Epidemiology of Pseudomonas aeruginosa and risk factors for carriage acquisition in an intensive care unit - PubMed (original) (raw)
Epidemiology of Pseudomonas aeruginosa and risk factors for carriage acquisition in an intensive care unit
M Thuong et al. J Hosp Infect. 2003 Apr.
Abstract
Because of a high prevalence of Pseudomonas aeruginosa infections, we conducted an epidemiological study to assess the need for systematic surveillance, as well as the value of applying barrier precautions toP. aeruginosa carriers. From July 1997 to February 1998, we conducted a prospective cohort study in an 18-bed medical intensive care unit (ICU), which is part of the infectious diseases department in a 1200-bed tertiary-care teaching hospital. Rectal and oropharyngeal swabs were obtained on admission and twice weekly. Acquired strains were genotypically characterized by pulsed-field gel electrophoresis (PFGE). A risk factor analysis for carriage, colonization and infection was performed. Among 269 eligible patients, 116 (43%) were P. aeruginosa carriers, with 46 (17%) detected on admission and 70 (26%) who acquired carriage during their stay in ICU. Among these 70 patients, 29 became colonized (N=13) or developed infection (N=16). Conversely, in the 121 patients who remained free of carriage, no colonization or infection were detected. Genotyping analysis using PFGE was performed for 81/85 (95%) acquired strains in 67 patients. The same genotype I was observed for 58/81 (70%) of these strains issued from 47 patients, and a distinct genotype II affected two other patients (three strains). The last 20 strains were not genetically related. In a multivariate model, mechanical ventilation was associated with the acquisition of P. aeruginosa carriage. Antibiotics ineffective against P. aeruginosa significantly increased the risk of colonization or infection in ICU. Although several recent studies concluded that endogenous sources account for the majority of P. aeruginosa colonizations or infections, we conclude that epidemiology may vary according to the ICU, and that cross-colonization (i.e., exogenous source) may occur and warrant reinforced barrier precautions.
Similar articles
- Endemic Pseudomonas aeruginosa infection in a neonatal intensive care unit.
Foca M, Jakob K, Whittier S, Della Latta P, Factor S, Rubenstein D, Saiman L. Foca M, et al. N Engl J Med. 2000 Sep 7;343(10):695-700. doi: 10.1056/NEJM200009073431004. N Engl J Med. 2000. PMID: 10974133 - Impact of intensive care unit relocation and role of tap water on an outbreak of Pseudomonas aeruginosa expressing OprD-mediated resistance to imipenem.
Tran-Dinh A, Neulier C, Amara M, Nebot N, Troché G, Breton N, Zuber B, Cavelot S, Pangon B, Bedos JP, Merrer J, Grimaldi D. Tran-Dinh A, et al. J Hosp Infect. 2018 Nov;100(3):e105-e114. doi: 10.1016/j.jhin.2018.05.016. Epub 2018 May 29. J Hosp Infect. 2018. PMID: 29857026 - [Nosocomial infections caused by Pseudomonas aeruginosa: Exogenous or endogenous origin of this bacterium?].
Floret N, Bertrand X, Thouverez M, Talon D. Floret N, et al. Pathol Biol (Paris). 2009 Feb;57(1):9-12. doi: 10.1016/j.patbio.2008.07.011. Epub 2008 Oct 9. Pathol Biol (Paris). 2009. PMID: 18848405 French. - Ecology of Pseudomonas aeruginosa in the intensive care unit and the evolving role of water outlets as a reservoir of the organism.
Trautmann M, Lepper PM, Haller M. Trautmann M, et al. Am J Infect Control. 2005 Jun;33(5 Suppl 1):S41-9. doi: 10.1016/j.ajic.2005.03.006. Am J Infect Control. 2005. PMID: 15940115 Review. - Pseudomonas aeruginosa outbreaks in the neonatal intensive care unit--a systematic review of risk factors and environmental sources.
Jefferies JMC, Cooper T, Yam T, Clarke SC. Jefferies JMC, et al. J Med Microbiol. 2012 Aug;61(Pt 8):1052-1061. doi: 10.1099/jmm.0.044818-0. Epub 2012 Jun 8. J Med Microbiol. 2012. PMID: 22683659 Review.
Cited by
- In vitro antimicrobial effects of aztreonam, colistin, and the 3-drug combination of aztreonam, ceftazidime and amikacin on metallo-beta-lactamase-producing Pseudomonas aeruginosa.
Oie S, Fukui Y, Yamamoto M, Masuda Y, Kamiya A. Oie S, et al. BMC Infect Dis. 2009 Aug 10;9:123. doi: 10.1186/1471-2334-9-123. BMC Infect Dis. 2009. PMID: 19664245 Free PMC article. - A prospective survey of Pseudomonas aeruginosa colonization and infection in the intensive care unit.
Cohen R, Babushkin F, Cohen S, Afraimov M, Shapiro M, Uda M, Khabra E, Adler A, Ben Ami R, Paikin S. Cohen R, et al. Antimicrob Resist Infect Control. 2017 Jan 11;6:7. doi: 10.1186/s13756-016-0167-7. eCollection 2017. Antimicrob Resist Infect Control. 2017. PMID: 28096975 Free PMC article. - Pathogenesis of intestinal Pseudomonas aeruginosa infection in patients with cancer.
Markou P, Apidianakis Y. Markou P, et al. Front Cell Infect Microbiol. 2014 Jan 7;3:115. doi: 10.3389/fcimb.2013.00115. eCollection 2014. Front Cell Infect Microbiol. 2014. PMID: 24432250 Free PMC article. Review. No abstract available. - Pseudomonas aeruginosa acquisition on an intensive care unit: relationship between antibiotic selective pressure and patients' environment.
Boyer A, Doussau A, Thiébault R, Venier AG, Tran V, Boulestreau H, Bébéar C, Vargas F, Hilbert G, Gruson D, Rogues AM. Boyer A, et al. Crit Care. 2011;15(1):R55. doi: 10.1186/cc10026. Epub 2011 Feb 9. Crit Care. 2011. PMID: 21306623 Free PMC article. - Risk factors for colonization and infection by Pseudomonas aeruginosa in patients hospitalized in intensive care units in France.
Hoang S, Georget A, Asselineau J, Venier AG, Leroyer C, Rogues AM, Thiébaut R. Hoang S, et al. PLoS One. 2018 Mar 9;13(3):e0193300. doi: 10.1371/journal.pone.0193300. eCollection 2018. PLoS One. 2018. PMID: 29522559 Free PMC article.