Pseudomonas aeruginosa in a Neonatal Intensive Care Unit: Reservoirs and Ecology of the Nosocomial Pathogen

Grundmann, Hajo; Kropec, Andrea; Hartung, Doris; Berner, Reinhard; Daschner, Franz

doi:10.1093/infdis/168.4.943

Cited by 93 publications

(29 citation statements)

References 20 publications

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“…To identify a possible inanimate source, 14 cultures were performed of moist areas (eg, sinks, faucets, and water samples), equipment (eg, respirators and bedside monitors), and containers of hand lotions and soaps.…”

Section: Surveillance Cultures Of Patients and The Environmentmentioning

confidence: 99%

An Outbreak ofPseudomonas aeruginosaPneumonia and Bloodstream Infection Associated With Intermittent Otitis Externa in a Healthcare Worker

Zawacki¹,

OʼRourke

Potter-Bynoe³

et al. 2004

Infect. Control Hosp. Epidemiol.

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ArstractObjectives:To investigate an outbreak ofPseudomonas aeruginosapneumonia and bloodstream infection among four neonates, determine risk factors for infection, and implement preventive strategies.Design:Retrospective case finding; prospective surveillance cultures of patients, personnel, and environmental sites; molecular typing by pulsed-field gel electrophoresis; and a matched case-control study.Patients and Setting:Neonates in the level-III neonatal intensive care unit of a tertiary-care pediatric institution.Interventions:Cohorting of patients with positive results forP. aeruginosa, work restrictions for staff with positive results, implementation of an alcohol-based hand product, review of infection control policies and procedures, and closure of the unit until completion of the investigation.Results:Seven (4%) of 190 environmental cultures and 5 (3%) of 178 cultures of individual healthcare workers' hands grewP. aeruginosa. All four outbreak isolates and one previous bloodstream isolate were genotypically identical, as were theP. aeruginosaisolates from the hands and external auditory canal of a healthcare worker with intermittent otitis externa. Four of 5 case-patients versus 5 of 15 matched control-patients had been cared for by this healthcare worker (P= .05). The healthcare worker was treated and no further cases occurred.Conclusions:These findings suggest that a healthcare worker with intermittent otitis externa may have caused this cluster of fatalP. aeruginosainfections, adding the external ear to the list of colonized body sites that may serve as a source of potentially pathogenic organisms.

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Section: Surveillance Cultures Of Patients and The Environmentmentioning

confidence: 99%

An Outbreak ofPseudomonas aeruginosaPneumonia and Bloodstream Infection Associated With Intermittent Otitis Externa in a Healthcare Worker

Zawacki¹,

OʼRourke

Potter-Bynoe³

et al. 2004

Infect. Control Hosp. Epidemiol.

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“…It can cause severe infections that may be associated with high rates of mortality in immunocompromised patients (3,8,24), and it is a frequent cause of infections acquired by patients during hospitalization (4). Almost any type of hospital equipment or utensil has been implicated as a reservoir for P. aeruginosa, and these sources may serve as foci for the dissemination of the organism in common-source outbreaks (9).…”

mentioning

confidence: 99%

Development of a Multilocus Sequence Typing Scheme for the Opportunistic Pathogen Pseudomonas aeruginosa

et al. 2004

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A multilocus sequence typing (MLST) scheme has been developed for Pseudomonas aeruginosa which provides molecular typing data that are highly discriminatory and electronically portable between laboratories. MLST data confirm the data from previous studies that suggest that P. aeruginosa is best described as nonclonal but as having an epidemic population. The index of association was 0.17, indicating a freely recombining population; however, there was evidence of clusters of closely related strains or clonal complexes among the members of this population. It is apparent that the sequence types (STs) from single isolates, representing each of the present epidemic clones in the United Kingdom from Liverpool, Manchester, and the West Midlands, are not closely related to each other. This suggests distinct evolutionary origins for each of these epidemic clones in the United Kingdom. Furthermore, these clones are distinct from European clone C. Comparison of the results of MLST with those of toxA typing and serotyping revealed that strains with identical STs may possess different toxA types and diverse serotypes. Given that recombination is important in the population of P. aeruginosa, the lack of a linkage between toxA type and serotype is not surprising and reveals the strength of the MLST approach for obtaining a better understanding of the epidemiology of P. aeruginosa.

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“…Alguns patógenos como a Serratia e a Pseudomonas podem utilizar alguns equipamentos (incubadoras, nebulizadores e circuitos respiratórios) como reservatórios em unidades de terapia intensiva 26 .…”

Section: Infecções Em Unidades Neonataisunclassified

Pediatric nosocomial infections

Carvalho¹,

Marques²

1999

J Pediatr (Rio J)

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Objective: Considering that the nosocomial infections have been a serious problem of public health all over the world in both developed and developing countries, this revision has the aim of amplifying the pediatrician's knowledge, in different interfaces of the question.Methods: A review of the articles from the specific literature of the area leading to a practical presentation of the topics as well on the personal experience of the writers, who work in this area.Results: We have characterized which topics are important when dealing with nosocomial infection as, for example, the concepts used in nosocomial infections, the methods of epidemiological surveillance, the nosocomial infections in pediatric critical areas as the intensive care and the neonatal units, the techniques of isolation and precaution, ending with general and specific preventive actions.Conclusion: Technical knowledge about the central questions in nosocomial infections should be basis for a conscious and responsible involvement of all the professionals in the health area to control and prevent these infections. ResumoObjetivo: Considerando que as infecções nosocomiais têm sido um sério problema de saúde pública em todo o mundo, tanto em países desenvolvidos como nos em desenvolvimento, tem essa revisão o objetivo de ampliar o conhecimento do pediatra em diferentes interfaces da questão.Métodos: Foram revistos artigos da literatura específica da área, apresentando-se o tema de maneira prática e fundamentado, também, na experiência pessoal dos autores, que atuam na área.Resultados: Descrevemos no artigo tópicos que consideramos de importância no manejo das infecções hospitalares, como conceitos utilizados em infecção hospitalar, métodos de vigilância epidemiológica, infecção hospitalar em áreas críticas da pediatria como unidades de terapia intensiva e neonatal, ténicas de isolamento e precauções, finalizando com medidas preventivas gerais e especí-ficas.Conclusão: O conhecimento técnico sobre as questões a serem discutidas em infecção hospitalar deve fornecer subsidios para envolver todos os profissionais da área da saúde de forma consciente e responsável frente ao controle e prevenção dessas infecções. As infecções nosocomiais têm sido um sério problema de saúde que afeta 3% a 6% dos pacientes hospitalizados nos Estados Unidos, resultando em aumento no tempo de internação, nos custos hospitalares e uma estimativa de 20.000 óbitos por ano. Representam nesse país a sexta causa de óbitos por ano.No Brasil alguns dados publicados revelam índices que variam de 1,5% a 15%, conforme estudos efetuados pelo GEPRO (Grupo Especial de Programas) da Secretaria de Estado da Saúde de São Paulo.Em 1994, realizou-se um estudo de prevalência das infecções hospitalares em 103 hospitais terciários, localizados em capitais brasileiras, com o objetivo de diagnosticar o problema das infecções hospitalares, direcionando planos de ações e investimentos. A taxa de infecção hospitalar foi de 13%. A prevalência de IH da UTI neonatal foi a mais alta (46,9%), se...

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Pseudomonas aeruginosa in a Neonatal Intensive Care Unit: Reservoirs and Ecology of the Nosocomial Pathogen

Cited by 93 publications

References 20 publications

An Outbreak ofPseudomonas aeruginosaPneumonia and Bloodstream Infection Associated With Intermittent Otitis Externa in a Healthcare Worker

An Outbreak ofPseudomonas aeruginosaPneumonia and Bloodstream Infection Associated With Intermittent Otitis Externa in a Healthcare Worker

Development of a Multilocus Sequence Typing Scheme for the Opportunistic Pathogen Pseudomonas aeruginosa

Pediatric nosocomial infections

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