Exogenous acquisition of Pseudomonas aeruginosa in intensive care units: a prospective multi-centre study (DYNAPYO study).
Cohort Studies
Cross Infection
/ epidemiology
Disease Outbreaks
/ prevention & control
Electrophoresis, Gel, Pulsed-Field
/ methods
France
/ epidemiology
Genotype
Humans
Intensive Care Units
/ statistics & numerical data
Mass Screening
/ methods
Prospective Studies
Pseudomonas Infections
/ epidemiology
Pseudomonas aeruginosa
/ genetics
Risk Assessment
Water Microbiology
Intensive care unit
Pseudomonas aeruginosa
Pulsed-field gel electrophoresis
Water taps
Journal
The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
03
06
2019
accepted:
06
08
2019
pubmed:
17
8
2019
medline:
12
11
2020
entrez:
17
8
2019
Statut:
ppublish
Résumé
Pseudomonas aeruginosa remains one of the most common nosocomial pathogens in intensive care units (ICUs). Although exogenous acquisition has been widely documented in outbreaks, its importance is unclear in non-epidemic situations. To elucidate the role of exogenous origin of P. aeruginosa in ICU patients. A chronological analysis of the acquisition of P. aeruginosa was performed using samples collected in 2009 in the DYNAPYO cohort study, during which patients and tap water were screened weekly. Molecular relatedness of P. aeruginosa isolates was investigated by pulsed-field gel electrophoresis. Exogenous acquisition was defined as identification of a P. aeruginosa pulsotype previously isolated from another patient or tap water in the ICU. The DYNAPYO cohort included 1808 patients (10,402 samples) and 233 water taps (4946 samples). Typing of 1515 isolates from 373 patients and 375 isolates from 81 tap water samples identified 296 pulsotypes. Analysis showed exogenous acquisition in 170 (45.6%) of 373 patients. The pulsotype identified had previously been isolated from another patient and from a tap water sample for 86 and 29 patients, respectively. The results differed according to the ICU. Exogenous acquisition of P. aeruginosa could be prevented in half of patients. The overall findings of this survey support the need for studies on routes of transmission and risk assessment approach to better define how to control exogenous acquisition in ICUs.
Sections du résumé
BACKGROUND
BACKGROUND
Pseudomonas aeruginosa remains one of the most common nosocomial pathogens in intensive care units (ICUs). Although exogenous acquisition has been widely documented in outbreaks, its importance is unclear in non-epidemic situations.
AIM
OBJECTIVE
To elucidate the role of exogenous origin of P. aeruginosa in ICU patients.
METHODS
METHODS
A chronological analysis of the acquisition of P. aeruginosa was performed using samples collected in 2009 in the DYNAPYO cohort study, during which patients and tap water were screened weekly. Molecular relatedness of P. aeruginosa isolates was investigated by pulsed-field gel electrophoresis. Exogenous acquisition was defined as identification of a P. aeruginosa pulsotype previously isolated from another patient or tap water in the ICU.
FINDINGS
RESULTS
The DYNAPYO cohort included 1808 patients (10,402 samples) and 233 water taps (4946 samples). Typing of 1515 isolates from 373 patients and 375 isolates from 81 tap water samples identified 296 pulsotypes. Analysis showed exogenous acquisition in 170 (45.6%) of 373 patients. The pulsotype identified had previously been isolated from another patient and from a tap water sample for 86 and 29 patients, respectively. The results differed according to the ICU.
CONCLUSION
CONCLUSIONS
Exogenous acquisition of P. aeruginosa could be prevented in half of patients. The overall findings of this survey support the need for studies on routes of transmission and risk assessment approach to better define how to control exogenous acquisition in ICUs.
Identifiants
pubmed: 31419468
pii: S0195-6701(19)30320-2
doi: 10.1016/j.jhin.2019.08.008
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
40-45Informations de copyright
Copyright © 2019 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.