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Nosocomial infection due to Pseudomonas pseudomallei: two cases and an epidemiologic study
Abstract:
Pseudomonas pseudomallei was recovered from urine specimens of two patients who acquired the organism after they were admitted to a hospital in a region in which it is endemic. Both patients were diabetic and both had urethral catheters passed while they were hospitalized. samples of soil taken from the hospital grounds yielded an isolate of P. pseudomallei that was identical biochemically and by antibiogram to the two isolates recovered from the urine specimens of the two patients. The two patients stayed in wards located in separate hospital blocks, which were geographically distinct but connected by a walkway. The relevant clinical histories of the two patients and the epidemiologic and microbiologic characteristics of the P. pseudomallei isolates were studied. Sera from both patients showed a significant rise in titers of antibody specific for P. pseudomallei. These two patients are considered to represent the first reported cases of hospital-acquired infection due to P. pseudomallei.
Insights
Two diabetic patients developed hospital-acquired Pseudomonas pseudomallei infections, likely from environmental soil contamination on hospital grounds. This highlights a new risk for endemic bacterial infections in healthcare settings.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Environmental Microbiology
Background:
- Pseudomonas pseudomallei (P. pseudomallei) causes melioidosis, a serious infection endemic in certain regions.
- Hospital-acquired infections (HAIs) are a significant concern, particularly in vulnerable patient populations.
- Diabetes mellitus is a known risk factor for P. pseudomallei infections.
Observation:
- Two diabetic patients in an endemic region developed P. pseudomallei urinary tract infections during hospitalization.
- Both patients had indwelling urethral catheters, a potential route for infection.
- P. pseudomallei isolates from patient urine matched environmental soil isolates from the hospital grounds.
Findings:
- The study identified the first reported cases of hospital-acquired P. pseudomallei infection.
- Environmental contamination of hospital grounds with P. pseudomallei was confirmed.
- Patient isolates were biochemically and antibiogrammatically identical to environmental isolates.
Implications:
- Hospital environmental hygiene is critical in regions where P. pseudomallei is endemic.
- Healthcare facilities must implement strategies to prevent P. pseudomallei transmission.
- Catheterized patients, especially those with diabetes, are at increased risk for P. pseudomallei HAIs.