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. 2003 Jun;58(6):525–527. doi: 10.1136/thorax.58.6.525

Identification of airborne dissemination of epidemic multiresistant strains of Pseudomonas aeruginosa at a CF centre during a cross infection outbreak

A Jones 1, J Govan 1, C Doherty 1, M Dodd 1, B Isalska 1, T Stanbridge 1, A Webb 1
PMCID: PMC1746694  PMID: 12775867

Abstract

Methods: Microbiological sampling of the environment of the CF facility was performed, including room air sampling. Individual P aeruginosa strains were identified by bacterial fingerprinting. The typing patterns were compared with those of epidemic strains responsible for cross infection among the patients.

Results: Epidemic P aeruginosa strains were isolated from room air when patients performed spirometric tests, nebulisation, and airway clearance, but were not present in other areas of the inanimate environment of the CF centre.

Conclusions: Aerosol dissemination may be the most important factor in patient-to-patient spread of epidemic strains of P aeruginosa during recent cross infection outbreaks at adult CF centres.

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Selected References

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  1. Armstrong D. S., Grimwood K., Carlin J. B., Carzino R., Olinsky A., Phelan P. D. Bronchoalveolar lavage or oropharyngeal cultures to identify lower respiratory pathogens in infants with cystic fibrosis. Pediatr Pulmonol. 1996 May;21(5):267–275. doi: 10.1002/(SICI)1099-0496(199605)21:5<267::AID-PPUL1>3.0.CO;2-K. [DOI] [PubMed] [Google Scholar]
  2. Ayliffe G. A., Babb J. R., Collins B. J., Lowbury E. J., Newsom S. W. Pseudomonas aeruginosa in hospital sinks. Lancet. 1974 Sep 7;2(7880):578–581. doi: 10.1016/s0140-6736(74)91893-5. [DOI] [PubMed] [Google Scholar]
  3. Burgos F., Torres A., González J., Puig de la Bellacasa J., Rodriguez-Roisin R., Roca J. Bacterial colonization as a potential source of nosocomial respiratory infections in two types of spirometer. Eur Respir J. 1996 Dec;9(12):2612–2617. doi: 10.1183/09031936.96.09122612. [DOI] [PubMed] [Google Scholar]
  4. Cheng K., Smyth R. L., Govan J. R., Doherty C., Winstanley C., Denning N., Heaf D. P., van Saene H., Hart C. A. Spread of beta-lactam-resistant Pseudomonas aeruginosa in a cystic fibrosis clinic. Lancet. 1996 Sep 7;348(9028):639–642. doi: 10.1016/S0140-6736(96)05169-0. [DOI] [PubMed] [Google Scholar]
  5. Döring G., Jansen S., Noll H., Grupp H., Frank F., Botzenhart K., Magdorf K., Wahn U. Distribution and transmission of Pseudomonas aeruginosa and Burkholderia cepacia in a hospital ward. Pediatr Pulmonol. 1996 Feb;21(2):90–100. doi: 10.1002/(SICI)1099-0496(199602)21:2<90::AID-PPUL5>3.0.CO;2-T. [DOI] [PubMed] [Google Scholar]
  6. Fyfe J. A., Harris G., Govan J. R. Revised pyocin typing method for Pseudomonas aeruginosa. J Clin Microbiol. 1984 Jul;20(1):47–50. doi: 10.1128/jcm.20.1.47-50.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Grothues D., Koopmann U., von der Hardt H., Tümmler B. Genome fingerprinting of Pseudomonas aeruginosa indicates colonization of cystic fibrosis siblings with closely related strains. J Clin Microbiol. 1988 Oct;26(10):1973–1977. doi: 10.1128/jcm.26.10.1973-1977.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Hunfeld K. P., Schmidt C., Krackhardt B., Posselt H. G., Bargon J., Yahaf Y., Schäfer V., Brade V., Wichelhaus T. A. Risk of Pseudomonas aeruginosa cross-colonisation in patients with cystic fibrosis within a holiday camp--a molecular-epidemiological study. Wien Klin Wochenschr. 2000 Apr 7;112(7):329–333. [PubMed] [Google Scholar]
  9. Hutchinson G. R., Parker S., Pryor J. A., Duncan-Skingle F., Hoffman P. N., Hodson M. E., Kaufmann M. E., Pitt T. L. Home-use nebulizers: a potential primary source of Burkholderia cepacia and other colistin-resistant, gram-negative bacteria in patients with cystic fibrosis. J Clin Microbiol. 1996 Mar;34(3):584–587. doi: 10.1128/jcm.34.3.584-587.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Jakobsson B. M., Onnered A. B., Hjelte L., Nyström B. Low bacterial contamination of nebulizers in home treatment of cystic fibrosis patients. J Hosp Infect. 1997 Jul;36(3):201–207. doi: 10.1016/s0195-6701(97)90195-x. [DOI] [PubMed] [Google Scholar]
  11. Jones A. M., Govan J. R., Doherty C. J., Dodd M. E., Isalska B. J., Stanbridge T. N., Webb A. K. Spread of a multiresistant strain of Pseudomonas aeruginosa in an adult cystic fibrosis clinic. Lancet. 2001 Aug 18;358(9281):557–558. doi: 10.1016/s0140-6736(01)05714-2. [DOI] [PubMed] [Google Scholar]
  12. Kerem E., Corey M., Gold R., Levison H. Pulmonary function and clinical course in patients with cystic fibrosis after pulmonary colonization with Pseudomonas aeruginosa. J Pediatr. 1990 May;116(5):714–719. doi: 10.1016/s0022-3476(05)82653-8. [DOI] [PubMed] [Google Scholar]
  13. Kosorok M. R., Zeng L., West S. E., Rock M. J., Splaingard M. L., Laxova A., Green C. G., Collins J., Farrell P. M. Acceleration of lung disease in children with cystic fibrosis after Pseudomonas aeruginosa acquisition. Pediatr Pulmonol. 2001 Oct;32(4):277–287. doi: 10.1002/ppul.2009.abs. [DOI] [PubMed] [Google Scholar]
  14. Kubesch P., Dörk T., Wulbrand U., Kälin N., Neumann T., Wulf B., Geerlings H., Weissbrodt H., von der Hardt H., Tümmler B. Genetic determinants of airways' colonisation with Pseudomonas aeruginosa in cystic fibrosis. Lancet. 1993 Jan 23;341(8839):189–193. doi: 10.1016/0140-6736(93)90062-l. [DOI] [PubMed] [Google Scholar]
  15. Mahadeva R., Webb K., Westerbeek R. C., Carroll N. R., Dodd M. E., Bilton D., Lomas D. A. Clinical outcome in relation to care in centres specialising in cystic fibrosis: cross sectional study. BMJ. 1998 Jun 13;316(7147):1771–1775. doi: 10.1136/bmj.316.7147.1771. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Mortensen J. E., Fisher M. C., LiPuma J. J. Recovery of Pseudomonas cepacia and other Pseudomonas species from the environment. Infect Control Hosp Epidemiol. 1995 Jan;16(1):30–32. doi: 10.1086/646999. [DOI] [PubMed] [Google Scholar]
  17. Munck A., Bonacorsi S., Mariani-Kurkdjian P., Lebourgeois M., Gérardin M., Brahimi N., Navarro J., Bingen E. Genotypic characterization of Pseudomonas aeruginosa strains recovered from patients with cystic fibrosis after initial and subsequent colonization. Pediatr Pulmonol. 2001 Oct;32(4):288–292. doi: 10.1002/ppul.1121. [DOI] [PubMed] [Google Scholar]
  18. Ojeniyi B., Frederiksen B., Hoiby N. Pseudomonas aeruginosa cross-infection among patients with cystic fibrosis during a winter camp. Pediatr Pulmonol. 2000 Mar;29(3):177–181. doi: 10.1002/(sici)1099-0496(200003)29:3<177::aid-ppul4>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  19. Orsi G. B., Mansi A., Tomao P., Chiarini F., Visca P. Lack of association between clinical and environmental isolates of Pseudomonas aeruginosa in hospital wards. J Hosp Infect. 1994 May;27(1):49–60. doi: 10.1016/0195-6701(94)90068-x. [DOI] [PubMed] [Google Scholar]
  20. Speert D. P., Campbell M. E. Hospital epidemiology of Pseudomonas aeruginosa from patients with cystic fibrosis. J Hosp Infect. 1987 Jan;9(1):11–21. doi: 10.1016/0195-6701(87)90089-2. [DOI] [PubMed] [Google Scholar]
  21. Zembrzuska-Sadkowska E., Sneum M., Ojeniyi B., Heiden L., Høiby N. Epidemiology of Pseudomonas aeruginosa infection and the role of contamination of the environment in the Danish Cystic Fibrosis Centre. J Hosp Infect. 1995 Jan;29(1):1–7. doi: 10.1016/0195-6701(95)90288-0. [DOI] [PubMed] [Google Scholar]
  22. Zimakoff J., Høiby N., Rosendal K., Guilbert J. P. Epidemiology of Pseudomonas aeruginosa infection and the role of contamination of the environment in a cystic fibrosis clinic. J Hosp Infect. 1983 Mar;4(1):31–40. doi: 10.1016/0195-6701(83)90062-2. [DOI] [PubMed] [Google Scholar]
  23. da Silva Filho L. V., Levi J. E., Bento C. N., Rodrigues J. C., da Silvo Ramos S. R. Molecular epidemiology of Pseudomonas aeruginosa infections in a cystic fibrosis outpatient clinic. J Med Microbiol. 2001 Mar;50(3):261–267. doi: 10.1099/0022-1317-50-3-261. [DOI] [PubMed] [Google Scholar]

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