Abstract
Pseudomonas aeruginosa, in intensive care units (ICUs), causes infections with high morbidity and mortality rates. Tap water outlets are often contaminated with P.aeruginosa and may represent a source of endemic infections in ICUs.The aim of this study was to explore the role of point-of-use (POU) filters in neo-natal intensive care unit (NICU) in reduc-ing P.aeruginosa colonizations/infections. Routine surveillance cultures, environ-mental cultures and samples from the hands of healthcare personnel, were taken and cultivated. P.aeruginosa isolates were identified according to standard proce-dures. For epidemiological purposes, anti-microbial susceptibility testing and pulse-field gel electrophoresis were performed. Data regarding use of antibiotics, disin-fectants, antiseptics, gloves and gowns from 2006 to 2012 were investigated.In March 2008, in the NICU of the Clini-cal Hospital Centre Zagreb (CHC Zagreb), we observed an increase in the total num-ber of pseudomonas infections compared to the previous months. This higher num-ber remained the same until October, de-spite rigorous infection control measures. Pseudomonas isolates were found in tap water, but not on the hands of healthcare workers. In that moment POU filters were introduced. The number of P.aeruginosa isolates in surveillance cultures dropped significantly.The number of positive cultures of P.aeruginosa in two consecutive periods (before and after installation of POU fil-ters) showed a statistically significant dif-ference.After the implementation of all infection control measures, we managed to stop the spread of pseudomonas colonization/infection. POU filters contributed only as one of these measures, resulting in a reduc-tion of chronically endemic P.aeruginosa infection/colonisation in the NICU.
Highlights
Pseudomonas aeruginosa is a frequently isolated gram-negative pathogen and is a common cause of infection in intensive care units (ICUs)
After the implementation of all infection control measures, we managed to stop the spread of pseudomonas colonization/ infection
To determine the influence of specific parameters on the increased number of P. aeruginosa isolates, all data regarding the use of antibiotics, disinfectants, antiseptics, gloves, gowns, P. aeruginosa isolates in primary sterile sites, surveillance cultures and environmental samples were collected and processed for the period from 2006 till 2012
Summary
Pseudomonas aeruginosa is a frequently isolated gram-negative pathogen and is a common cause of infection in intensive care units (ICUs). It is well known that tap water outlets are often contaminated with P. aeruginosa and may represent a source of endemic infections in neonatal intensive care units (NICUs). The implementation of point-of-use (POU) filters (PallAquasafe, Pall Medical, Switzerland) in ICUs, has been shown to be a successful infection control measure because it has led to a significant reduction in P.aeruginosa colonizations/infections. In March 2008, we observed an increase in the number of P.aeruginosa isolates from surveillance cultures in the NICU at the Clinical Hospital Centre Zagreb (CHC Zagreb), Croatia. In October 2008 significant rise in positive cultures of P. aeruginosa was observed again, and at that point POU filters were installed. To determine the influence of specific parameters on the increased number of P. aeruginosa isolates, all data regarding the use of antibiotics, disinfectants, antiseptics, gloves, gowns, P. aeruginosa isolates in primary sterile sites, surveillance cultures and environmental samples were collected and processed for the period from 2006 till 2012
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