Outbreak of nosocomial urinary tract infections due to Pseudomonas aeruginosa in a paediatric surgical unit associated with tap-water contamination

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

“…29 Previous P. aeruginosa outbreak investigations have also confirmed the waterborne source through the detection of P. aeruginosa in swabs from drains and faucets. 5,6,11,13,14,20 Notably, in this case and despite the established link between aerators and drains swabs and clinical cases, P. aeruginosa was not isolated from water by culture during the outbreak. The high level of aerator positivity (ie, 4 of the 5 positive aerators harbored strains shared with clinical isolates during the outbreak) led to the hypothesis of retrograde contamination from the drain.…”

“…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.…”

Microbial Contamination of Suction Tubes Attached to Suction Instrument and Its Preventive Methods

“…BAL using suction tubes that are contaminated or have not been disinfected runs the risk of the contamination of patients and BALF, which may induce nosocomial infection (2,3). When suction tubes are washed or disinfected in sink such as the ward or outpatient clinic, water drops containing patients' body fluid and microorganism's splash on health care workers, which runs the risk of exposure and infection (4)(5)(6). The use of disposable (single-use) suction tubes or washing/disinfection of suction tubes in each patient is necessary.…”

Characterization of the poxAB Operon Encoding a Class D Carbapenemase in Pseudomonas aeruginosa,

“…Specifically, a study found P. aeruginosa was able to not only grow but thrive in the distilled water of several mist therapy units (28). Tap water is also a major source of nosocomial infections when it is inadvertently used for the preparation of solutions to be used in that setting (29)(30)(31)(32)(33). The prevalence of P. aeruginosa in tap water likely results from the colonization of showerheads, faucets, and sinks from which it has also been detected (32,(34)(35)(36)(37)(38).…”

“…OprD is specific for basic amino acids, dipeptides and carbapenems (imipenem, meropenem, doripenem) (20,21,23,34). In the clinical setting, exposure to imipenem often leads to mutations, deletions or insertions in oprD and loss of the protein resulting in impermeability and clinical resistance to imipenem (29)(30)(31)(32)(33)38). Although loss of OprD also increases the MIC against meropenem, it does not by itself usually lead to clinical resistance (303)(304)(305), presumably because meropenem can also get inside the cells via other routes (306)(307)(308).…”