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Molecular epidemiology of Pseudomonas aeruginosa--urinary tract infections in paraplegic patients
D Worlitzsch1, C Wolz, K Botzenhart
1Department of General and Environmental Hygiene, Hygiene Institut, Universität Tübingen, Federal Republic of Germany.
Abstract:
84 Pseudomonas aeruginosa strains from 29 paraplegic patients with urinary tract infections (UTI) and from the water reservoirs of specialized wards in two German hospitals were typed using a P. aeruginosa-specific DNA probe. P. aeruginosa strains were present in 51% of all accessible water reservoirs, including sinks of wash-basins and toilets in the wards. 14 of the 29 patients with UTI (48%) were infected by P. aeruginosa strains which were also isolated from these sources. Groups of up to four patients were infected by single strains. Some of the strains persisted in the wards and were isolated from the water reservoirs five to eight months after causing UTI. 89.5% of the investigated water samples yielded P. aeruginosa strains which were identical with strains from up to nine other sites. The wide distribution of single P. aeruginosa genotypes in the ward, the isolation of strains causing UTI from rooms inaccessible to the patients, and the outbreak of UTI caused by single, identical P. aeruginosa strains in groups of patients within short time periods, suggest that the strains are distributed by the personnel rather than by the patients who for the most part are immobile.
Insights
Pseudomonas aeruginosa, a common cause of hospital-acquired urinary tract infections (UTIs), frequently contaminates hospital water systems. Healthcare personnel likely spread these persistent P. aeruginosa strains to immobile patients.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Pseudomonas aeruginosa is a significant opportunistic pathogen causing hospital-acquired infections, particularly in vulnerable patient populations.
- Urinary tract infections (UTIs) are common nosocomial infections, and P. aeruginosa is a frequent causative agent.
Purpose of the Study:
- To investigate the source and transmission routes of P. aeruginosa strains causing UTIs in paraplegic patients.
- To determine the prevalence of P. aeruginosa in hospital water reservoirs and its association with patient infections.
Main Methods:
- DNA fingerprinting using a P. aeruginosa-specific DNA probe to type bacterial strains.
- Sampling of P. aeruginosa from patient urine isolates and hospital water reservoirs (sinks, toilets).
- Epidemiological analysis to correlate patient infections with environmental isolates.
Main Results:
- P. aeruginosa was detected in 51% of hospital water reservoirs.
- 48% of patients with UTIs were infected by P. aeruginosa strains found in the water sources.
- Identical P. aeruginosa strains were isolated from multiple patients and environmental sites, with some persisting for over eight months.
Conclusions:
- Hospital water systems serve as a reservoir for P. aeruginosa, contributing to UTIs in patients.
- The distribution patterns suggest healthcare personnel are the primary vectors for P. aeruginosa transmission, rather than immobile patients.
- Effective infection control measures targeting environmental contamination and personnel hygiene are crucial.