Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-24T23:36:56.606Z Has data issue: false hasContentIssue false
  • English
  • Français

Investigation of an Epidemic of Multi-Drug Resistant Pseudomonas aeruginosa

Published online by Cambridge University Press:  02 January 2015

Susan A. Murray  and
David R. Snydman
Susan A. Murray
Affiliation:
Hospital Epidemiology Section, Division of Infectious Disease, Department of Medicine, New England Medical Center, Boston, Massachusetts
David R. Snydman*
Affiliation:
Hospital Epidemiology Section, Division of Infectious Disease, Department of Medicine, New England Medical Center, Boston, Massachusetts
*
Box 238, 171 Harrison Avenue, Boston, MA 02111
Get access Rights & Permissions [Opens in a new window]

Abstract

Inter- and intrahospital epidemics of nosocomial infections due to gram-negative bacilli resistant to many antimicrobials have been well-documented. Prospective studies on the use of isolation along with epidemiologic analysis and appropriate environmental control have been lacking. In the six-month period from November 1978 to April 1979 Pseudomonas aeruginosa (MDR) resistant to all antibiotics except amikacin was isolated from 15 patients. This organism had not previously been seen in our hospital. Epidemiologic assessment of infected patients revealed that nine of 15 patients had contact either with a previously infected case or contaminated area. All strains of P. aeruginosa were identical by pyocin typing and antibiogram. The organism was present in an environmental reservoir, the urine graduated cylinder, and was found in three of eight receptacles (p = 0.002 vs. other environmental cultures). A case control study of patient risk factors showed aminoglycoside use, other antibiotic use, surgery, intravenous lines, Foley catheter use and mechanical ventilation to be no more frequent in cases than controls. The use of aminoglycosides in only 40% of cases suggests that antibiotic pressure was not the sole factor in perpetuating the epidemic.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 3 , Issue 6 , December 1982 , pp. 456 - 460
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1982

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Weinstein, RA, Nathan, C, Gruenfelder, R, et al: Endemie aminoglycoside resistance in gram-negative bacilli: Epidemiology and mechanism. J Infect Dis 1980;141:338–345.CrossRefGoogle Scholar
2. Chow, AW, Taylor, PR, Yoshikawa, TT, et al: A nosocomial outbreak of infections due to multiply resistant Proteus Mirabilis: Role of intestinal colonization as a major reservoir. J Infect Dis 1979;139:621–627.Google Scholar
3. Yu, VL, Oakes, CA, Axnick, KJ, et al: Patient factors contributing to the emergence of gentamicin-resistant Serratia marcescens . Am J Med 1979;66:468–472.Google Scholar
4. Graham, DR, Clegg, HW II, Anderson, RL, et al: Gentamicin treatment associated with later nosocomial gentamicin resistant Serratia marcescens . Infect Control 1981;2:31–37.CrossRefGoogle ScholarPubMed
5. Kaslow, RW, Lindsey, JO, Bisno, AL, et al: Nosocomial infection with highly resistant Proteus Rettgeri: Report of an epidemic. Am J Epid 1976;104:278–286.Google Scholar
6. Weinstein, RA, Kabins, SA: Strategies for prevention and control of multiple drug-resistant nosocomial infection. Am J Med 1981;70:449–454.CrossRefGoogle ScholarPubMed
7. Simon, GL, Snydman, DR, Tally, FP, et al: Clinical trial of piperacillin with acquisition of resistance by Pseudomonas and clinical relapse. Antimicrob Agents Chemother 1980;18:167–170.CrossRefGoogle ScholarPubMed
8. Farmer, JJ III, Herman, LG: Epidemiologic fingerprinting of Pseudomonas aeruginosa by production and sensitivity to pyocin and bacteriophage. Appl Microbiol 1969;18:760–765.Google Scholar
9. Gardner, P, Bennett, JV, Burke, JB, et al: Nosocomial management of resistant gram-negative bacilli. J Infect Dis 1980;141:415–417.Google Scholar
10. Gaman, W, Cates, CFT, Snelling, CFT, et al: Emergence of gentamicin-and carbenicillin-resistant Pseudomonas aeruginosa in hospital environment. Antimicrob Agents Chemother 1976;9:474–480.Google Scholar
11. Marrie, TJ, Major, H, Gurwith, M, el al: Prolonged outbreak of nosocomial urinary tract infection with a single strain of Pseudomonas aeruginosa . Can Med Assoc J 1978;119:593–598.Google ScholarPubMed
12. Rutala, WA, Kennedy, VA, Loflin, HB, et al: Serratia marcescens nosocomial infections of the urinary tract associated with urine measuring containers and urinometers. Am J Med 1981;70:659–663.CrossRefGoogle ScholarPubMed