Related Experiment Video
Updated: Jul 26, 2025
Replication of the Ordered, Nonredundant Library of Pseudomonas aeruginosa strain PA14 Transposon Insertion Mutants
Published on: May 4, 2018
An intensive care unit outbreak with multi-drug-resistant Pseudomonas aeruginosa - spotlight on sinks
V Schärer1, M-T Meier1, R A Schuepbach2
1Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Background:
Pseudomonas aeruginosa and other Gram-negative bacteria have the ability to persist in moist environments in healthcare settings, but their spread from these areas can result in outbreaks of healthcare-associated infections.
Methods:
This study reports the investigation and containment of a multi-drug-resistant P. aeruginosa outbreak in three intensive care units of a Swiss university hospital. In total, 255 patients and 276 environmental samples were screened for the multi-drug-resistant P. aeruginosa outbreak strain. The environmental sampling and molecular characterization of patient and environmental strains, and control strategies implemented, including waterless patient care, are described.
Results:
Between March and November 2019, the outbreak affected 29 patients. Environmental sampling detected the outbreak strain in nine samples of sink siphons of three different intensive care units with a common water sewage system, and on one gastroscope. Three weeks after replacement of the sink siphons, the outbreak strain re-grew in siphon-derived samples and newly affected patients were identified. The outbreak ceased after removal of all sinks in the proximity of patients and in medication preparation areas, and minimization of tap water use. Multi-locus sequence typing indicated clonality (sequence type 316) in 28/29 patient isolates and all 10 environmental samples.
Conclusions:
Sink removal combined with the introduction of waterless patient care terminated the multi-drug-resistant P. aeruginosa outbreak. Sinks in intensive care units may pose a risk for point source outbreaks with P. aeruginosa and other bacteria persisting in moist environments.
Insights
Sink removal and waterless care stopped a multi-drug-resistant Pseudomonas aeruginosa outbreak in intensive care units. This highlights sinks as potential sources for hospital-acquired infections.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Microbiology
Background:
- Healthcare-associated infections (HAIs) pose significant risks, often linked to environmental persistence of pathogens.
- Gram-negative bacteria, such as Pseudomonas aeruginosa, thrive in moist healthcare settings, facilitating transmission.
- Controlling outbreaks requires understanding environmental reservoirs and effective intervention strategies.
Purpose of the Study:
- To investigate and contain a multi-drug-resistant Pseudomonas aeruginosa outbreak in intensive care units (ICUs).
- To identify the environmental source of the outbreak strain and evaluate control measures.
- To assess the role of sinks as potential point sources for bacterial persistence and transmission.
Main Methods:
- Conducted extensive environmental sampling and molecular characterization of Pseudomonas aeruginosa isolates from patients and the environment.
- Implemented interventions including sink siphon replacement, sink removal, and waterless patient care protocols.
- Utilized multi-locus sequence typing (MLST) to confirm strain clonality.
Main Results:
- The outbreak involved 29 patients between March and November 2019.
- The outbreak strain was identified in sink siphons across three ICUs and on a gastroscope.
- Sink removal and waterless care successfully terminated the outbreak, with re-growth observed after initial siphon replacement.
Conclusions:
- Sink removal, coupled with waterless patient care, effectively ended the multi-drug-resistant Pseudomonas aeruginosa outbreak.
- Intensive care unit sinks can serve as critical point sources for Pseudomonas aeruginosa outbreaks.
- Minimizing tap water use and removing potential reservoirs are key to preventing Gram-negative bacterial persistence and HAIs.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:28Gene Regulation in Microbial Communities: Quorum Sensing
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:25Urinary Tract Infection II: Pathophysiology
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include: