Possible nosocomial transmission of Pseudomonas cepacia in patients with cystic fibrosis.
OBJECTIVE
To determine whether nosocomial transmission of Pseudomonas cepacia occurred at a hospital with endemic P cepacia infection of patients with cystic fibrosis.


METHODS
Two retrospective case-control studies.


METHODS
A large pediatric cystic fibrosis center.


METHODS
To assess risk factors for acquisition of P cepacia, 18 cases, defined as any patient with cystic fibrosis with first documented isolation of P cepacia in 1988 or 1989, were compared with 18 matched P cepacia-negative controls with cystic fibrosis. To assess potential modes of nosocomial P cepacia transmission, 14 cases with a hospitalization(s) between their last P cepacia-negative culture and first P cepacia-positive culture were compared with 14 hospitalized P cepacia-negative controls with cystic fibrosis.


METHODS
Handwiping cultures (N = 68) and selective environmental cultures were performed.


RESULTS
Cases tended to be more likely than controls to have been hospitalized at the cystic fibrosis center in the 3 months before their first P cepacia-positive culture (P = .08). In addition, cases tended to be more likely than hospitalized controls with cystic fibrosis to have had a P cepacia-positive roommate (P = .06) before becoming colonized with P cepacia organisms. Pseudomonas cepacia was cultured from the hands of two individuals: a P cepacia-colonized patient who had just undergone chest physiotherapy and consequent coughing and the investigator who shook the P cepacia-positive patient's hand after the patient's procedure.


CONCLUSIONS
These results suggest that in this cystic fibrosis center, hospitalization is a risk factor for P cepacia acquisition and that person-to-person transmission of P cepacia may occur in the hospital via hand contact.
Pegues
D A
DA
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
Schidlow
D V
DV
Tablan
O C
OC
Carson
L A
LA
Clark
N C
NC
Jarvis
W R
WR
D000293:Adolescent; D000328:Adult; D015373:Bacterial Typing Techniques; D016956:Burkholderia cepacia / Q000145:classification; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology / Q000635:transmission*; D003550:Cystic Fibrosis / Q000150:complications* / Q000628:therapy; D005260:Female; D006225:Hand / Q000382:microbiology; D006235:Hand Disinfection; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D007223:Infant; D017053:Infection Control; D008297:Male; D016555:Matched-Pair Analysis; D015143:Philadelphia; D016016:Proportional Hazards Models; D011552:Pseudomonas Infections / Q000453:epidemiology / Q000635:transmission*; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors