Different opinions of physicians on the importance of measures to prevent acquisition of Pseudomonas aeruginosa from the environment.
BACKGROUND
Since chronic infection with mucoid Pseudomonas aeruginosa (PA) is associated with deteriorating lung function, many parents of young children with cystic fibrosis (CF) fear the first PA positive throat swab as a milestone in the progression of the disease. To reduce the risk of PA acquisition from the environment, they perform preventive measures at home or outdoors.


METHODS
In an attempt to evaluate the attitude of CF physicians towards these measures and the respective consulting practice, we mailed a questionnaire to all 65 certified paediatric CF centres in Germany.


RESULTS
Physicians from 54 (83%) CF clinics replied. They expressed widely different ideas about the impact of the environment for the acquisition of P. aeruginosa, and recommended a large spectrum of preventive measures. Some physicians proposed only few precautions, which focussed on the prevention of cross-infection between patients, whereas others suggested prevention of any contact with moist or wet places, e.g. use different toothbrushes for mornings and evenings, or do without air-conditioning in the car.


CONCLUSIONS
CF physicians have different opinions on the risk of PA acquisition from the environment. Doctors who recommend strict precautions could engender a parental fear of a ubiquous threat from invisible bacteria. The resulting extended safety measures might impair the family's quality of life.
Steinkamp
Gratiana
G
Clinical Research, Hannover, Germany, and CF Centre Hamburg-Altona, Germany.
Ullrich
Gerald
G
D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D003550:Cystic Fibrosis / Q000175:diagnosis / Q000382:microbiology*; D004784:Environmental Monitoring / Q000379:methods*; D062665:Epidemiological Monitoring; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D017053:Infection Control / Q000379:methods; D008297:Male; D008875:Middle Aged; D010372:Pediatrics / Q000592:standards / Q000639:trends; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D011336:Probability; D011552:Pseudomonas Infections / Q000453:epidemiology / Q000517:prevention & control*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D018570:Risk Assessment; D011795:Surveys and Questionnaires