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Exogenous acquisition of Pseudomonas aeruginosa in intensive care units: a prospective multi-centre study (DYNAPYO

M Coppry1, C Leroyer2, M Saly2

  • 1Université de Bordeaux, CHU Bordeaux, Hygiène hospitalière, Bordeaux, France; Université de Bordeaux, Inserm, Bordeaux Population Health Research Centre, UMR 1219, France.

The Journal of Hospital Infection
|August 17, 2019
PubMed
Abstract

Insights

Exogenous acquisition of Pseudomonas aeruginosa (P. aeruginosa) is common in intensive care units (ICUs), affecting nearly half of patients. Preventing environmental transmission could significantly reduce P. aeruginosa infections in ICUs.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Hospital Epidemiology

Background:

  • Pseudomonas aeruginosa is a frequent cause of nosocomial infections in intensive care units (ICUs).
  • The contribution of exogenous acquisition to P. aeruginosa infections during non-outbreak periods is not well understood.

Purpose of the Study:

  • To investigate the role and prevalence of exogenous acquisition of P. aeruginosa in ICU patients.
  • To differentiate between endogenous and exogenous sources of P. aeruginosa colonization and infection.

Main Methods:

  • A prospective cohort study (DYNAPYO) involving weekly screening of ICU patients and tap water for P. aeruginosa.
  • Molecular typing (pulsed-field gel electrophoresis) to determine the relatedness of bacterial isolates.
  • Definition of exogenous acquisition based on matching pulsotypes found in patients and environmental sources (tap water) or other patients.

Main Results:

  • The study analyzed 1808 patients and 181 tap water samples, identifying 296 distinct P. aeruginosa pulsotypes.
  • Exogenous acquisition was identified in 170 (45.6%) of 373 patients.
  • A significant proportion of exogenous acquisitions were linked to strains previously isolated from other patients (86 patients) or tap water (29 patients), with variations observed between ICUs.

Conclusions:

  • Exogenous acquisition of P. aeruginosa is a substantial contributor to patient infections in ICUs, potentially preventable in nearly half of cases.
  • Further research into transmission routes and risk assessment is crucial for developing effective control strategies against P. aeruginosa in healthcare settings.
Keywords:
Intensive care unitPseudomonas aeruginosaPulsed-field gel electrophoresisWater taps

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