title: Pseudomonas aeruginosa outbreak in a pediatric intensive care unit linked to a humanitarian organization residential center.
abstract: BACKGROUND
  Pseudomonas aeruginosa commonly colonizes the hospital environment. Between April 2006 and September 2008, we investigated an outbreak of P. aeruginosa infection occurring in a pediatric intensive care unit. We conducted epidemiologic and molecular investigations to identify the source of the outbreak.
  
  
  METHODS
  Retrospective case finding; surveillance cultures of patients and environmental sites; admission screening; case-control study; and molecular typing.
  
  
  METHODS
  Infants and children in a pediatric intensive care unit of a tertiary-care institution.
  
  
  RESULTS
  Thirty-seven cases of P. aeruginosa infection or colonization were detected between April 2006 and September 2008, including 3 fatal bloodstream infections. A closely-related strain was detected in 4 residents of a humanitarian nongovernmental organization (NGO) center who developed an infection, from 4 additional residents upon their hospital admission, and from a sink drain at the NGO residential center. NGO recipients represented 65% (24/37) of the total number of cases of P. aeruginosa colonization or infection during the outbreak period. Investigation at the residential center showed widespread contamination of the sewage system (10/14 sinks and shower drains, 70%) and a high prevalence (38%) of P. aeruginosa carriage among children.
  
  
  CONCLUSIONS
  These findings suggest that the probable cause of the outbreak was the contamination of the NGO residential center with further nosocomial transmission after admission, and highlight the importance of considering external sources when investigating hospital outbreaks.
authors: Infection Control Program, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
authors: Yves
authors: Y
authors: Longtin
authors: Nicolas
authors: N
authors: Troillet
authors: Sylvie
authors: S
authors: Touveneau
authors: Noémie
authors: N
authors: Boillat
authors: Peter
authors: P
authors: Rimensberger
authors: Sasi
authors: S
authors: Dharan
authors: Alain
authors: A
authors: Gervaix
authors: Didier
authors: D
authors: Pittet
authors: Stephan
authors: S
authors: Harbarth
mesh_terms: D000293:Adolescent; D015373:Bacterial Typing Techniques; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016358:Contact Tracing; D003428:Cross Infection / Q000453:epidemiology*; D016172:DNA Fingerprinting; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D004783:Environmental Microbiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D017720:Molecular Epidemiology; D011552:Pseudomonas Infections / Q000453:epidemiology*; D011550:Pseudomonas aeruginosa / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D012189:Retrospective Studies