Ecology of Pseudomonas aeruginosa in the intensive care unit and the evolving role of water outlets as a reservoir of the organism.
In spite of the significant changes in the spectrum of organisms causing intensive care unit (ICU)-associated infections, Pseudomonas aeruginosa has held a nearly unchanged position in the rank order of pathogens causing ICU-related infections during the last 4 decades. Horizontal transmissions between patients have long been considered the most frequent source of P aeruginosa colonizations/infections. The application of molecular typing methods made it possible, during the last approximately 7 years, to identify ICU tap water as a significant source of exogenous P aeruginosa isolates. A review of prospective studies published between 1998 and 2005 showed that between 9.7% and 68.1% of randomly taken tap water samples on different types of ICUs were positive for P aeruginosa , and between 14.2% and 50% of infection/colonization episodes in patients were due to genotypes found in ICU water. Faucets are easily accessible for preventive measures, and the installation of single-use filters on ICU water outlets appears to be an effective concept to reduce water-to-patient transmissions of this important nosocomial pathogen.
Trautmann
Matthias
M
Institute of Hospital Hygiene, Klinikum Stuttgart, Stuttgart, Germany. m.trautmann@katharinenhospital.de
Lepper
Philipp M
PM
Haller
Mathias
M
D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control*; D004203:Disinfection / Q000379:methods; D024881:Drug Resistance, Bacterial; D005374:Filtration / Q000295:instrumentation; D006801:Humans; D007362:Intensive Care Units; D011552:Pseudomonas Infections / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000472:pathogenicity*; D014871:Water Microbiology; D014881:Water Supply / Q000592:standards