Multi-resistant Pseudomonas aeruginosa outbreak associated with contaminated tap water in a neurosurgery intensive care unit

Bert, Frédéric; E, Maubec; Bruneau, B.; Berry, P J; Lambert-Zechovsky, N

doi:10.1016/s0195-6701(98)90243-2

Cited by 165 publications

(96 citation statements)

References 20 publications

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“…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.…”

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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.…”

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confidence: 99%

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Post-Outbreak Investigation of Pseudomonas aeruginosa Faucet Contamination by Quantitative Polymerase Chain Reaction and Environmental Factors Affecting Positivity

Bédard

Laferrière

Charron

et al. 2015

Infect. Control Hosp. Epidemiol.

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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

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Post-Outbreak Investigation of Pseudomonas aeruginosa Faucet Contamination by Quantitative Polymerase Chain Reaction and Environmental Factors Affecting Positivity

Bédard

Laferrière

Charron

et al. 2015

Infect. Control Hosp. Epidemiol.

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“…[8][9][10][11] However, comparison between studies is often difficult, because definitions of multidrug resistance have not been uniform. 9,10,12 The reasons for increasing nosocomial spread of MDR isolates may include lack of adherence to approved infection control policies in hospitals, increasing or cumulative antimicrobial use, and changes in the public health infrastructure.…”

Section: Discussionmentioning

confidence: 99%

A prospective study to analyse antibiotic susceptibility pattern of Pseudomonas aeruginosa in a tertiary care hospital

Ameen¹,

Bairy

Imran

et al. 2016

Int J Basic Clin Pharmacol

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“…[12][13][14][15] However, comparison between studies is often difficult, because definitions of multidrug resistance have not been uniform. 13,14,16 To analyze the MDR P. aeruginosa our study was compared with Karlowsky JA et al, frequency of MDR isolates were considerably high and SDR isolates were very low; indicating progression of MDR (Figure 4).…”

Section: Mdrmentioning

confidence: 99%

Antimicrobial drug sensitivity pattern of Pseudomonas aeruginosa in respiratory infections

Ameen¹,

Prakash²,

Bairy³

et al. 2017

Int J Basic Clin Pharmacol

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Background: Pseudomonas aeruginosa, a gram-negative pathogen commonly associated with nosocomial infections is the most widespread multidrug-resistant pathogen causing pneumonia in hospitalized patients. Inadequate empirical therapy has been associated with high mortality and morbidity. Objective: To evaluate and analyze the antimicrobial susceptibility pattern of P. aeruginosa in respiratory infections in a tertiary care hospital.Methods: The study was carried out at Kasturba Hospital, Manipal from Jan 2011 to Dec 2011. Specimens of 63 in-patients were analyzed who were culture positive for P. aeruginosa.Results: Majority of patients were aged above 40yrs with a male preponderance. Specimens were taken from patients who were diagnosed with bronchiectasis, pneumonia, COPD, bronchial asthma etc. Overall the organism was most sensitive to carbapenems (87.3%) followed by cefoperazone-sulbactam combination (85.7%). Sensitivity to ceftazidime and cefepime was equal (82.5%) and was more when compared to piperacillin-tazobactam (81.5%). Overall resistance rate was highest for fluoroquinolones (23.8%) followed by aztreonam (22.2%).Conclusions: Hence we would like to recommend cefoperazone-sulbactam as the preferred antipseudomonal agent and carbapenems as reserved drugs in treating pseudomonal lung infections. Use of fluoroquinolones and aztreonam as monotherapy in resistant P. aeruginosa infections should be restricted.

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Multi-resistant Pseudomonas aeruginosa outbreak associated with contaminated tap water in a neurosurgery intensive care unit

Cited by 165 publications

References 20 publications

Post-Outbreak Investigation of Pseudomonas aeruginosa Faucet Contamination by Quantitative Polymerase Chain Reaction and Environmental Factors Affecting Positivity

Post-Outbreak Investigation of Pseudomonas aeruginosa Faucet Contamination by Quantitative Polymerase Chain Reaction and Environmental Factors Affecting Positivity

A prospective study to analyse antibiotic susceptibility pattern of Pseudomonas aeruginosa in a tertiary care hospital

Antimicrobial drug sensitivity pattern of Pseudomonas aeruginosa in respiratory infections

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