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Molecular epidemiology of Pseudomonas aeruginosa in an intensive care unit

Published online by Cambridge University Press:  15 May 2009

G. Döring ,
M. Hörz ,
J. Ortelt ,
H. Grupp  and
C. Wolz
G. Döring
Affiliation:
Department of General and Environmental Hygiene, Hygiene-Institut, University of Tübingen, Silcherstrasse 7, D-7400 Tübingen, Federal Republic of Germany
M. Hörz
Affiliation:
Department of General and Environmental Hygiene, Hygiene-Institut, University of Tübingen, Silcherstrasse 7, D-7400 Tübingen, Federal Republic of Germany
J. Ortelt
Affiliation:
Department of General and Environmental Hygiene, Hygiene-Institut, University of Tübingen, Silcherstrasse 7, D-7400 Tübingen, Federal Republic of Germany
H. Grupp
Affiliation:
Department of General and Environmental Hygiene, Hygiene-Institut, University of Tübingen, Silcherstrasse 7, D-7400 Tübingen, Federal Republic of Germany
C. Wolz
Affiliation:
Department of General and Environmental Hygiene, Hygiene-Institut, University of Tübingen, Silcherstrasse 7, D-7400 Tübingen, Federal Republic of Germany
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Genotyping was used to analyse Pseudomonas aeruginosa isolates from sink drains and 15 intubated patients as part of a 3-month prospective study of strain transmission in a medical-surgical intensive care unit. Ninety percent of all washbasin drains were persistently contaminated with several P. aeruginosa genotypes. In 60% (9/15) of the patients, P. aeruginosa colonization or infection was hospital-acquired: P. aeruginosa strains isolated from these patients were present in hospital sinks or in other patients before their admission. Since all patients were immobile, personnel were the probable route of transmission of P. aeruginosa in the hospital. The mechanism of strain transmission from sinks to hands during hand washing was investigated in a children's hospital. When P. aeruginosa was present at densities of > 105/c.f.u. per ml in sink drains, hand washing resulted in hand contamination with P. aeruginosa via aerosol generation in the majority of experiments or P. aeruginosa was detected using an air sampler above the washing basin. High P. aeruginosa cfu were present at 4.30 h in the eight sinks (5.4 × 105−7.0 × 1010 c.f.u./ml), whereas at 13.00 h P. aeruginosa c.f.u. were significantly lower (3.1 × 102−8.0 × 105 c.f.u. / ml). These data reveal that the danger of bacterial contamination of hands during hand washing is highest in the morning. The identified transmission routes demand more effective hygienic measures in hospital settings particularly concerning personnel hands and sink drains.

Type
Research Article
Information
Epidemiology & Infection , Volume 110 , Issue 3 , June 1993 , pp. 427 - 436
Copyright
Copyright © Cambridge University Press 1993

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