Abstract
Sink drains in a medical-surgical intensive care unit (ICU) were cultured during six consecutive weeks as part of a seven month prospective study of acquisition of Pseudomonas aeruginosa by ICU patients. Isolates were typed serologically and by aminoglycoside and chlorhexidine susceptibility patterns. All 11 sinks contained multiple strains of P aeruginosa; some strains persisted for weeks while others were isolated once. Of the sink isolates 56% had high level resistance to gentamicin and tobramycin whereas none of the strains found in patients. In sink isolates chlorhexidine resistance correlated with aminoglycoside resistance and with the presence of a chlorhexidine dispenser at a sink. The sequence of recovery of phenotypically similar isolates suggested that sinks were the source of at most two acquisitions of P aeruginosa by patients during the six weeks. Our study confirms that sinks may be reservoirs for large numbers of highly resistant P aeruginosa but are rarely the source of organisms colonising patients in our ICU.
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Selected References
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- 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]
- Feeley T. W., Du Moulin G. C., Hedley-Whyte J., Bushnell L. S., Gilbert J. P., Feingold D. S. Aerosol polymyxin and pneumonia in seriously ill patients. N Engl J Med. 1975 Sep 4;293(10):471–475. doi: 10.1056/NEJM197509042931003. [DOI] [PubMed] [Google Scholar]
- Gaynes R. P., Weinstein R. A., Smith J., Carman M., Kabins S. A. Control of aminoglycoside resistance by barrier precautions. Infect Control. 1983 Jul-Aug;4(4):221–224. doi: 10.1017/s0195941700058264. [DOI] [PubMed] [Google Scholar]
- Moody M. R., Young V. M., Kenton D. M., Vermeulen G. D. Pseudomonas aeruginosa in a center for cancer research. I. Distribution of intraspecies types from human and environmental sources. J Infect Dis. 1972 Feb;125(2):95–101. doi: 10.1093/infdis/125.2.95. [DOI] [PubMed] [Google Scholar]
- Nakahara H., Kozukue H. Isolation of chlorhexidine-resistant Pseudomonas aeruginosa from clinical lesions. J Clin Microbiol. 1982 Jan;15(1):166–168. doi: 10.1128/jcm.15.1.166-168.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Perryman F. A., Flournoy D. J. Prevalence of gentamicin- and amikacin-resistant bacteria in sink drains. J Clin Microbiol. 1980 Jul;12(1):79–83. doi: 10.1128/jcm.12.1.79-83.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pickett M. J., Pedersen M. M. Nonfermentative bacilli associated with man. II. Detection and identification. Am J Clin Pathol. 1970 Aug;54(2):164–177. doi: 10.1093/ajcp/54.2.164. [DOI] [PubMed] [Google Scholar]
- Stickler D. J., Thomas B. Antiseptic and antibiotic resistance in Gram-negative bacteria causing urinary tract infection. J Clin Pathol. 1980 Mar;33(3):288–296. doi: 10.1136/jcp.33.3.288. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stickler D. J., Thomas B., Chawla J. C. Antiseptic and antibiotic resistance in gram-negative bacteria causing urinary tract infection in spinal cord injured patients. Paraplegia. 1981;19(1):50–58. doi: 10.1038/sc.1981.13. [DOI] [PubMed] [Google Scholar]
- Weinstein R. A., Nathan C., Gruensfelder R., Kabins S. A. Endemic aminoglycoside resistance in gram-negative bacilli: epidemiology and mechanisms. J Infect Dis. 1980 Mar;141(3):338–345. doi: 10.1093/infdis/141.3.338. [DOI] [PubMed] [Google Scholar]