title: Patient risk of contact with respiratory pathogens from inanimate surfaces in a cystic fibrosis outpatient clinic. A prospective study over a four-year period.
abstract: Acquisition of respiratory pathogens such as Pseudomonas aeruginosa (PA) is associated with increased morbidity and mortality in cystic fibrosis (CF). Research on the prevalence of these pathogens on environmental surfaces of a CF Center is scanty, and so far no study has determined what risk CF patients have of coming in contact with them during their visits to the CF Center. This study is aimed at assessing the prevalence of some respiratory pathogens in samples taken systematically during a 4-year period from inanimate surfaces and sinks in a CF Outpatient Clinic, and to estimate the risk that a non-PA colonized CF patient has of contact with PA when visiting the CF Center. Microbiological samples were taken and cultured from the inanimate surfaces and sinks of the Outpatient clinic of a CF Center once a month from 2001 to 2005. Four hundred and sixty environmental specimens were collected: 36.3% were positive for respiratory pathogens (23% of rooms' inert surfaces, 49.5% of sinks). Achromobacter xylosoxidans was found in 0.8% of surface samples. PA was isolated in 22.8% samples. The estimated risk for each non-colonized patient of coming in contact with PA on the surfaces in the Clinic at each visit was 5.4 per thousand (CI95% 0.9-30.1). Genotyping of a sample of environmental PA strains revealed a genetic relation between environmental and clinical isolates in most cases. Micro-organisms relevant for CF patients can be found on inanimate surfaces of a CF Center, although the risk for patients of coming in contact with PA during their visits to the CF center seems low.
authors.affiliation: University of Florence, Department of Paediatrics, Florence, Italy. filippo.festini@unifi.it
authors.forename: Filippo
authors.initials: F
authors.lastname: Festini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Taccetti
authors.forename: Claudia
authors.initials: C
authors.lastname: Mannini
authors.forename: Silvia
authors.initials: S
authors.lastname: Campana
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Mergni
authors.forename: Noemi
authors.initials: N
authors.lastname: Vignoli
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Allegretti
authors.forename: Novella
authors.initials: N
authors.lastname: Ravenni
authors.forename: Priscilla
authors.initials: P
authors.lastname: Cocchi
authors.forename: Stella
authors.initials: S
authors.lastname: Neri
authors.forename: Teresa
authors.initials: T
authors.lastname: Repetto
authors.forename: Maurizio
authors.initials: M
authors.lastname: de Martino
mesh_terms: D003550:Cystic Fibrosis / Q000382:microbiology*; D018562:Disease Transmission, Infectious; D004783:Environmental Microbiology; D006801:Humans; D010045:Outpatients; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000517:prevention & control* / Q000635:transmission*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D012307:Risk Factors