Pseudomonas aeruginosa in CF and non-CF homes is found predominantly in drains

Purdy-Gibson, Megan E.; Hundley, Thomas C.; Eid, Nemr; Remold, Susanna K.

doi:10.1016/j.jcf.2014.10.008

Cited by 29 publications

(33 citation statements)

References 44 publications

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“…but also by several other known CF opportunistic pathogens (17)(18)(19)(20), including Stenotrophomonas maltophilia, Bordetella, Ochrobactrum, and Agrobacterium/ Rhizobium. As shown in previous studies, wastewater drains are the primary habitat of P. aeruginosa (10)(11)(12)(13); we confirm that siphons and other similar draining systems host a large number of opportunistic pathogens. These devices are more and more frequently described as reservoirs for pathogens and multidrug-resistant bacteria in both hospitals and domestic environments (21)(22)(23).…”

supporting

confidence: 89%

Chronic Airway Colonization by Achromobacter xylosoxidans in Cystic Fibrosis Patients Is Not Sustained by Their Domestic Environment

Dupont

Jumas‐Bilak

Doisy

et al. 2018

Appl Environ Microbiol

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spp. are nonfermentative Gram-negative bacilli considered emergent pathogens in cystic fibrosis (CF). Although some cross-transmission events between CF patients have been described, strains were mostly patient specific, suggesting sporadic acquisitions from nonhuman reservoirs. However, sources of these emergent CF pathogens remain unknown. A large collection of specimens ( = 273) was sampled in the homes of 3 CF patients chronically colonized by with the aim of evaluating the potential role of domestic reservoirs in sustaining airway colonization of the patients. Samples were screened for the presence of by using genus-specific molecular detection. Species identification, multilocus genotypes, and antimicrobial susceptibility patterns observed for environmental isolates were compared with those of clinical strains. Patient homes hosted a high diversity of species ( = 7), including and, two species previously isolated from human samples only, and genotypes ( = 15), all showing an overall susceptibility to antimicrobial agents. strains were mostly isolated from indoor moist environments and siphons, which are potential reservoirs for several CF emerging pathogens., the worldwide prevalent species colonizing CF patients, was not the major species inhabiting domestic environments. genotypes chronically colonizing the patients were not detected in their household environments. These results support the notions that the domestic environment could not be incriminated in sustained patient colonization and that after initial colonization, the environmental survival of clones adapted to the CF airways is probably impaired. spp. are worldwide emerging opportunistic pathogens in CF patients, able to chronically colonize the respiratory tract. Apart from regular consultations at the hospital CF center, patients spend most of their time at home. Colonization from nonhuman sources has been suggested, but the presence of spp. in CF patients' homes has not been explored. The domestic environments of CF patients chronically colonized by , especially wet environments, host several opportunistic pathogens, including a large diversity of species and genotypes. However, genotypes colonizing the patients were not detected in their domestic environments, making it unlikely that a shuttle between environment and CF airways is involved in persisting colonization. This also suggests that once the bacteria have adapted to the respiratory tract, their survival in the domestic environment is presumably impaired. Nevertheless, measures for reducing domestic patient exposure should be targeted on evacuation drains, which are frequently contaminated by CF opportunistic pathogens.

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supporting

confidence: 89%

Chronic Airway Colonization by Achromobacter xylosoxidans in Cystic Fibrosis Patients Is Not Sustained by Their Domestic Environment

Dupont

Jumas‐Bilak

Doisy

et al. 2018

Appl Environ Microbiol

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“…Recovery of P . aeruginosa from this sampling effort is described elsewhere [ 29 ], and, consistent with other studies of human households, indicated that this species differs from other Pseudomonas in being almost a drain specialist in a household context [ 14 , 29 – 32 ]. We explored a broad range of types of environments both inside and outside the home, in a longitudinal study including 15 households sampled up to 8 times each, over a 4.5-year period.…”

Section: Introductionsupporting

confidence: 76%

Pseudomonas putida and Pseudomonas fluorescens Species Group Recovery from Human Homes Varies Seasonally and by Environment

2015

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By shedding light on variation in time as well as in space, long-term biogeographic studies can help us define organisms’ distribution patterns and understand their underlying drivers. Here we examine distributions of Pseudomonas in and around 15 human homes, focusing on the P. putida and P. fluorescens species groups. We describe recovery from 10,941 samples collected during up to 8 visits per home, occurring on average 2.6 times per year. We collected a mean of 141 samples per visit, from sites in most rooms of the house, from the surrounding yards, and from human and pet occupants. We recovered Pseudomonas in 9.7% of samples, with the majority of isolates being from the P. putida and P. fluorescens species groups (approximately 62% and 23% of Pseudomonas samples recovered respectively). Although representatives of both groups were recovered from every season, every house, and every type of environment sampled, recovery was highly variable across houses and samplings. Whereas recovery of P. putida group was higher in summer and fall than in winter and spring, P. fluorescens group isolates were most often recovered in spring. P. putida group recovery from soils was substantially higher than its recovery from all other environment types, while higher P. fluorescens group recovery from soils than from other sites was much less pronounced. Both species groups were recovered from skin and upper respiratory tract samples from healthy humans and pets, although this occurred infrequently. This study indicates that even species that are able to survive under a broad range of conditions can be rare and variable in their distributions in space and in time. For such groups, determining patterns and causes of stochastic and seasonal variability may be more important for understanding the processes driving their biogeography than the identity of the types of environments in which they can be found.

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“…They may also contaminate similar environments in the home. PA has been found in the home environment, commonly in sinks and drains [8,9]. However, in only 9 out of 50 patients with acute PA infection was an identical strain isolated in both the patient and their home environment [9].…”

Section: Out Of Hospital Acquisition Through Environmental Reservoirsmentioning

confidence: 99%

Infection prevention and control in cystic fibrosis: a systematic review of interventions

Rowbotham

Palser

Smith

et al. 2019

Expert Review of Respiratory Medicine

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Introduction: Cystic fibrosis is a life-limiting genetic condition characterized by recurrent pulmonary infection. Acquisition of infection can occur from environmental reservoirs, person-to-person transmission and from the healthcare environment. Primary prevention of infections through infection prevention and control measures is an important strategy in cystic fibrosis care. Areas covered: Here we present a systematic review of the evidence base around infection prevention and control in cystic fibrosis. We found 36 studies and 7 guidelines that met our inclusion criteria. Strategies covered include cohort segregation, individual segregation, hand hygiene, facemasks, combination strategies, equipment strategies, and adherence. Quality of evidence overall was deemed low or very low. Most guideline recommendations have little or no evidence to support them. Expert opinion: Although low quality, there is an abundance of evidence suggesting segregation is beneficial in reducing pathogen spread. Undertaking high-quality studies may, therefore, be ethically challenging. Large-scale registry studies may provide a better strategy for answering questions on the efficacy of infection control policy. With the rise of antibiotic resistance, effective eradication of cystic fibrosis pathogens is becoming more difficult so primary prevention through infection control will become increasingly important over the coming years. ARTICLE HISTORY

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Pseudomonas aeruginosa in CF and non-CF homes is found predominantly in drains

Abstract: These findings implicate drains as important potential sources of P. aeruginosa infection. They suggest that maximizing P. aeruginosa control efforts for drains would reduce exposure with minimal extra burden to CF patients and families.

Cited by 29 publications

References 44 publications

Chronic Airway Colonization by Achromobacter xylosoxidans in Cystic Fibrosis Patients Is Not Sustained by Their Domestic Environment

Chronic Airway Colonization by Achromobacter xylosoxidans in Cystic Fibrosis Patients Is Not Sustained by Their Domestic Environment

Pseudomonas putida and Pseudomonas fluorescens Species Group Recovery from Human Homes Varies Seasonally and by Environment

Infection prevention and control in cystic fibrosis: a systematic review of interventions

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