Pseudomonas aeruginosa infection in augmented care: the molecular ecology and transmission dynamics in four large UK hospitals.

Halstead, Fenella D, Quick, Joshua, Niebel, Marc O, Garvey, Mark, Cumley, Nicola, Smith, Robin, Neal, Timothy, Roberts, Paul, Hardy, Katie, Shabir, Sahida, Walker, James T, Hawkey, Peter and Loman, Nicholas J (2021) Pseudomonas aeruginosa infection in augmented care: the molecular ecology and transmission dynamics in four large UK hospitals. The Journal of hospital infection. ISSN 1532-2939. (In Press)

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Official URL: https://www.journalofhospitalinfection.com/article...

Abstract

BACKGROUND

Pseudomonas aeruginosa is a common opportunistic pathogen and molecular typing in outbreaks has linked patient acquisition to contaminated hospital water systems.

AIM

To elucidate the role of P. aeruginosa transmission rates in non-outbreak augmented care setting in the UK.

METHODS

Over a 16-week period, all water outlets in augmented care units of four hospitals were sampled for P. aeruginosa and clinical isolates were collected. Outlet and clinical P. aeruginosa isolates underwent whole genome sequencing (WGS), which with epidemiological data identified acquisition from water as definite (level 1), probable (level 2), possible (level 3), and no evidence (level 4).

FINDINGS

Outlets were positive in each hospital on all three occasions, W (16%), X (2.5%), Y (0.9%) and Z (2%), and there were 51 persistently positive outlets in total. WGS identified likely transmission (at levels 1, 2 and 3) from outlets to patients in three hospitals for P. aeruginosa positive patients: W (63%), X (54.5%) and Z (26%). According to the criteria (intimate epidemiological link and no phylogenetic distance), approximately 5% of patients in the study 'definitely' acquired their P. aeruginosa from their water outlets in ICU. This study found extensive evidence of transmission from the outlet to the patients particularly in the newest hospital (W), which had the highest rate of positive outlets.

CONCLUSIONS

The overall findings suggest that water outlets are the most likely source of P. aeruginosa nosocomial infections in some settings, and that widespread introduction of control measures would have a substantial impact on infections.

Item Type: Article
Subjects: WC Communicabable diseases
WF Respiratory system. Respiratory medicine
Divisions: Clinical Support > Infection Control
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Depositing User: Mrs Yolande Brookes
Date Deposited: 25 Feb 2021 12:18
Last Modified: 25 Feb 2021 12:18
URI: http://www.repository.uhblibrary.co.uk/id/eprint/4015

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