Skip to main content
NCBI home page
Epidemiology and Infection logoLink to Epidemiology and Infection
. 1993 Jun;110(3):427–436. doi: 10.1017/s0950268800050858

Molecular epidemiology of Pseudomonas aeruginosa in an intensive care unit.

G Döring 1, M Hörz 1, J Ortelt 1, H Grupp 1, C Wolz 1
PMCID: PMC2272285  PMID: 8519308

Abstract

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 > 10(5)/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 x 10(5)-7.0 x 10(10) c.f.u./ml), whereas at 13.00 h P. aeruginosa c.f.u. were significantly lower (3.1 x 10(2)-8.0 x 10(5) 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.

Full text

PDF
427

Images in this article

430Fig. 1
on p.430

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Botzenhart K., Rüden H. Hospital infections caused by Pseudomonas aeruginosa. Antibiot Chemother (1971) 1987;39:1–15. doi: 10.1159/000414328. [DOI] [PubMed] [Google Scholar]
  2. Brown D. G., Baublis J. Reservoirs of pseudomonas in an intensive care unit for newborn infants: mechanisms of control. J Pediatr. 1977 Mar;90(3):453–457. doi: 10.1016/s0022-3476(77)80715-4. [DOI] [PubMed] [Google Scholar]
  3. Craven D. E., Daschner F. D. Nosocomial pneumonia in the intubated patient: role of gastric colonization. Eur J Clin Microbiol Infect Dis. 1989 Jan;8(1):40–50. doi: 10.1007/BF01964119. [DOI] [PubMed] [Google Scholar]
  4. Döring G., Bareth H., Gairing A., Wolz C., Botzenhart K. Genotyping of Pseudomonas aeruginosa sputum and stool isolates from cystic fibrosis patients: evidence for intestinal colonization and spreading into toilets. Epidemiol Infect. 1989 Dec;103(3):555–564. doi: 10.1017/s0950268800030958. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Döring G., Ulrich M., Müller W., Bitzer J., Schmidt-Koenig L., Münst L., Grupp H., Wolz C., Stern M., Botzenhart K. Generation of Pseudomonas aeruginosa aerosols during handwashing from contaminated sink drains, transmission to hands of hospital personnel, and its prevention by use of a new heating device. Zentralbl Hyg Umweltmed. 1991 May;191(5-6):494–505. [PubMed] [Google Scholar]
  6. Freeman R., McPeake P. K. Acquisition, spread, and control of Pseudomonas aeruginosa in a cardiothoracic intensive care unit. Thorax. 1982 Oct;37(10):732–736. doi: 10.1136/thx.37.10.732. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Gerba C. P., Wallis C., Melnick J. L. Microbiological hazards of household toilets: droplet production and the fate of residual organisms. Appl Microbiol. 1975 Aug;30(2):229–237. doi: 10.1128/am.30.2.229-237.1975. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Griffith S. J., Nathan C., Selander R. K., Chamberlin W., Gordon S., Kabins S., Weinstein R. A. The epidemiology of Pseudomonas aeruginosa in oncology patients in a general hospital. J Infect Dis. 1989 Dec;160(6):1030–1036. doi: 10.1093/infdis/160.6.1030. [DOI] [PubMed] [Google Scholar]
  9. Kohn J. A waste-trap-sterilising method. Lancet. 1970 Sep 12;2(7672):550–551. doi: 10.1016/s0140-6736(70)91351-6. [DOI] [PubMed] [Google Scholar]
  10. Levin M. H., Olson B., Nathan C., Kabins S. A., Weinstein R. A. Pseudomonas in the sinks in an intensive care unit: relation to patients. J Clin Pathol. 1984 Apr;37(4):424–427. doi: 10.1136/jcp.37.4.424. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. MacArthur R. D., Lehman M. H., Currie-McCumber C. A., Shlaes D. M. The epidemiology of gentamicin-resistant Pseudomonas aeruginosa on an intermediate care unit. Am J Epidemiol. 1988 Oct;128(4):821–827. doi: 10.1093/oxfordjournals.aje.a115035. [DOI] [PubMed] [Google Scholar]
  12. Murthy S. K., Baltch A. L., Smith R. P., Desjardin E. K., Hammer M. C., Conroy J. V., Michelsen P. B. Oropharyngeal and fecal carriage of Pseudomonas aeruginosa in hospital patients. J Clin Microbiol. 1989 Jan;27(1):35–40. doi: 10.1128/jcm.27.1.35-40.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Mäkelä P., Ojajärvi J., Salminen E. Decontaminating waste-trap. Lancet. 1972 Jun 3;1(7762):1216–1217. doi: 10.1016/s0140-6736(72)90930-0. [DOI] [PubMed] [Google Scholar]
  14. Noone M. R., Pitt T. L., Bedder M., Hewlett A. M., Rogers K. B. Pseudomonas aeruginosa colonisation in an intensive therapy unit: role of cross infection and host factors. Br Med J (Clin Res Ed) 1983 Jan 29;286(6362):341–344. doi: 10.1136/bmj.286.6362.341. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Ogle J. W., Janda J. M., Woods D. E., Vasil M. L. Characterization and use of a DNA probe as an epidemiological marker for Pseudomonas aeruginosa. J Infect Dis. 1987 Jan;155(1):119–126. doi: 10.1093/infdis/155.1.119. [DOI] [PubMed] [Google Scholar]
  16. Olson B., Weinstein R. A., Nathan C., Chamberlin W., Kabins S. A. Epidemiology of endemic Pseudomonas aeruginosa: why infection control efforts have failed. J Infect Dis. 1984 Dec;150(6):808–816. doi: 10.1093/infdis/150.6.808. [DOI] [PubMed] [Google Scholar]
  17. Schimpff S. C., Greene W. H., Young V. M., Wiernik P. H. Significance of Pseudomonas aeruginosa in the patient with leukemia or lymphoma. J Infect Dis. 1974 Nov;130 (Suppl)(0):S24–S31. doi: 10.1093/infdis/130.supplement.s24. [DOI] [PubMed] [Google Scholar]
  18. Sherertz R. J., Sarubbi F. A. A three-year study of nosocomial infections associated with Pseudomonas aeruginosa. J Clin Microbiol. 1983 Jul;18(1):160–164. doi: 10.1128/jcm.18.1.160-164.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Southern E. M. Detection of specific sequences among DNA fragments separated by gel electrophoresis. J Mol Biol. 1975 Nov 5;98(3):503–517. doi: 10.1016/s0022-2836(75)80083-0. [DOI] [PubMed] [Google Scholar]
  20. Teres D., Schweers P., Bushnell L. S., Hedley-Whyte J., Feingold D. S. Sources of Pseudomonas aeruginosa infection in a respiratory-surgical intensive-therapy unit. Lancet. 1973 Feb 24;1(7800):415–417. doi: 10.1016/s0140-6736(73)90266-3. [DOI] [PubMed] [Google Scholar]
  21. Valenti W. M., Trudell R. G., Bentley D. W. Factors predisposing to oropharyngeal colonization with gram-negative bacilli in the aged. N Engl J Med. 1978 May 18;298(20):1108–1111. doi: 10.1056/NEJM197805182982002. [DOI] [PubMed] [Google Scholar]
  22. Vasil M. L., Chamberlain C., Grant C. C. Molecular studies of Pseudomonas exotoxin A gene. Infect Immun. 1986 May;52(2):538–548. doi: 10.1128/iai.52.2.538-548.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Wenzel R. P. Hospital-acquired pneumonia: overview of the current state of the art for prevention and control. Eur J Clin Microbiol Infect Dis. 1989 Jan;8(1):56–60. doi: 10.1007/BF01964121. [DOI] [PubMed] [Google Scholar]
  24. Wolz C., Kiosz G., Ogle J. W., Vasil M. L., Schaad U., Botzenhart K., Döring G. Pseudomonas aeruginosa cross-colonization and persistence in patients with cystic fibrosis. Use of a DNA probe. Epidemiol Infect. 1989 Apr;102(2):205–214. doi: 10.1017/s0950268800029873. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Worlitzsch D., Wolz C., Botzenhart K., Hansis M., Burgdörfer H., Ogle J. W., Döring G. Molecular epidemiology of Pseudomonas aeruginosa--urinary tract infections in paraplegic patients. Zentralbl Hyg Umweltmed. 1989 Nov;189(2):175–184. [PubMed] [Google Scholar]

Articles from Epidemiology and Infection are provided here courtesy of Cambridge University Press

RESOURCES