An Outbreak of Pseudomonas aeruginosa Infection Caused by Contaminated Mouth Swabs

Iversen, Bjørn G.; Jacobsen, Trond; Eriksen, Hanne-Merete; Bukholm, Geir; Melby, K; Nygård, Karin; Aavitsland, Preben

doi:10.1086/511644

Cited by 55 publications

(52 citation statements)

References 109 publications

(168 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1,3,6,13,14,17,19,20 Hemodialysis was one of the factors that was associated with the outcome in univariate analysis in the present study but was not kept in the final model. temporal, spatial and clinical associations between this variable and the dependent variable (infection or colonization by MR-PA strain during hospitalization) were observed during the study.…”

Section: Discussionmentioning

confidence: 77%

“…1,[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Among immunocompromised patients with human immunodeficiency virus (HIV) infection or AIDS, few studies have shown prior hospitalization, antimicrobial use, and CD4 cell count below 50/mm 3 as risk factors for P. aeruginosa infection. [21][22][23] none of these HIV/AIDS studies assessed the risk factors for acquisition of MR-PA strains.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Factors associated with epidemic multiresistant Pseudomonas aeruginosa infections in a hospital with AIDS-predominant admissions

Gomes¹,

Oliveira²,

Machado³

et al. 2012

Braz J Infect Dis

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Factors associated with epidemic multiresistant Pseudomonas aeruginosa infections in a hospital with AIDS-predominant admissions

Gomes¹,

Oliveira²,

Machado³

et al. 2012

Braz J Infect Dis

View full text Add to dashboard Cite

“…P. aeruginosa has also been linked to infectious outbreaks from contaminated medical devices. This is mainly due to the organism's ability to effectively produce a biofilm that allows adherence to plastic materials and catheters and helps prevent destruction by antibiotics [24][25][26] . This property, along with increasing broad-spectrum antibiotic use, especially in critical care settings, has led to an increase in MDR strains across the USA and the world [2] .…”

Section: Quinolone Resistancementioning

confidence: 99%

Emerging Resistant Gram-Negative Aerobic Bacilli in Hospital-Acquired Infections

2010

View full text Add to dashboard Cite

The increasing emergence of serious multidrug-resistant (MDR) Gram-negative infections has led to a new health-care crisis. These infections predominately include MDR Pseudomonas aeruginosa, extended-spectrum beta-lactamase-producing Enterobacteriaceae and MDR Acinetobacter baumannii. These organisms are present in a variety of clinical settings, but there is a distinct paucity of antibiotics to effectively treat these infections. The increasing use of broad-spectrum antibiotics and lack of good stewardship have contributed to the increase in these MDR organisms. This review focuses on the main MDR Gram-negative infections contributing to the current crisis in health care, their mechanisms of resistance and various treatment options for empiric therapy.

show abstract

“…Pseudomonas aeruginosa is a Gram-negative bacterium that is well known to be involved in a large number of human infections (14,30). Numerous outbreaks have been linked directly to its presence on medical equipment (11,15,16,25). The persistence of this bacterium in the environment can be attributed to its ability to form biofilms that increase its resistance to disinfection treatments.…”

mentioning

confidence: 99%

Dynamics of the Action of Biocides in Pseudomonas aeruginosa Biofilms

Bridier

Dubois‐Brissonnet

Greub

et al. 2011

Antimicrob Agents Chemother

109

View full text Add to dashboard Cite

The biocidal activity of peracetic acid (PAA) and benzalkonium chloride (BAC) on Pseudomonas aeruginosa biofilms was investigated by using a recently developed confocal laser scanning microscopy (CLSM) method that enables the direct and real-time visualization of cell inactivation within the structure. This technique is based on monitoring the loss of fluorescence that corresponds to the leakage of a fluorophore out of cells due to membrane permeabilization by the biocides. Although this approach has previously been used with success with various Gram-positive species, it is not directly applicable to the visualization of Gram-negative strains such as P. aeruginosa, particularly because of limitations regarding fluorescence staining. After adapting the staining procedure to P. aeruginosa, the action of PAA and BAC on the biofilm formed by strain ATCC 15442 was investigated. The results revealed specific inactivation patterns as a function of the mode of action of the biocides. While PAA treatment triggered a uniform loss of fluorescence in the structure, the action of BAC was first localized at the periphery of cell clusters and then gradually spread throughout the biofilm. Visualization of the action of BAC in biofilms formed by three clinical isolates then confirmed the presence of a delay in penetration, showing that diffusion-reaction limitations could provide a major explanation for the resistance of P. aeruginosa biofilms to this biocide. Biochemical analysis suggested a key role for extracellular matrix characteristics in these processes.The control of microbial surface contamination is a major concern in terms of public health. Pseudomonas aeruginosa is a Gram-negative bacterium that is well known to be involved in a large number of human infections (14, 30). Numerous outbreaks have been linked directly to its presence on medical equipment (11,15,16,25). The persistence of this bacterium in the environment can be attributed to its ability to form biofilms that increase its resistance to disinfection treatments. Numerous studies have indeed reported the high resistance of P. aeruginosa biofilms (compared to their planktonic counterparts) to numerous biocides, including chlorine, quaternary ammonium compounds, and aldehydes (5,10,13,26). Although the precise mechanisms underlying this resistance remain unclear, it appears to be a multifactorial process that is primarily related to the physiological and structural characteristics of the biofilm. It is now generally accepted that biofilms constitute heterogeneous structures that group subpopulations with distinct physiological states and resistance phenotypes (28).Data on biocide reactivity within these heterogeneous structures could provide a clearer understanding of the mechanisms involved in biofilm resistance and ultimately facilitate the development of new and more efficient treatments. Recently, a noninvasive technique based on confocal laser scanning microscopy (CLSM) was developed and used to investigate spatial and temporal patterns of antimicrobial...

show abstract

An Outbreak of Pseudomonas aeruginosa Infection Caused by Contaminated Mouth Swabs

Abstract: Contamination of mouth swabs during production caused the largest-ever outbreak of P. aeruginosa infection in Norway. Susceptible patient groups should use only documented quality-controlled, high-level-disinfected products and items in the oropharynx.

Cited by 55 publications

References 109 publications

Factors associated with epidemic multiresistant Pseudomonas aeruginosa infections in a hospital with AIDS-predominant admissions

Factors associated with epidemic multiresistant Pseudomonas aeruginosa infections in a hospital with AIDS-predominant admissions

Emerging Resistant Gram-Negative Aerobic Bacilli in Hospital-Acquired Infections

Dynamics of the Action of Biocides in Pseudomonas aeruginosa Biofilms

Contact Info

Product

Resources

About