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Updated: Apr 25, 2026
Long Term Chronic Pseudomonas aeruginosa Airway Infection in Mice
Published on: March 17, 2014
Risk factors for Pseudomonas aeruginosa acquisition in intensive care units: a prospective multicentre study
A-G Venier1, C Leroyer2, C Slekovec3
1CHU, CCLIN Sud-Ouest, Bordeaux, France; INSERM U657, Université de Bordeaux, Bordeaux, France.
Background:
Pseudomonas aeruginosa is a major nosocomial pathogen in intensive care units (ICUs); however, endogenous versus exogenous origin of contamination remains unclear.
Aim:
To identify individual and environmental ICU risk factors for P. aeruginosa acquisition.
Methods:
A five-month prospective multicentric study was performed in ten French ICUs. Adult patients hospitalized in ICU for ≥ 24 h were included and screened for P. aeruginosa colonization on admission, weekly and before discharge. P. aeruginosa acquisition was defined by a subsequent colonization or infection if screening swabs on admission were negative. Water samples were obtained weekly on water taps of the ICUs. Data on patient characteristics, invasive devices exposure, antimicrobial therapy, P. aeruginosa water and patient colonization pressures, and ICU characteristics were collected. Hazard ratios (HRs) were estimated using multivariate Cox model.
Findings:
Among the 1314 patients without P. aeruginosa on admission, 201 (15%) acquired P. aeruginosa during their ICU stay. Individual characteristics significantly associated with P. aeruginosa acquisition were history of previous P. aeruginosa infection or colonization, cumulative duration of mechanical ventilation and cumulative days of antibiotics not active against P. aeruginosa. Environmental risk factors for P. aeruginosa acquisition were cumulative daily ward 'nine equivalents of nursing manpower use score' (NEMS) [hazard ratio (HR): 1.47 for ≥ 30 points; 95% confidence interval (CI): 1.06-2.03] and contaminated tap water in patient's room (HR: 1.76; CI: 1.09-2.84).
Conclusion:
Individual risk factors and environmental factors for which intervention is possible were identified for P. aeruginosa acquisition.
Insights
Pseudomonas aeruginosa acquisition in ICUs is linked to patient history, ventilation, and antibiotics. Environmental factors like nursing workload and contaminated tap water also increase risk.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Hospital Epidemiology
Background:
- Pseudomonas aeruginosa is a significant cause of hospital-acquired infections in intensive care units (ICUs).
- The source of P. aeruginosa contamination, whether from patients themselves or the environment, requires further investigation.
Purpose of the Study:
- To determine individual patient and environmental risk factors associated with P. aeruginosa acquisition in ICUs.
- To inform targeted interventions for preventing P. aeruginosa infections in critical care settings.
Main Methods:
- A prospective, multicenter study involving ten French ICUs over five months.
- Screening for P. aeruginosa colonization in adult ICU patients (≥ 24h hospitalization) on admission, weekly, and at discharge.
- Analysis of patient data, device use, antibiotic exposure, and environmental factors including tap water contamination using multivariate Cox models.
Main Results:
- 15% (201/1314) of patients acquired P. aeruginosa during their ICU stay.
- Individual risk factors included prior P. aeruginosa infection/colonization, prolonged mechanical ventilation, and non-active antibiotic use.
- Environmental factors associated with acquisition were high nursing workload (NEMS score ≥ 30) and contaminated ICU tap water.
Conclusions:
- Identified key individual and environmental risk factors for P. aeruginosa acquisition in ICUs.
- Highlights the potential for interventions targeting both patient-specific and environmental elements to reduce P. aeruginosa spread.
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