National outbreak of Pseudomonas aeruginosa associated with an aftercare solution following piercings, July to September 2016, England

Evans, Hannah; Bolt, Hikaru; Heinsbroek, Ellen; Lloyd, Bryony H.; English, Peter M; Latif, Samia; Elviss, Nicola; Turton, Jane F.; Hoffman, Peter; Crook, Paul; Puleston, Richard

doi:10.2807/1560-7917.es.2018.23.37.1700795

Cited by 7 publications

(7 citation statements)

References 11 publications

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“…Cases of P. aeruginosa infections associated with the use of cosmetics rarely appear in the literature. The most severe case described in the literature concerned the national outbreak of P. aeruginosa associated with an aftercare solution following piercings in England . Also, corneal ulcers developed after the usage of Pseudomonas ‐contaminated mascara were identified in Egypt…”

Section: Discussionmentioning

confidence: 99%

“…The most severe case described in the literature concerned the national outbreak of P. aeruginosa associated with an aftercare solution following piercings in England. 28 Also, corneal ulcers developed after the usage of Pseudomonas-contaminated mascara were identified in Egypt. 29 The second most commonly identified species of Gramnegative bacteria in cosmetics was Enterobacter gergoviae.…”

Section: Main Findings Of the Studymentioning

confidence: 99%

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Microbiological contamination of cosmetic products – observations from Europe, 2005–2018

Michałek

John

Santos

2019

Acad Dermatol Venereol

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Background Although cosmetic products are not expected to be fully aseptic, their potential microbiological contamination might be dangerous, especially for immunocompromised patients. The extent of such contamination of cosmetics in Europe is poorly studied. Objectives The objective of this study was to explore whether microbiologically contaminated cosmetic products are available for sale in Europe and what type of contamination was reported. Methods We searched the European Union Rapid Information System for dangerous non‐food products (Rapex), a database of non‐compliant products among 31 European countries, to identify microbiologically contaminated cosmetics reported between 2005 and 2018, and present a detailed summary of these notifications. Results In the years 2005–2018, 104 reports on microbiologically contaminated cosmetics were identified. Twenty of them were products for children. The majority of the products (65.38%) were produced in Rapex member states. In most cases, contamination was caused by Gram‐negative bacteria (59.62%), mostly Pseudomonas spp. (35.58%) and Enterobacter spp. (11.54%). Conclusions Gram‐negative rod‐shaped bacteria are the most common microbiota contaminating cosmetic products in Europe. Most of the reported microbiologically contaminated cosmetics originated from European countries.

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Section: Discussionmentioning

confidence: 99%

Section: Main Findings Of the Studymentioning

confidence: 99%

Microbiological contamination of cosmetic products – observations from Europe, 2005–2018

Michałek

John

Santos

2019

Acad Dermatol Venereol

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“…31 In addition, as it is a polymerase chain reaction-based method, results can be generated rapidly and are portable between laboratories, making it preferable to PFGE, which is more laborious and not easily comparable between laboratories. Of the nine loci chosen for this scheme, the ninth is particularly discriminatory and may be used to evaluate relatedness between isolates from hospital outbreaks and in other settings among non-CF patients, [33][34][35][36] but this locus is not always useful for CF isolate discrimination, as variation in copy number may be found in different colonies from the same sputum sample.…”

Section: Use Of Variable Number Tandem Repeat In a Reference Laboratory Settingmentioning

confidence: 99%

Intravenous or oral antibiotic treatment in adults and children with cystic fibrosis and Pseudomonas aeruginosa infection: the TORPEDO-CF RCT

Hewer

Smyth

Brown

et al. 2021

Health Technol Assess

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Background People with cystic fibrosis are susceptible to pulmonary infection with Pseudomonas aeruginosa. This may become chronic and lead to increased mortality and morbidity. If treatment is commenced promptly, infection may be eradicated through prolonged antibiotic treatment. Objective To compare the clinical effectiveness, cost-effectiveness and safety of two eradication regimens. Design This was a Phase IV, multicentre, parallel-group, randomised controlled trial. Setting Seventy UK and two Italian cystic fibrosis centres. Participants Participants were individuals with cystic fibrosis aged > 28 days old who had never had a P. aeruginosa infection or who had been infection free for 1 year. Interventions Fourteen days of intravenous ceftazidime and tobramycin or 3 months of oral ciprofloxacin. Inhaled colistimethate sodium was included in both regimens over 3 months. Consenting patients were randomly allocated to either treatment arm in a 1 : 1 ratio using simple block randomisation with random variable block length. Main outcome measures The primary outcome was eradication of P. aeruginosa at 3 months and remaining free of infection to 15 months. Secondary outcomes included time to reoccurrence, spirometry, anthropometrics, pulmonary exacerbations and hospitalisations. Primary analysis used intention to treat (powered for superiority). Safety analysis included patients who had received at least one dose of any of the study drugs. Cost-effectiveness analysis explored the cost per successful eradication and the cost per quality-adjusted life-year. Results Between 5 October 2010 and 27 January 2017, 286 patients were randomised: 137 patients to intravenous antibiotics and 149 patients to oral antibiotics. The numbers of participants achieving the primary outcome were 55 out of 125 (44%) in the intravenous group and 68 out of 130 (52%) in the oral group. Participants randomised to the intravenous group were less likely to achieve the primary outcome; although the difference between groups was not statistically significant, the clinically important difference that the trial aimed to detect was not contained within the confidence interval (relative risk 0.84, 95% confidence interval 0.65 to 1.09; p = 0.184). Significantly fewer patients in the intravenous group (40/129, 31%) than in the oral group (61/136, 44.9%) were hospitalised in the 12 months following eradication treatment (relative risk 0.69, 95% confidence interval 0.5 to 0.95; p = 0.02). There were no clinically important differences in other secondary outcomes. There were 32 serious adverse events in 24 participants [intravenous: 10/126 (7.9%); oral: 14/146 (9.6%)]. Oral therapy led to reductions in costs compared with intravenous therapy (–£5938.50, 95% confidence interval –£7190.30 to –£4686.70). Intravenous therapy usually necessitated hospital admission, which accounted for a large part of this cost. Limitations Only 15 out of the 286 participants recruited were adults – partly because of the smaller number of adult centres participating in the trial. The possibility that the trial participants may be different from the rest of the cystic fibrosis population and may have had a better clinical status, and so be more likely to agree to the uncertainty of trial participation, cannot be ruled out. Conclusions Intravenous antibiotics did not achieve sustained eradication of P. aeruginosa in a greater proportion of cystic fibrosis patients. Although there were fewer hospitalisations in the intravenous group during follow-up, this confers no advantage over the oral therapy group, as intravenous eradication frequently requires hospitalisation. These results do not support the use of intravenous antibiotics to eradicate P. aeruginosa in cystic fibrosis. Future work Future research studies should combine long-term follow-up with regimens to reduce reoccurrence after eradication. Trial registration Current Controlled Trials ISRCTN02734162 and EudraCT 2009-012575-10. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 65. See the NIHR Journals Library website for further project information.

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“…Another example is the tracking of Pseudomonas infections to a cleaning solution marketed for ear piercings; WGS of the organisms in infected individuals proved conclusively that they had been infected by organisms within a barrel used to produce the cleaning solution. This enabled rapid tracking, successful removal of the inadequately manufactured product, and in fact, prosecution (Evans et al., 2018).…”

Section: Infectious Disease Surveillancementioning

confidence: 99%

Introduction to the genomics of infectious diseases

Rafi

Hayward

English

2020

InnovAiT: Education and inspiration for general practice

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The COVID-19 Genomics UK (COG-UK) Consortium was created to deliver large-scale and rapid whole-genome virus sequencing. Its data will help Public Health Agencies to manage the COVID-19 pandemic in the UK and inform vaccine research efforts. From a wider perspective, data sharing around the genomics of viruses (and bacteria, protozoa parasites and fungi) offers researchers contrasting perspectives and new biological insights into the evolution of microbes and the development of new tools in managing infectious disease, which on a global scale causes significant mortality. Genomics has an evolving role in pathogen diagnosis and surveillance.

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National outbreak of Pseudomonas aeruginosa associated with an aftercare solution following piercings, July to September 2016, England

Cited by 7 publications

References 11 publications

Microbiological contamination of cosmetic products – observations from Europe, 2005–2018

Microbiological contamination of cosmetic products – observations from Europe, 2005–2018

Intravenous or oral antibiotic treatment in adults and children with cystic fibrosis and Pseudomonas aeruginosa infection: the TORPEDO-CF RCT

Introduction to the genomics of infectious diseases

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