Article Data

  • Views 1943
  • Dowloads 127

Original Research

Open Access

Outbreak of Pseudomonas aeruginosa in a Neonatal Intensive Care Unit: Are Point-of-Use Filters Useful?

  • VANDA PLECKO1
  • VESNA TRIPKOVIC1
  • LIDIJA ZELE STARCEVIC2
  • DIJANA VARDA BRKIC2
  • ALEKSANDRA PRESECKI STANKO2
  • SANJA PLESKO2
  • DAVOR PLAVEC3

1Department for Microbiology, University Hospitals of Morecabe bay, NHS Trust Lancaster, UK

2 Department of Clinical and Molecular Microbiology, Clinical Hospital Center Zagreb, Zagreb, Croatia

3 Research Department, Children’s Hospital Srebrnjak, Zagreb, Croatia

DOI: 10.22514/SV131.042017.20 Vol.13,Issue 1,March 2017 pp.75-79

Published: 20 March 2017

*Corresponding Author(s): LIDIJA ZELE STARCEVIC E-mail: lidija.zele@gmail.com

Abstract

Pseudomonas aeruginosa, in intensive care units (ICUs), causes infections with high morbidity and mortality rates. Tap water outlets are often contaminated with P.aeruginosa and may represent a source of endemic infections in ICUs.

The aim of this study was to explore the role of point-of-use (POU) filters in neo-natal intensive care unit (NICU) in reduc-ing P.aeruginosa colonizations/infections. Routine surveillance cultures, environ-mental cultures and samples from the hands of healthcare personnel, were taken and cultivated. P.aeruginosa isolates were identified according to standard proce-dures. For epidemiological purposes, anti-microbial susceptibility testing and pulse-field gel electrophoresis were performed. Data regarding use of antibiotics, disin-fectants, antiseptics, gloves and gowns from 2006 to 2012 were investigated.

In March 2008, in the NICU of the Clini-cal Hospital Centre Zagreb (CHC Zagreb), we observed an increase in the total num-ber of pseudomonas infections compared to the previous months. This higher num-ber remained the same until October, de-spite rigorous infection control measures. Pseudomonas isolates were found in tap water, but not on the hands of healthcare workers. In that moment POU filters were introduced. The number of P.aeruginosa isolates in surveillance cultures dropped significantly.

The number of positive cultures of P.aeruginosa in two consecutive periods (before and after installation of POU fil-ters) showed a statistically significant dif-ference.

After the implementation of all infection control measures, we managed to stop the spread of pseudomonas colonization/infection. POU filters contributed only as one of these measures, resulting in a reduc-tion of chronically endemic P.aeruginosa infection/colonisation in the NICU.

Keywords

P.aeruginosa, neonatal intensive care unit, point of use filters, infection con-trol

Cite and Share

VANDA PLECKO,VESNA TRIPKOVIC,LIDIJA ZELE STARCEVIC,DIJANA VARDA BRKIC,ALEKSANDRA PRESECKI STANKO,SANJA PLESKO,DAVOR PLAVEC. Outbreak of Pseudomonas aeruginosa in a Neonatal Intensive Care Unit: Are Point-of-Use Filters Useful?. Signa Vitae. 2017. 13(1);75-79.

References

1. Petignat C, Francioli P, Nahimana I, Wenger A, Bille J, Schaller MD, et al. Exogenous sources of Pseudomonas aeruginosa in intensive care unit patients: implementation of infection control measures and follow-up with molecular typing. Infect Control Hosp Epide-miol 2006 Sep;27(9):953-7.

2. Blanc DS, Nahimana I, Petignat C, Wenger A , Bille J, Francioli P. Faucets as a reservoir of endemic Pseudomonas aeruginosa coloni-zation/infections in intensive care units. Intensive Care Med 2004 Jul;30;1964–8.

3. Barna Z, Antmann K, Paszti J, Bánfi R, Kádár M, Szax A, et al. Infection control by point of use water filtration in an intensive care unit - a Hungarian case study. J Water Health 2014 Dec;12(4):858-67.

4. Vianelli N, Giannini MB, Quarti C, Bucci Sabattini MA, Fiacchin M , de Vivo A, et al. Resolution of a Pseudomonas aeruginosa out-break in a hematology unit with the use of disposable sterile water filters. Haematologica 2006 Jun;91(7):983-5.

5. Trautmann M, Lepper PM, Haller M. Ecology of Pseudomonas aeruginosa in the intensive care unit and the evolving role of water outlets as a reservoir of the organism. Am J Infect Control 2005 Jun;3(5 Suppl 1):S41–9.

6. Isenberg HD. Clinical Microbiology Procedures Handbook. Vol 1, 2nd ed.Washington, D.C.: ASM Press; 2004.

7. Performance standards for antimicrobial susceptibility testing; 17th informational supplement M100-S17. Wayne, PA, USA: Clinical and Laboratory Standards Institute; 2007.

8. Dimech WJ, Hellyar AG, Kotiw M, Marcon D, Ellis S, Carson M. Typing of strains from a single-source outbreak of Pseudomonas pickettii. J Clin Microbiol 1993 Nov;31 (11);3001-6.

9. Tenover FC, Arbeit RD, Goering RV, Mickelsen PA, Murray BE, Persing DH, et al.

10. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995 Sep; 33(9):2233-9.

11. Cholley P, Thouverez M, Floret N, Bertrand X, Talon D. The role of fittings in intensive care rooms as reservoirs for the colonization of patients with Pseudomonas aeruginosa. Intens Care Med 2008 Aug;34(8):1428-33.

12. Foca M, Jakob K, Whittier S, Della Latta P, Factor S, Rubenstein D, et al. Endemic Pseudomonas aeruginosa infection in a neonatal intensive care unit. N Engl J Med 2000 Sep;343(10):695-700.

13. Jefferies JMC, Cooper T, Yam T, Clarke SC. Pseudomonas aeruginosa outbreaks in the neonatal intensive care unit – a systematic review of risk factors and environmental sources. J Med Microbiol 2012 Aug;61(Pt 8):1052–61.

14. Contribution of tap water to patient colonization with Pseudomonas aeruginosa in a medical intensive care unit. J Hosp Infect 2007 Sep;67(1):72-8.

15. Simon A, Krawtschenko O, Reiffert SM, Exner M, Trautmann M, Engelhart S. Outbreaks of Pseudomonas aeruginosa in pediatric patients – clinical aspects, risk factors and management. Pediatr Infect Dis J 2008;3(4):249–69.

16. Crivaro V, Popolo A, Caprio A, Lambiase A, Di Resta M, Borriello T, et al. Pseudomonas aeruginosa in a neonatal intensive care unit: molecular epidemiology and infection control measures. BMC Infect Dis 2009 May;9:70.

17. Trautmann M, Halder S, Hoegel J, Royer H, Haller M. Point-of-use water filtration reduces endemic Pseudomonas aeruginosa infec-tions on a surgical intensive care unit. Am J Infect Control 2008 Aug;36(6):421-9.

18. Zhou ZY, Hu BJ, Qin L, Lin YE, Watanabe H, Zhou Q, et al. Removal of waterbone pathogens from liver transplant unit water taps in prevention of helathcare-associated infections: a proposal for a cost-effective, proactive infection control strategy. Clin Microbiol Infect 2014 Apr;20(4):310-4.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.3 (2023) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

Top