Pseudomonas species contamination of cystic fibrosis patients' home inhalation equipment

Pitchford, Karen C.; Corey, Mary; Highsmith, Anita K.; Perlman, Rosemary; Bannatyne, Robert M.; Gold, Ronald; Levison, Henry; Ford-Jones, E. Lee

doi:10.1016/s0022-3476(87)80069-0

Cited by 69 publications

(54 citation statements)

References 3 publications

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“…As the vast majority of environmental P. aeruginosa isolates were found in the bathroom of the patients, it would be advisable to pay special attention to the cleaning and disinfecting procedures for bathrooms. Compared with data from other studies [30,31], contamination of the nebulisers with P. aeruginosa in the present study was low. These findings suggest that the specific disinfecting procedures of the nebuliser equipment, as advised by the medical committee of the Belgian CF patient association [32], are effective.…”

Section: Resultscontrasting

confidence: 90%

Pseudomonas aeruginosa in the home environment of newly infected cystic fibrosis patients

Schelstraete¹,

Daele²,

Boeck³

et al. 2008

European Respiratory Journal

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The source of acquisition of Pseudomonas aeruginosa in cystic fibrosis (CF) patients remains unknown. Patient-to-patient transmission has been well documented but the role of the environment as a source of initial infection is as yet unclear.In the present study, the origin of the first P. aeruginosa isolate in CF patients was investigated by comparing the P. aeruginosa genotype(s) from newly infected patients with genotypes of P. aeruginosa isolates from the home environment and from other patients from the same CF centre.A total of 50 newly infected patients were studied. P. aeruginosa could be cultured from 5.9% of the environmental samples, corresponding to 18 patients. For nine of these, the genotype of the environmental P. aeruginosa isolate was identical to the patient's isolate. In total, 72% of the environmental P. aeruginosa isolates were encountered in the bathroom. Patient-to-patient transmission within the CF centre could not be ruled out for three patients.In summary, a low prevalence of Pseudomonas aeruginosa was found in the home environment of the newly infected cystic fibrosis patients. The bathroom should be targeted in any preventive cleaning procedures. An environmental source of the new infection could not be ruled out in nine patients.

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Section: Resultscontrasting

confidence: 90%

Pseudomonas aeruginosa in the home environment of newly infected cystic fibrosis patients

Schelstraete¹,

Daele²,

Boeck³

et al. 2008

European Respiratory Journal

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“…[428][429][430][431][432] Additionally, cleaning and drying home respiratory therapy equipment between uses was associated with a decreased risk of acquiring B. cepacia complex. 1 In a study of experimental contamination of nebulizers, hot water and soap effectively removed most inoculated bacteria.…”

Section: Ive3 Nonhealthcare Settings: Nebulizersmentioning

confidence: 99%

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Saiman

Siegel

LiPuma

et al. 2014

Infect. Control Hosp. Epidemiol.

346

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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“…However, several lines of circumstantial evidence suggest that contaminated respiratory therapy equipment used in the home may play a role in the acquisition of potential pathogens by patients with CF. First, contamination of home (95,97,157,168). Second, use of aerosolized medications was associated with earlier acquisition of P. aeruginosa in a newborn screening study (104).…”

Section: Care Of Respiratory Therapy Equipmentmentioning

confidence: 99%

Infection Control in Cystic Fibrosis

2004

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Over the past 20 years there has been a greater interest in infection control in cystic fibrosis (CF) as patient-to-patient transmission of pathogens has been increasingly demonstrated in this unique patient population. The CF Foundation sponsored a consensus conference to craft recommendations for infection control practices for CF care providers. This review provides a summary of the literature addressing infection control in CF. Burkholderia cepacia complex, Pseudomonas aeruginosa, and Staphylococcus aureus have all been shown to spread between patients with CF. Standard precautions, transmission-based precautions including contact and droplet precautions, appropriate hand hygiene for health care workers, patients, and their families, and care of respiratory tract equipment to prevent the transmission of infectious agents serve as the foundations of infection control and prevent the acquisition of potential pathogens by patients with CF. The respiratory secretions of all CF patients potentially harbor clinically and epidemiologically important microorganisms, even if they have not yet been detected in cultures from the respiratory tract. CF patients should be educated to contain their secretions and maintain a distance of >3 ft from other CF patients to avoid the transmission of potential pathogens, even if culture results are unavailable or negative. To prevent the acquisition of pathogens from respiratory therapy equipment used in health care settings as well as in the home, such equipment should be cleaned and disinfected. It will be critical to measure the dissemination, implementation, and potential impact of these guidelines to monitor changes in practice and reduction in infections

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Pseudomonas species contamination of cystic fibrosis patients' home inhalation equipment

Cited by 69 publications

References 3 publications

Pseudomonas aeruginosa in the home environment of newly infected cystic fibrosis patients

Pseudomonas aeruginosa in the home environment of newly infected cystic fibrosis patients

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Infection Control in Cystic Fibrosis

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