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The epidemiology of nosocomial epidemic Pseudomonas cepacia infections
W J Martone1, O C Tablan, W R Jarvis
1Epidemiology Branch, Center for Infectious Diseases, Atlanta, Georgia 30333.
Abstract:
Pseudomonas cepacia has occasionally been identified as an epidemic and endemic nosocomial pathogen. In outbreaks, usually one clinical site predominates but many may be involved. Detailed investigations have usually implicated a contaminated liquid reservoir or moist environmental surface as the source. Liquid sources have included a number of different classes of antiseptics and disinfectants such as quaternary ammonium chlorides, biguanides, hexachlorophene, and iodophors. Environmental and patient isolates have had multiply resistant antimicrobial susceptibility patterns. The clinical distinction between colonization and infection may be difficult and may challenge the skills of the clinician. Expenditure of resources needed to solve epidemics is justified in view of the potential virulence of this organism and the high likelihood that an unrecognized but easily eliminated liquid environmental reservoir may be the source.
Insights
Pseudomonas cepacia, a nosocomial pathogen, often originates from contaminated liquid reservoirs like disinfectants. Identifying and eliminating these sources is crucial for controlling outbreaks and preventing infections.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Pseudomonas cepacia is an opportunistic nosocomial pathogen.
- Outbreaks involve multiple clinical sites, often linked to contaminated liquid reservoirs.
Purpose of the Study:
- To investigate the sources and characteristics of Pseudomonas cepacia outbreaks.
- To highlight the importance of environmental reservoirs in hospital-acquired infections.
Main Methods:
- Review of outbreak investigations.
- Analysis of implicated liquid antiseptics and disinfectants.
- Assessment of antimicrobial susceptibility patterns.
Main Results:
- Contaminated liquid reservoirs (antiseptics, disinfectants) are common sources.
- Patient and environmental isolates exhibit multidrug resistance.
- Distinguishing colonization from infection can be challenging.
Conclusions:
- Environmental reservoirs, particularly liquids, are key to Pseudomonas cepacia epidemiology.
- Resource expenditure for outbreak control is justified due to the organism's virulence.
- Early identification and elimination of environmental sources are critical.