The epidemiology of Pseudomonas aeruginosa in oncology patients in a general hospital.
Pseudomonas aeruginosa colonization and infection was studied over a 6-mo period in a 36-bed mixed general medical-oncology unit. We used selective media for serial surveillance cultures on 283 patients, the environment, and personnel. Twelve percent of patients were colonized on admission and 10% acquired P. aeruginosa. Using serotyping and multilocus enzyme electrophoresis, we identified 63 genetically distinctive strains; four prevalent strains accounted for 21% of isolates. Only 5 of 33 nosocomial acquisitions were due to horizontal transmission. Nine acquisitions were linked to environmental sources (e.g., sink surfaces), which often harbored antibiotic-resistant strains but posed a risk only to oncology patients. Although significant Pseudomonas infections occurred in only 11% of colonized patients, 63% of colonized severely neutropenic patients--predominantly those who had acquired the prevalent, often environmentally linked strains--developed infections. Thus, P. aeruginosa was a significant pathogen in oncology patients; typing by multilocus enzyme electrophoresis allowed the detection of important environmental sources.
Griffith
S J
SJ
Michael Reese Hospital, Chicago, IL.
Nathan
C
C
Selander
R K
RK
Chamberlin
W
W
Gordon
S
S
Kabins
S
S
Weinstein
R A
RA
D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000150:complications / Q000453:epidemiology* / Q000635:transmission; D011550:Pseudomonas aeruginosa / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification