Nosocomial outbreak of severe Pseudomonas aeruginosa infections in haematological patients

Grigis, A.; Goglio, Antonio; Parea, M.; Gnecchi, Fabrizio; Minetti, Bruno; Barbui, Tiziano

doi:10.1007/bf00157395

Cited by 18 publications

(8 citation statements)

References 14 publications

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“…The presence of outbreak strains in tap water, not including only P. aeruginosa but also other microorganisms, seem to be an important factor in subsequent dispersion and potential disease transmission within a healthcare setting [8]. Regular disinfection of contaminated water lines, water fittings, and change of water aerators in critical areas can reduce the number of colony-forming units and was shown to reduce the number of healthcare associated infections due to water-borne pathogens [9].…”

Section: Discussionmentioning

confidence: 99%

Influence of pre- and post-usage flushing frequencies on bacterial water quality of non-touch water fittings

et al. 2013

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BackgroundNon-touch fittings have been reported to be susceptible for Pseudomonas aeruginosa accumulation. A number of factors may contribute to this, including the frequency of usage, duration of water stagnation, or presence of plastic materials. Programmable non-touch fittings are appearing which allow regular automated post-flushing with cold water to prevent water stagnation. However, the ideal duration of post-flushing is unknown as well as the effect of pre-rinsing with cold water before use.MethodsEight non-touch fittings with brass valve blocks were mounted on a mobile test sink and connected to the same central water pipe source, differing only in presence or absence of water connection pipes, length of connection pipe, frequency of usage, and time intervals for pre- and post-usage water flush. The total bacteria colony-forming unit (cfu) counts were obtained by the spread plate technique.ResultsLow frequency of water use in combination with a long stagnating water column resulted in high bacterial cfu counts. Post-usage flushing for 2 seconds did not differ from no flushing. Flushing for 10 seconds with cold water after use or 30 seconds flush before use were both the most effective measures to prevent non-touch fittings from biofilm formation over a period of 20 weeks.ConclusionFurther improvements in water fitting technology could possibly solve the problem of bacterial water contamination in health care settings.

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Section: Discussionmentioning

confidence: 99%

Influence of pre- and post-usage flushing frequencies on bacterial water quality of non-touch water fittings

et al. 2013

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“…In the analysis, only those studies in which the outbreak had been confirmed by genotyping of the Pseudomonas isolates were included (Tables 1-5). We then decided to include three additional publications: the first one from 1989 used antimicrobial sensitivity testing, and plasmid analysis [2]; the second one from 1993 used serotyping, pigment production, lysotyping, and antibiotic susceptibility testing [20], and the last one from 2006 described the nosocomial spread of pandrug-resistant P. aeruginosa sensitive only to colistin [21]. No typing of the isolates was performed for the latter study.…”

Section: Methodsmentioning

confidence: 99%

“…Although inoculation of blood culture bottles subsequently to that of the blood-gas machine was not a practice in the NICU, a new member of the staff had unwittingly performed this procedure (2 pseudoinfections). Grigis et al 1993 [20] Sanitary [31] Colonized/infected patients appeared to be the major source of cross-contamination. Patient-to-patient transmission via physicians / HCWs Contaminated antiseptic?…”

Section: Confirmation Of An Outbreak By Typing Of the Isolatesmentioning

confidence: 99%

Outbreaks of Pseudomonas aeruginosa in pediatric patients – Clinical aspects, risk factors and management

Simon

Krawtschenko

Reiffert

et al. 2015

J Pediatr Infect Dis

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Several outbreaks of Pseudomonas aeruginosa have been published in neonatal and pediatric patients, but no systematic analysis is available. Medline and outbreak-database search, systematic analysis of outbreak reports (confirmed by genotyping). Twenty-four studies were included. Outbreaks caused by P. aeruginosa resulted in high morbidity (median clinical infection rate: 68%; range: 0?100%), mortality (median 27%; 0?100%) and resource consumption in neonatal and pediatric inpatient facilities. In most cases, these outbreaks indicate certain breaches in basic hygienic practices or are due to the persistence of P. aeruginosa in environmental vectors and reservoirs (tap water, medical devices, and fomites). The majority of the reported isolates displayed multi-resistance to first-line antibiotics. The clinical observation of two or more temporally related cases of nosocomial P. aeruginosa infections should raise the suspicion of an outbreak particularly in high-risk pediatric patient populations (neonatal intensive care unit, pediatric intensive care unit, oncology) and when the isolate displays resistance to two or more first-line antibiotics. Strict hygienic barrier precautions should immediately be implemented, re-educated and supervised. Well-planned environmental culturing should be performed, paying special attention to water, water outlets, sinks and other wet areas, to identify environmental reservoirs. A water safety plan based on the WHO Guidelines for Drinking Water Quality must be introduced. The current strategy of empiric antibiotic treatment should be investigated by an infectious diseases' specialist. Genotyping of the isolates by pulse-field gel electrophoresis should be performed, but any interventions to interrupt further nosocomial spread should be carried out without waiting for the results.

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“…It is often found in moist environment and can cause infections in immunocompromised or otherwise susceptible hosts [1,2]. Numerous outbreaks have been associated with faulty or unclean medical equipment or products [3-9], contaminations from personnel or environmental reservoirs [10-16]. Cross-colonization and cross-contamination within hospitals has been documented [13,17,18].…”

Section: Introductionmentioning

confidence: 99%

Pseudomonas aeruginosa contamination of mouth swabs during production causing a major outbreak

Iversen

Eriksen

Bø

et al. 2007

Ann Clin Microbiol Antimicrob

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Nosocomial outbreak of severe Pseudomonas aeruginosa infections in haematological patients

Cited by 18 publications

References 14 publications

Influence of pre- and post-usage flushing frequencies on bacterial water quality of non-touch water fittings

Influence of pre- and post-usage flushing frequencies on bacterial water quality of non-touch water fittings

Outbreaks of Pseudomonas aeruginosa in pediatric patients – Clinical aspects, risk factors and management

Pseudomonas aeruginosa contamination of mouth swabs during production causing a major outbreak

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