hydraulic regime) on the persistence of P. aeruginosa are summarized. As a result from the review, recommendations for proactive control measures of water contamination by P. aeruginosa are presented. A better understanding of the ecology of P. aeruginosa and key influencing factors in premise plumbing are essential to identify culprit areas and implement effective control measures.
“…The epidemiological importance of P. aeruginosa from water systems has been debated because it could be argued that patients contaminate their environment directly or indirectly rather than vice versa. However, prospective studies in ICUs, including isolate typing, confirmed that contaminated water systems can be a source of infection; this finding was supported by the fact that corrective actions on water systems led to a significant decrease in P. aeruginosa infections caused by water isolates (Petignat et al., ; Rogues et al., ; Romano et al., ; Vallés et al., ). Furthermore, a correlation was observed between high prevalence of faucet contamination and number of cases of patients who harbor a genotype that is identical to one isolated from the water (Cuttelod et al., ).…”
Pseudomonas aeruginosa is an opportunistic bacterial pathogen that is widely occurring in the environment and is recognized for its capacity to form or join biofilms. The present review consolidates current knowledge on P. aeruginosa ecology and its implication in healthcare facilities premise plumbing. The adaptability of P. aeruginosa and its capacity to integrate the biofilm from the faucet and the drain highlight the role premise plumbing devices can play in promoting growth and persistence. A meta‐analysis of P. aeruginosa prevalence in faucets (manual and electronic) and drains reveals the large variation in device positivity reported and suggest the high variability in the sampling approach and context as the main reason for this variation. The effects of the operating conditions that prevail within water distribution systems (disinfection, temperature, and hydraulic regime) on the persistence of P. aeruginosa are summarized. As a result from the review, recommendations for proactive control measures of water contamination by P. aeruginosa are presented. A better understanding of the ecology of P. aeruginosa and key influencing factors in premise plumbing are essential to identify culprit areas and implement effective control measures.
“…1 Several of these outbreaks have been directly or indirectly linked to water distribution systems. [2][3][4][5][6][7][8][9][10][11][12][13][14] In ICUs, 30%-50% of P. aeruginosa infections have been associated with water. 15 A multicentric prospective study recently established tap contamination in patient rooms as an important environmental risk factor for P. aeruginosa acquisition.…”
mentioning
confidence: 99%
“…16 Several factors promote water contamination, including the type of faucet, 9,17,18 the presence and type of aerator on the faucet, 19 the volume of mixed hot and cold water, 17 the alignment of the sink drain, 20 construction or renovation settings, and ICU vs non-ICU settings. 3,20 Once contaminated, eradication of P. aeruginosa in the water system is challenging and often results in replacing related devices 5,[7][8][9][10][11][12]14 or installing point-of-use 0.2-μm filters. 4,13,14 Although cultivation is the reference method, it may not reveal background contamination that may flare up when the environment becomes favorable for growth and culturability.…”
OBJECTIVETo perform a post-outbreak prospective study of the Pseudomonas aeruginosa contamination at the faucets (water, aerator and drain) by culture and quantitative polymerase chain reaction (qPCR) and to assess environmental factors influencing occurrenceSETTINGA 450-bed pediatric university hospital in Montreal, CanadaMETHODSWater, aerator swab, and drain swab samples were collected from faucets and analyzed by culture and qPCR for the post-outbreak investigation. Water microbial and physicochemical parameters were measured, and a detailed characterization of the sink environmental and design parameters was performed.RESULTSThe outbreak genotyping investigation identified drains and aerators as the source of infection. The implementation of corrective measures was effective, but post-outbreak sampling using qPCR revealed 50% positivity for P. aeruginosa remaining in the water compared with 7% by culture. P. aeruginosa was recovered in the water, the aerator, and the drain in 21% of sinks. Drain alignment vs the faucet and water microbial quality were significant factors associated with water positivity, whereas P. aeruginosa load in the water was an average of 2 log higher for faucets with a positive aerator.CONCLUSIONSP. aeruginosa contamination in various components of sink environments was still detected several years after the resolution of an outbreak in a pediatric university hospital. Although contamination is often not detectable in water samples by culture, P. aeruginosa is present and can recover its culturability under favorable conditions. The importance of having clear maintenance protocols for water systems, including the drainage components, is highlighted.Infect. Control Hosp. Epidemiol. 2015;36(11):1283–1291
“…45 The contamination of medical equipment with P. aeruginosa biofilms contributes to hospital-acquired infections, particularly caused by antibiotic-resistant strains. [46][47][48][49][50] While other antibacterial agents fail to inhibit P. aeruginosa, two amphiphiles in this study [3 (M-P,12,12) and 8 (M-1,12,12)] kill this organism at relatively low concentrations, which may prove useful in a healthcare setting. Notably, MIC values of compounds 3 (M-P,12,12) and 8 (M-1,12,12) against P. aeruginosa (8 lM and 16 lM, respectively) are comparable to those of tobramycin (6.4 lM), commonly used to treat infection in cystic fibrosis patients, and cefepime (12.5 lM), an antipseudomonal cephalosporin.…”
Two novel series of tris-cationic, tripled-headed, double-tailed amphiphiles were synthesized and the effects of tail length and head group composition on the critical aggregation concentration (CAC), thermodynamic parameters, and minimum inhibitory concentration (MIC) against six bacterial strains were investigated. Synergistic antibacterial combinations of these amphiphiles were also identified. Amphiphiles in this study are composed of a benzene core with three benzylic ammonium bromide groups, two of which have alkyl chains, each 8-16 carbons in length. The third head group is a trimethylammonium or pyridinium. Log of critical aggregation concentration (log[CAC]) and heat of aggregation (ΔHagg) were both inversely proportional to the length of the linear hydrocarbon chains. Antibacterial activity increases with tail length until an optimal tail length of 12 carbons per chain, above which, activity decreased. The derivatives with two 12 carbon chains had the best antibacterial activity, killing all tested strains at concentrations of 1-2μM for Gram-positive and 4-16μM for Gram-negative bacteria. The identity of the third head group (trimethylammonium or pyridinium) had minimal effect on colloidal and antibacterial activity. The antibacterial activity of several binary combinations of amphiphiles from this study was higher than activity of individual amphiphiles, indicating that these combinations are synergistic. These amphiphiles show promise as novel antibacterial agents that could be used in a variety of applications.
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