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Case-Control and Vector Studies of Nosocomial Acquisition of Pseudomonas Cepacia in Adult Patients with Cystic Fibrosis

Published online by Cambridge University Press:  21 June 2016

David R. Burdge ,
E.M. Nakielna  and
M.A. Noble
David R. Burdge*
Affiliation:
Division of Infectious Disease, University Hospital and the University of British Columbia, Vancouver, British Columbia, Canada
E.M. Nakielna
Affiliation:
Division of Respiratory Medicine, University Hospital and the University of British Columbia, Vancouver, British Columbia, Canada
M.A. Noble
Affiliation:
Division of Medical Microbiology, University Hospital and the University of British Columbia, Vancouver, British Columbia, Canada
*
Division of Infectious Diseases, University Hospital—Shaughnessy Site, G611 4500 Oak St., Vancouver, British Columbia, Canada V6H 3Nl
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Abstract

Objective:

To examine factors associated with nosocomial acquisition of Pseudomonas cepacia in adult patients with cystic fibrosis.

Design:

A retrospective case-control study of 5 patients with nosocomial acquisition of P cepacia versus 20 matched controls who failed to develop P cepacia infection. Selective handwashing, air sampling, and respiratory equipment sampling also were performed.

Setting:

A university hospital providing tertiary care to 95 adult cystic fibrosis patients.

Patience:

All patients are adults with known cystic fibrosis. Case definition required multiple negative sputum cultures for P cepacia prior to and during admission, with a positive sputum culture prior to discharge. Controls had negative sputum cultures for P cepacia prior to and throughout hospitalization. Controls were matched for age, gender, disease severity, and frequency of hospitalizations.

Results:

Factors associated with increased risk of nosocomial acquisition of P cepacia included receiving humidifier or nebulized treatments (60% versus 5%, p = .016, odds ratio= 28.5, 95% confidence interval= 1.93 to 420.58). Factors without significance included ward, room, teaching versus nonteaching status, use of steroids, sharing a hospital room with another cystic fibrosis patient, antibiotic use, presence of portocath in situ, or socializing with another individual with cystic fibrosis known to be P cepacia -positive. Air sampling studies failed to demonstrate aerosolization of P cepacia by coughing cystic fibrosis patients over a 1-hour sampling time. Handwashing studies failed to demonstrate P cepacia on hands of cystic fibrosis patients, nurses, or physiotherapists (before or after physiotherapy). Reservoirs from nebulizers consistently grew P cepacia following therapy.

Conclusions:

Respiratory equipment may be an important source of nosocomial acquisition of P cepacia in adult cystic fibrosis patients.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 14 , Issue 3 , March 1993 , pp. 127 - 130
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1993

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