title: Association between Pseudomonas aeruginosa positive water samples and healthcare-associated cases: nine-year study at one university hospital.
abstract: OBJECTIVE
  To study the association between the results of water samples and Pseudomonas aeruginosa healthcare-associated cases in a French university hospital.
  
  
  METHODS
  Generalized Estimating Equations were used on complete case and imputed datasets. The spatial unit was the building and the time unit was the quarter.
  
  
  RESULTS
  For the period 2004-2013, 2932 water samples were studied; 17% were positive for P. aeruginosa. A higher incidence of P. aeruginosa cases was associated with a higher proportion of positive water samples (P=0.056 in complete case analysis and P=0.031 with the imputed dataset). The association was no longer observed when haematology and intensive care units were excluded, but was significant in analyses of data concerning intensive care units alone (P<0.001).
  
  
  CONCLUSIONS
  This study suggests that water outlet contamination in hospitals can lead to an increase in healthcare-associated P. aeruginosa cases in wards dealing with susceptible patients, but does not play a significant role in other wards.
authors.affiliation: Service d'épidémiologie et hygiène hospitalières, CHU Dijon, France; Laboratoire Microbiologie Environnementale et Risques Sanitaires, Dijon, France. Electronic address: alefebvre@chu-reims.fr.
authors.forename: A
authors.initials: A
authors.lastname: Lefebvre
authors.affiliation: Université Paris Diderot, Paris, France; Service d'hygiène, CHU Besançon, France.
authors.forename: X
authors.initials: X
authors.lastname: Bertrand
authors.affiliation: Biostatistics and Bioinformatics (DIM), University Hospital, Bourgogne Franche-Comté University, Dijon, France; INSERM, CIC 1432, Dijon University Hospital, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, Dijon, France; Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ, Institut Pasteur, Université Paris-Saclay, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Quantin
authors.affiliation: Service d'Hygiène Hospitalière, Epidémiologie et Prévention, groupe hospitalier Edouard Herriot, Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Vanhems
authors.affiliation: Equipe d'épidémiologie et santé publique, Université Claude Bernard, Lyon, France; UHLIN, groupe hospitalier Bichat - Claude Bernard, HUPNVS, AP-HP, Paris, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Lucet
authors.affiliation: Biostatistics and Bioinformatics (DIM), University Hospital, Bourgogne Franche-Comté University, Dijon, France; INSERM, CIC 1432, Dijon University Hospital, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, Dijon, France.
authors.forename: G
authors.initials: G
authors.lastname: Nuemi
authors.affiliation: Service d'épidémiologie et hygiène hospitalières, CHU Dijon, France.
authors.forename: K
authors.initials: K
authors.lastname: Astruc
authors.affiliation: Laboratoire Chrono-environnement, UMR CNRS 6249, Université de Franche-Comté, Besançon, France; Département de maladies infectieuses, CHU Dijon, France.
authors.forename: P
authors.initials: P
authors.lastname: Chavanet
authors.affiliation: Service d'épidémiologie et hygiène hospitalières, CHU Dijon, France.
authors.forename: L S
authors.initials: LS
authors.lastname: Aho-Glélé
mesh_terms: D000368:Aged; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005602:France / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D008297:Male; D011552:Pseudomonas Infections / Q000453:epidemiology* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000145:classification / Q000302:isolation & purification*; D014871:Water Microbiology
keywords: Healthcare-associated infections; Pseudomonas aeruginosa; Water