1887

Abstract

is a Gram-negative bacterium commonly occurring in soil and water. It is an opportunistic pathogen and an important cause of healthcare-associated infections, particularly among infants in neonatal intensive care units (NICUs). Several reports regarding outbreaks of in NICUs have been published. MEDLINE and EMBASE databases were searched using the MeSH terms [], [Outbreak OR Infection OR bacteraemia, OR sepsis OR disease] and [Neonat* OR baby OR babies OR newborn*]. Fifteen studies describing a total of 414 infants colonized or infected with were reviewed. The mean percentage of infections occurring in the populations that had been colonized by the organism (calculated as / + ) was 22 %. Environmental sampling was performed in 14 studies, nine of which detected . The risk factors identified were antimicrobial drug use and the number of days of antimicrobial therapy prescribed before positive blood culture, exposure to particular healthcare workers (HCW), transfusion of blood products, and intravenous delivery of nutrients/electrolytes. Exposure to umbilical venous catheters was associated with bloodstream infections. Increasing age and use of artificial fingernails were risk factors for colonization of hands of HCWs. Low birth weight pre-term infants were at greater risk of mortality from infection than older infants.

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2012-08-01
2024-03-29
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References

  1. Archibald L. K., Ramos M., Arduino M. J., Aguero S. M., Deseda C., Banerjee S., Jarvis W. R. 1998; Enterobacter cloacae and Pseudomonas aeruginosa polymicrobial bloodstream infections traced to extrinsic contamination of a dextrose multidose vial. J Pediatr 133:640–644 [View Article][PubMed]
    [Google Scholar]
  2. Ayliffe G., Fraise A., Geddes A., Mitchell K. 2000 Control of Hospital Infection: A Practical Handbook, 4th Edition. London: Hodder Arnold;
    [Google Scholar]
  3. Barraud N., Hassett D. J., Hwang S. H., Rice S. A., Kjelleberg S., Webb J. S. 2006; Involvement of nitric oxide in biofilm dispersal of Pseudomonas aeruginosa . J Bacteriol 188:7344–7353 [View Article][PubMed]
    [Google Scholar]
  4. Becks V. E., Lorenzoni N. M. 1995; Pseudomonas aeruginosa outbreak in a neonatal intensive care unit: a possible link to contaminated hand lotion. Am J Infect Control 23:396–398 [View Article][PubMed]
    [Google Scholar]
  5. Begg C., Cho M., Eastwood S., Horton R., Moher D., Olkin I., Pitkin R., Rennie D., Schulz K. F. other authors 1996; Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA 276:637–639 [View Article][PubMed]
    [Google Scholar]
  6. Coleman D. C., O’Donnell M. J., Shore A. C., Russell R. J. 2009; Biofilm problems in dental unit water systems and its practical control. J Appl Microbiol 106:1424–1437 [View Article][PubMed]
    [Google Scholar]
  7. Costerton J. W., Cheng K. J., Geesey G. G., Ladd T. I., Nickel J. C., Dasgupta M., Marrie T. J. 1987; Bacterial biofilms in nature and disease. Annu Rev Microbiol 41:435–464 [View Article][PubMed]
    [Google Scholar]
  8. Crivaro V., Di Popolo A., Caprio A., Lambiase A., Di Resta M., Borriello T., Scarcella A., Triassi M., Zarrilli R. 2009; Pseudomonas aeruginosa in a neonatal intensive care unit: molecular epidemiology and infection control measures. BMC Infect Dis 9:70–70 [View Article][PubMed]
    [Google Scholar]
  9. Department of Health 2006; Health Technical Memorandum 04–01: The control of Legionella, hygiene, “safe” hot water, cold water and drinking water systems. Part B: Operational management;
  10. Des Jarlais D. C., Lyles C., Crepaz N. TREND Group 2004; Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: the TREND statement. Am J Public Health 94:361–366 [View Article][PubMed]
    [Google Scholar]
  11. Foca M. D. 2002; Pseudomonas aeruginosa infections in the neonatal intensive care unit. Semin Perinatol 26:332–339 [View Article][PubMed]
    [Google Scholar]
  12. Foca M., Jakob K., Whittier S., Della Latta P., Factor S., Rubenstein D., Saiman L. 2000; Endemic Pseudomonas aeruginosa infection in a neonatal intensive care unit. N Engl J Med 343:695–700 [View Article][PubMed]
    [Google Scholar]
  13. Fonseca A. P., Extremina C., Fonseca A. F., Sousa J. C. 2004; Effect of subinhibitory concentration of piperacillin/tazobactam on Pseudomonas aeruginosa . J Med Microbiol 53:903–910 [View Article][PubMed]
    [Google Scholar]
  14. Garcia D. C., Trevisan A. R., Botto L., Cervetto M., Sarubbi M. A., Zorzópulos J. 1989; An outbreak of multiply resistant Pseudomonas aeruginosa in a neonatal unit: plasmid pattern analysis. J Hosp Infect 14:99–105 [View Article][PubMed]
    [Google Scholar]
  15. Garland S. M., Mackay S., Tabrizi S., Jacobs S. 1996; Pseudomonas aeruginosa outbreak associated with a contaminated blood-gas analyser in a neonatal intensive care unit. J Hosp Infect 33:145–151 [View Article][PubMed]
    [Google Scholar]
  16. Gaynes R., Edwards J. R. National Nosocomial Infections Surveillance System 2005; Overview of nosocomial infections caused by Gram-negative bacilli. Clin Infect Dis 41:848–854 [View Article][PubMed]
    [Google Scholar]
  17. Gras-Le Guen C., Lepelletier D., Debillon T., Gournay V., Espaze E., Roze J. C. 2003; Contamination of a milk bank pasteuriser causing a Pseudomonas aeruginosa outbreak in a neonatal intensive care unit. Arch Dis Child Fetal Neonatal Ed 88:F434–F435 [View Article][PubMed]
    [Google Scholar]
  18. Gupta A. K., Shashi S., Mohan M., Lamba I. M., Gupta R. 1993; Epidemiology of Pseudomonas aeruginosa infections in a neonatal intensive care unit. J Trop Pediatr 39:32–36[PubMed] [CrossRef]
    [Google Scholar]
  19. Hota S., Hirji Z., Stockton K., Lemieux C., Dedier H., Wolfaardt G., Gardam M. A. 2009; Outbreak of multidrug-resistant Pseudomonas aeruginosa colonization and infection secondary to imperfect intensive care unit room design. Infect Control Hosp Epidemiol 30:25–33 [View Article][PubMed]
    [Google Scholar]
  20. Hu H. B., Huang H. J., Peng Q. Y., Lu J., Lei X. Y. 2010; Prospective study of colonization and infection because of Pseudomonas aeruginosa in mechanically ventilated patients at a neonatal intensive care unit in China. Am J Infect Control 38:746–750 [View Article][PubMed]
    [Google Scholar]
  21. Jarvis W. R., Olson D., Tablan O., Martone W. J. 1987; The epidemiology of nosocomial Pseudomonas cepacia infections: endemic infections. Eur J Epidemiol 3:233–236 [View Article][PubMed]
    [Google Scholar]
  22. Jones S. 2011; Hand hygiene and transmission of Pseudomonas aeruginosa on hands in a hospital environment. Journal of Infection Prevention 12:146–148 [View Article]
    [Google Scholar]
  23. Lautenbach E., Polk R. E. 2007; Resistant Gram-negative bacilli: a neglected healthcare crisis?. American Journal of Health-System Pharmacy 64:Suppl. 14S3–21 [CrossRef]
    [Google Scholar]
  24. Loureiro M. M., de Moraes B. A., Mendonca V. L., Quadra M. R., Pinheiro G. S., Asensi M. D. 2002; Pseudomonas aeruginosa: study of antibiotic resistance and molecular typing in hospital infection cases in a neonatal intensive care unit from Rio de Janeiro City, Brazil. Mem Inst Oswaldo Cruz 97:387–394 [View Article][PubMed]
    [Google Scholar]
  25. Majumdar S., Kirby A., Berry N., Williams C., Hassan I., Eddleston J., Burnie J. P. 2004; An outbreak of imipenem-resistant Pseudomonas aeruginosa in an intensive care unit. J Hosp Infect 58:160–161 [View Article][PubMed]
    [Google Scholar]
  26. Mammina C., Di Carlo P., Cipolla D., Casuccio A., Tantillo M., Plano M. R., Mazzola A., Corsello G. 2008; Nosocomial colonization due to imipenem-resistant Pseudomonas aeruginosa epidemiologically linked to breast milk feeding in a neonatal intensive care unit. Acta Pharmacol Sin 29:1486–1492 [View Article][PubMed]
    [Google Scholar]
  27. Mellmann A., Harmsen D., Cummings C. A., Zentz E. B., Leopold S. R., Rico A., Prior K., Szczepanowski R., Ji Y. other authors 2011; Prospective genomic characterization of the German enterohemorrhagic Escherichia coli O104 : H4 outbreak by rapid next generation sequencing technology. PLoS ONE 6:e22751 [View Article][PubMed]
    [Google Scholar]
  28. Molin S., Tolker-Nielsen T. 2003; Gene transfer occurs with enhanced efficiency in biofilms and induces enhanced stabilisation of the biofilm structure. Curr Opin Biotechnol 14:255–261 [View Article][PubMed]
    [Google Scholar]
  29. Montero M., Domínguez M., Orozco-Levi M., Salvadó M., Knobel H. 2009; Mortality of COPD patients infected with multi-resistant Pseudomonas aeruginosa: a case and control study. Infection 37:16–19 [View Article][PubMed]
    [Google Scholar]
  30. Moolenaar R. L., Crutcher J. M., San Joaquin V. H., Sewell L. V., Hutwagner L. C., Carson L. A., Robison D. A., Smithee L. M., Jarvis W. R. 2000; A prolonged outbreak of Pseudomonas aeruginosa in a neonatal intensive care unit: did staff fingernails play a role in disease transmission?. Infect Control Hosp Epidemiol 21:80–85 [View Article][PubMed]
    [Google Scholar]
  31. Muyldermans G., de Smet F., Pierard D., Steenssens L., Stevens D., Bougatef A., Lauwers S. 1998; Neonatal infections with Pseudomonas aeruginosa associated with a water-bath used to thaw fresh frozen plasma. J Hosp Infect 39:309–314 [View Article][PubMed]
    [Google Scholar]
  32. Naze F., Jouen E., Randriamahazo R. T., Simac C., Laurent P., Blériot A., Chiroleu F., Gagnevin L., Pruvost O., Michault A. 2010; Pseudomonas aeruginosa outbreak linked to mineral water bottles in a neonatal intensive care unit: fast typing by use of high-resolution melting analysis of a variable-number tandem-repeat locus. J Clin Microbiol 48:3146–3152 [View Article][PubMed]
    [Google Scholar]
  33. Orrett F. A. 2000; Fatal multi-resistant Pseudomonas aeruginosa septicemia outbreak in a neonatal intensive care unit in Trinidad. Ethiop Med J 38:85–91[PubMed]
    [Google Scholar]
  34. Palmas F., Schivo M. L., Obino P., Meloni V.,, Saddi B., Mascia V. 1999; Circulation of Pseudomonas aeruginosa in a neonatal intensive care unit. Ig Mod 111:285–297
    [Google Scholar]
  35. Pittet D., Allegranzi B., Boyce J. World Health Organization World Alliance for Patient Safety First Global Patient Safety Challenge Core Group of Experts 2009; The World Health Organization guidelines on hand hygiene in health care and their consensus recommendations. Infect Control Hosp Epidemiol 30:611–622 [View Article][PubMed]
    [Google Scholar]
  36. Pratt R. J., Pellowe C. M., Wilson J. A., Loveday H. P., Harper P. J., Jones S. R., McDougall C., Wilcox M. H. 2007; epic2: National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect 65:Suppl. 1S1–S59 [View Article][PubMed]
    [Google Scholar]
  37. Rohde H., Qin J., Cui Y., Li D., Loman N. J., Hentschke M., Chen W., Pu F., Peng Y. other authors 2011; Open-source genomic analysis of Shiga-toxin-producing E. coli O104 : H4. N Engl J Med 365:718–724 [View Article][PubMed]
    [Google Scholar]
  38. Sánchez-Carrillo C., Padilla B., Marin M., Rivera M., Cercenado E., Vigil D., Sánchez-Luna M., Bouza E. 2009; Contaminated feeding bottles: the source of an outbreak of Pseudomonas aeruginosa infections in a neonatal intensive care unit. American Journal of Infection Control 37:150–154 [CrossRef]
    [Google Scholar]
  39. Schutze G. E., Gilliam C. H., Jin S., Cavenaugh C. K., Hall R. W., Bradsher R. W., Jacobs R. F. 2004; Use of DNA fingerprinting in decision making for considering closure of neonatal intensive care units because of Pseudomonas aeruginosa bloodstream infections. Pediatr Infect Dis J 23:110–114 [View Article][PubMed]
    [Google Scholar]
  40. SHFN 2007 Scottish Health Facilities Note 30: version 3. Infection Control in the Built Environment: Design and Planning. Health Facilities Scotland. National Services Scotland. Available online http://www.hfs.scot.nhs.uk/publications/shfn-30-v3.pdf
  41. Simon A., Krawtschenko O., Reiffert S.-M., Exner M., Trautmann M, Engelhart S. 2008; Outbreaks of Pseudomonas aeruginosa in pediatric patients – clinical aspects, risk factors and management. Journal of Pediatric Infectious Diseases 3:249–269
    [Google Scholar]
  42. Souli M., Galani I., Giamarellou H. 2008 Emergence of extensively drug-resistant and pandrug-resistant Gram-negative bacilli in Europe. Euro Surveillance 13, pii 19045. Available online http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19045
  43. Stone S. P., Cooper B. S., Kibbler C. C., Cookson B. D., Roberts J. A., Medley G. F., Duckworth G., Lai R., Ebrahim S. other authors 2007; The ORION statement: guidelines for transparent reporting of outbreak reports and intervention studies of nosocomial infection. J Antimicrob Chemother 59:833–840 [View Article][PubMed]
    [Google Scholar]
  44. Tenover F. C., Arbeit R. D., Goering R. V., Mickelsen P. A., Murray B. E., Persing D. H., Swaminathan B. 1995; Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 33:2233–2239[PubMed]
    [Google Scholar]
  45. Trautmann M., Lepper P. M., Haller M. 2005; Ecology of Pseudomonas aeruginosa in the intensive care unit and the evolving role of water outlets as a reservoir of the organism. Am J Infect Control 33:Suppl. 1S41–S49 [View Article][PubMed]
    [Google Scholar]
  46. Trautmann M., Halder S., Hoegel J., Royer H., Haller M. 2008; Point-of-use water filtration reduces endemic Pseudomonas aeruginosa infections on a surgical intensive care unit. Am J Infect Control 36:421–429 [View Article][PubMed]
    [Google Scholar]
  47. Verweij P. E., Geven W. B., van Belkum A., Meis J. F. 1993; Cross-infection with Pseudomonas aeruginosa in a neonatal intensive care unit characterized by polymerase chain reaction fingerprinting. Pediatr Infect Dis J 12:1027–1029 [View Article][PubMed]
    [Google Scholar]
  48. Waters V., Larson E., Wu F., San Gabriel P., Haas J., Cimiotti J., Della-Latta P., Saiman L. 2004; Molecular epidemiology of Gram-negative bacilli from infected neonates and health care workers’ hands in neonatal intensive care units. Clin Infect Dis 38:1682–1687 [View Article][PubMed]
    [Google Scholar]
  49. Webb J. S., Thompson L. S., James S., Charlton T., Tolker-Nielsen T., Koch B., Givskov M., Kjelleberg S. 2003; Cell death in Pseudomonas aeruginosa biofilm development. J Bacteriol 185:4585–4592 [View Article][PubMed]
    [Google Scholar]
  50. WHO 2006 Guidelines for drinking-water quality. Third edition incorporating the first and second addenda. Volume 1: recommendations. Geneva. World Health Organization. Available online http://www.who.int/water_sanitation_health/dwq/fulltext.pdf
  51. Wise J. 2012; Three babies die in Pseudomonas outbreak at Belfast neonatal unit. BMJ 344:jan24 1e592 [View Article][PubMed]
    [Google Scholar]
  52. Zabel L. T., Heeg P., Goelz R. 2004; Surveillance of Pseudomonas aeruginosa isolates in a neonatal intensive care unit over a one year-period. Int J Hyg Environ Health 207:259–266 [View Article][PubMed]
    [Google Scholar]
  53. Zawacki A., O’Rourke E., Potter-Bynoe G., Macone A., Harbarth S., Goldmann D. 2004; An outbreak of Pseudomonas aeruginosa pneumonia and bloodstream infection associated with intermittent otitis externa in a healthcare worker. Infect Control Hosp Epidemiol 25:1083–1089 [View Article][PubMed]
    [Google Scholar]
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