M. Virieux-Petit , J. Ferreira , A. Masnou , C. Bormes , M-P. Paquis , M. Toubiana , L. Bonzon , S. Godreuil , S. Romano-Bertrand
{"title":"评估环境在铜绿假单胞菌医源性血流感染中的作用：为期一年的前瞻性调查。","authors":"M. Virieux-Petit , J. Ferreira , A. Masnou , C. Bormes , M-P. Paquis , M. Toubiana , L. Bonzon , S. Godreuil , S. Romano-Bertrand","doi":"10.1016/j.jhin.2024.11.009","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Deciphering precise sources and patterns of healthcare-associated <em>Pseudomonas aeruginosa</em> colonization/infection is crucial in defining strategies of prevention and control.</div></div><div><h3>Aim</h3><div>To prospectively investigate the role of hospital environment in <em>P</em>. <em>aeruginosa</em> nosocomial bloodstream infections (Pa-BSIs) during one year in a tertiary-care hospital.</div></div><div><h3>Methods</h3><div>Clinical records of patients presenting Pa-BSIs after >48 h of hospitalization were investigated to confirm the nosocomial character of BSIs and identify the routes of entry and risk factors. Environmental investigations were performed to track <em>P</em>. <em>aeruginosa</em> source/reservoir along the care pathway. Clinical and environmental strains were compared by whole-genome sequencing to identify the route of contamination from hospital environment to patients.</div></div><div><h3>Findings</h3><div>Fifty-three BSIs episodes in 49 patients were considered as nosocomial, mostly involving men (73%), with an average age of 62.4 years, immunosuppressed in >40% of cases, and after previous antibiotic therapy in almost 92% of cases. BSIs occurred after 27 days of hospitalization on average. The main routes of entry were urinary (30%, on indwelling catheters for two-thirds of cases) and cutaneous (17%, catheter-related in almost 80% of cases). <em>P</em>. <em>aeruginosa</em> was found in 16 out of 49 investigations, representing 34 positive samples, including 54% of sink traps, 23% of water, and 20% of tap aerators. An epidemiological link was established between environmental and clinical strains only for eight patients, representing 15% of nosocomial BSIs.</div></div><div><h3>Conclusion</h3><div>The hospital environment usually considered as the main source of <em>P</em>. <em>aeruginosa</em> healthcare-associated infections was identified as responsible for nosocomial BSIs in only 15% of patients. Since the implementation of water and hospital environment management, one may hypothesize that <em>P</em>. <em>aeruginosa</em> has become a community-acquired pathogen with a nosocomial expression in infection.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"156 ","pages":"Pages 26-33"},"PeriodicalIF":3.9000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Assessing the role of environment in Pseudomonas aeruginosa healthcare-associated bloodstream infections: a one-year prospective survey\",\"authors\":\"M. Virieux-Petit , J. Ferreira , A. Masnou , C. Bormes , M-P. Paquis , M. Toubiana , L. Bonzon , S. Godreuil , S. Romano-Bertrand\",\"doi\":\"10.1016/j.jhin.2024.11.009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Deciphering precise sources and patterns of healthcare-associated <em>Pseudomonas aeruginosa</em> colonization/infection is crucial in defining strategies of prevention and control.</div></div><div><h3>Aim</h3><div>To prospectively investigate the role of hospital environment in <em>P</em>. <em>aeruginosa</em> nosocomial bloodstream infections (Pa-BSIs) during one year in a tertiary-care hospital.</div></div><div><h3>Methods</h3><div>Clinical records of patients presenting Pa-BSIs after >48 h of hospitalization were investigated to confirm the nosocomial character of BSIs and identify the routes of entry and risk factors. Environmental investigations were performed to track <em>P</em>. <em>aeruginosa</em> source/reservoir along the care pathway. Clinical and environmental strains were compared by whole-genome sequencing to identify the route of contamination from hospital environment to patients.</div></div><div><h3>Findings</h3><div>Fifty-three BSIs episodes in 49 patients were considered as nosocomial, mostly involving men (73%), with an average age of 62.4 years, immunosuppressed in >40% of cases, and after previous antibiotic therapy in almost 92% of cases. BSIs occurred after 27 days of hospitalization on average. The main routes of entry were urinary (30%, on indwelling catheters for two-thirds of cases) and cutaneous (17%, catheter-related in almost 80% of cases). <em>P</em>. <em>aeruginosa</em> was found in 16 out of 49 investigations, representing 34 positive samples, including 54% of sink traps, 23% of water, and 20% of tap aerators. An epidemiological link was established between environmental and clinical strains only for eight patients, representing 15% of nosocomial BSIs.</div></div><div><h3>Conclusion</h3><div>The hospital environment usually considered as the main source of <em>P</em>. <em>aeruginosa</em> healthcare-associated infections was identified as responsible for nosocomial BSIs in only 15% of patients. Since the implementation of water and hospital environment management, one may hypothesize that <em>P</em>. <em>aeruginosa</em> has become a community-acquired pathogen with a nosocomial expression in infection.</div></div>\",\"PeriodicalId\":54806,\"journal\":{\"name\":\"Journal of Hospital Infection\",\"volume\":\"156 \",\"pages\":\"Pages 26-33\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hospital Infection\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0195670124003888\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hospital Infection","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0195670124003888","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Assessing the role of environment in Pseudomonas aeruginosa healthcare-associated bloodstream infections: a one-year prospective survey
Background
Deciphering precise sources and patterns of healthcare-associated Pseudomonas aeruginosa colonization/infection is crucial in defining strategies of prevention and control.
Aim
To prospectively investigate the role of hospital environment in P. aeruginosa nosocomial bloodstream infections (Pa-BSIs) during one year in a tertiary-care hospital.
Methods
Clinical records of patients presenting Pa-BSIs after >48 h of hospitalization were investigated to confirm the nosocomial character of BSIs and identify the routes of entry and risk factors. Environmental investigations were performed to track P. aeruginosa source/reservoir along the care pathway. Clinical and environmental strains were compared by whole-genome sequencing to identify the route of contamination from hospital environment to patients.
Findings
Fifty-three BSIs episodes in 49 patients were considered as nosocomial, mostly involving men (73%), with an average age of 62.4 years, immunosuppressed in >40% of cases, and after previous antibiotic therapy in almost 92% of cases. BSIs occurred after 27 days of hospitalization on average. The main routes of entry were urinary (30%, on indwelling catheters for two-thirds of cases) and cutaneous (17%, catheter-related in almost 80% of cases). P. aeruginosa was found in 16 out of 49 investigations, representing 34 positive samples, including 54% of sink traps, 23% of water, and 20% of tap aerators. An epidemiological link was established between environmental and clinical strains only for eight patients, representing 15% of nosocomial BSIs.
Conclusion
The hospital environment usually considered as the main source of P. aeruginosa healthcare-associated infections was identified as responsible for nosocomial BSIs in only 15% of patients. Since the implementation of water and hospital environment management, one may hypothesize that P. aeruginosa has become a community-acquired pathogen with a nosocomial expression in infection.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
