64 Infection control (IC) knowledge, beliefs and behaviours (KBB) amongst those with epidemic Pseudomonas aeruginosa (ePA)

Abstract

Objective ePA strains are common in CF, and are associated with worse outcomes. Factors associated with ePA are unclear, and evidence based IC is lacking. Methods Patients attending the Calgary Adult CF clinic completed a survey on IC KBB using a 7-point Likert scale. Chronic infection (CI) was defined using the Leeds criteria. For patients who had received lung transplantation (LTx), pre-LTx cultures were used to determine CI. PA strain typing was performed using PFGE. ePA strains were defined as strains shared by ≥3 individuals or established strains including: LES (Liverpool Epidemic Strain) and PES (Prairie Epidemic Strain). Results 144 of 169 patients (85%) participated. Median age was 30.3 years (45% males), and 18% were post LTx. CI was observed with PA 69%, MSSA 47%, MRSA 6%, NTM 10%, Bcc 3%. 30 patients with ePA were identified (28 PES, 2 LES). Those with ePA were no more likely to have other co-infections, but were less likely to have MSSA (OR 0.29). Patients with ePA did not differ with respect to beliefs regarding transmission potential of specific pathogens, circumstances that may lead to transmission or strategies to avoid infection. However, patients with ePA were more likely to associate with others outside of (p = 0.03) and at clinic (p = 0.05). Patients with ePA were more likely to have attended a CF camp (OR 8.32), and have a personal history of past (but not current) involvement with fundraising (OR 1.83). Conclusion Infections with ePA are closely linked to past behaviours and exposures, now routinely discouraged. In contrast, current beliefs and practices with the exception of direct patient–patient contact do not associate with risk of ePA.