Identification of airborne dissemination of epidemic multiresistant strains of Pseudomonas aeruginosa at a CF centre during a cross infection outbreak.
BACKGROUND
Chronic Pseudomonas aeruginosa infection is a major cause of morbidity and mortality for individuals with cystic fibrosis (CF). P aeruginosa cross infection outbreaks have recently been reported at CF holiday camps and specialist centres. The mechanism of cross infection is unknown. A study was performed to look for the presence of epidemic strains of P aeruginosa in the environment of a CF centre during a cross infection outbreak and to examine their potential modes of spread between patients.


METHODS
Microbiological sampling of the environment of the CF facility was performed, including room air sampling. Individual P aeruginosa strains were identified by bacterial fingerprinting. The typing patterns were compared with those of epidemic strains responsible for cross infection among the patients.


RESULTS
Epidemic P aeruginosa strains were isolated from room air when patients performed spirometric tests, nebulisation, and airway clearance, but were not present in other areas of the inanimate environment of the CF centre.


CONCLUSIONS
Aerosol dissemination may be the most important factor in patient-to-patient spread of epidemic strains of P aeruginosa during recent cross infection outbreaks at adult CF centres.
Jones
A M
AM
Adult Cystic Fibrosis Centre, Wythenshawe Hospital, Manchester M23 9LT, UK. andmarkj@hotmail.com
Govan
J R W
JR
Doherty
C J
CJ
Dodd
M E
ME
Isalska
B J
BJ
Stanbridge
T N
TN
Webb
A K
AK
D000391:Air Microbiology; D016902:Air Pollution, Indoor; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial; D018432:Drug Resistance, Multiple; D004739:England / Q000453:epidemiology; D006801:Humans; D006920:Hygiene; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D013147:Spirometry