title: Outbreak caused by tobramycin-resistant Pseudomonas aeruginosa in a bone marrow transplantation unit.
abstract: Between May and August 1995, 5 patients in a bone marrow transplantation (BMT) ward developed bacteremia caused by Pseudomonas aeruginosa resistant to tobramycin (TRPA). Previously, isolates of TRPA had been limited to patients who were treated in 1 intensive care unit (ICU) of this tertiary care teaching hospital in Helsinki, Finland. To study whether the outbreak was caused by a single or multiple strains of P. aeruginosa, 102 isolates of TRPA from clinical samples obtained from different hospital units and 22 isolates obtained from the hospital environment were characterized by pulsed-field gel electrophoresis. All isolates from hematological patients produced 1 unique fragment pattern, which was also isolated from 3 ICU patients before the BMT ward outbreak began as well as from 5 shower heads in the BMT ward. The outbreak in the BMT ward was successfully controlled by eradicating the probable environmental source--contaminated hand showers--but the endemic infections continued in the ICU.
authors.affiliation: Department of Infectious Disease Epidemiology, National Public Health Institute, Helsinki, Finland.
authors.forename: O
authors.initials: O
authors.lastname: Lyytikäinen
authors.forename: V
authors.initials: V
authors.lastname: Golovanova
authors.forename: E
authors.initials: E
authors.lastname: Kolho
authors.forename: P
authors.initials: P
authors.lastname: Ruutu
authors.forename: A
authors.initials: A
authors.lastname: Sivonen
authors.forename: L
authors.initials: L
authors.lastname: Tiittanen
authors.forename: M
authors.initials: M
authors.lastname: Hakanen
authors.forename: J
authors.initials: J
authors.lastname: Vuopio-Varkila
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007362:Intensive Care Units; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D014031:Tobramycin / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D014031:Tobramycin