Cross-colonisation with Pseudomonas aeruginosa of patients in an intensive care unit.

D.C.J.J. Bergmans, M.J. Bonten, F.H. van Tiel, C.E. Gaillard, S. van der Geest, R.M. Wilting, P.W. de Leeuw, E.E. Stobberingh

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Abstract

Department of Internal Medicine, University Hospital Maastricht, The Netherlands.

BACKGROUND: Ventilator-associated pneumonia (VAP) caused by Pseudomonas aeruginosa is usually preceded by colonisation of the respiratory tract. During outbreaks, colonisation with P aeruginosa is mainly derived from exogenous sources. The relative importance of different pathways of colonisation of P aeruginosa has rarely been determined in non-epidemic settings. METHODS: In order to determine the importance of exogenous colonisation, all isolates of P aeruginosa obtained by surveillance and clinical cultures from two identical intensive care units (ICUs) were genotyped with pulsed field gel electrophoresis. RESULTS: A total of 100 patients were studied, 44 in ICU 1 and 56 in ICU 2. Twenty three patients were colonised with P aeruginosa, seven at the start of the study or on admission and 16 of the remaining 93 patients became colonised during the study. Eight patients developed VAP due to P aeruginosa. The incidence of respiratory tract colonisation and VAP with P aeruginosa in our ICU was similar to that before and after the study period, and therefore represents an endemic situation. Genotyping of 118 isolates yielded 11 strain types: eight in one patient each, two in three patients each, and one type in eight patients. Based on chronological evaluation and genotypical identity of isolates, eight cases of cross-colonisation were identified. Eight (50%) of 16 episodes of acquired colonisation and two (25%) of eight cases of VAP due to P aeruginosa seemed to be the result of cross-colonisation. CONCLUSIONS: Even in non-epidemic settings cross-colonisation seems to play an important part in the epidemiology of colonisation and infection with P aeruginosa.
Original languageEnglish
Pages (from-to)1053-1058
Number of pages6
JournalThorax
Volume53
Issue number12
DOIs
Publication statusPublished - 1 Jan 1998

Cite this

Bergmans, D. C. J. J., Bonten, M. J., van Tiel, F. H., Gaillard, C. E., van der Geest, S., Wilting, R. M., de Leeuw, P. W., & Stobberingh, E. E. (1998). Cross-colonisation with Pseudomonas aeruginosa of patients in an intensive care unit. Thorax, 53(12), 1053-1058. https://doi.org/10.1136/thx.53.12.1053