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Case-Control and Vector Studies of Nosocomial Acquisition of Pseudomonas Cepacia in Adult Patients with Cystic Fibrosis

Published online by Cambridge University Press:  21 June 2016

David R. Burdge ,
E.M. Nakielna  and
M.A. Noble
David R. Burdge*
Affiliation:
Division of Infectious Disease, University Hospital and the University of British Columbia, Vancouver, British Columbia, Canada
E.M. Nakielna
Affiliation:
Division of Respiratory Medicine, University Hospital and the University of British Columbia, Vancouver, British Columbia, Canada
M.A. Noble
Affiliation:
Division of Medical Microbiology, University Hospital and the University of British Columbia, Vancouver, British Columbia, Canada
*
Division of Infectious Diseases, University Hospital—Shaughnessy Site, G611 4500 Oak St., Vancouver, British Columbia, Canada V6H 3Nl
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Abstract

Objective:

To examine factors associated with nosocomial acquisition of Pseudomonas cepacia in adult patients with cystic fibrosis.

Design:

A retrospective case-control study of 5 patients with nosocomial acquisition of P cepacia versus 20 matched controls who failed to develop P cepacia infection. Selective handwashing, air sampling, and respiratory equipment sampling also were performed.

Setting:

A university hospital providing tertiary care to 95 adult cystic fibrosis patients.

Patience:

All patients are adults with known cystic fibrosis. Case definition required multiple negative sputum cultures for P cepacia prior to and during admission, with a positive sputum culture prior to discharge. Controls had negative sputum cultures for P cepacia prior to and throughout hospitalization. Controls were matched for age, gender, disease severity, and frequency of hospitalizations.

Results:

Factors associated with increased risk of nosocomial acquisition of P cepacia included receiving humidifier or nebulized treatments (60% versus 5%, p = .016, odds ratio= 28.5, 95% confidence interval= 1.93 to 420.58). Factors without significance included ward, room, teaching versus nonteaching status, use of steroids, sharing a hospital room with another cystic fibrosis patient, antibiotic use, presence of portocath in situ, or socializing with another individual with cystic fibrosis known to be P cepacia -positive. Air sampling studies failed to demonstrate aerosolization of P cepacia by coughing cystic fibrosis patients over a 1-hour sampling time. Handwashing studies failed to demonstrate P cepacia on hands of cystic fibrosis patients, nurses, or physiotherapists (before or after physiotherapy). Reservoirs from nebulizers consistently grew P cepacia following therapy.

Conclusions:

Respiratory equipment may be an important source of nosocomial acquisition of P cepacia in adult cystic fibrosis patients.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 14 , Issue 3 , March 1993 , pp. 127 - 130
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1993

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References

1. Gilligan, PH. Microbiology of airway disease in patients with cystic fibrosis. Clin Microbial Rev. 1991;4:35–51.CrossRefGoogle ScholarPubMed
2. Isles, A, MacLusky, I, Corey, M, Gold, R, Prober, C, Fleming, P, Levison, H. Pseudomonas cepacia infection in cystic fibrosis: an emerging problem. J Pediatr. 1984;104:206–210.CrossRefGoogle Scholar
3. Tablan, OC, Chorba, TL, Schidlow, DV, et al. Pseudomonas cepacia colonization in patients with cystic fibrosis: risk factors and clinical outcome. J Pediatr. 1985;107:382–387.CrossRefGoogle ScholarPubMed
4. Thomassen, MJ, Demko, CA, Klinger, JD, Stern, RC. Pseudomonas cepacia colonization among patients with cystic fibrosis: a new opportunist. Am Rev Respir Dis. 1985;131:791–796.Google ScholarPubMed
5. Lewin, LO, Byard, PJ, Davis, PB. Effect of Pseudomonas cepacia colonization on survival and pulmonary function of cystic fibrosis patients. J Clin Epidemiol. 1990;4:125–131.10.1016/0895-4356(90)90175-OCrossRefGoogle Scholar
6. Tablan, OC, Martone, WJ, Doershuk, CF, et al. Colonization of the respiratory tract with Pseudomonas cepacia in cystic fibrosis: reg factors and outcomes. Chest. 1987;91:527–532.CrossRefGoogle Scholar
7. Hardy, KA, McGowan, KL, Fisher, MC, Schidlow, DV. Pseudomonas cepacia in the hospital setting: lack of transmission between cystic fibrosis patients. J Pediatr. 1986;109:51–54.10.1016/S0022-3476(86)80571-6CrossRefGoogle ScholarPubMed
8. Simmonds, EJ, Conway, SF: Ghoneim, ATM, Ross, H, Littlewood, JM. Pseudomonas cepacia: a new pathogen in patients with cystic fibrosis referred to a large center in the United Kingdom. Arch Dis Child. 1990;65:874–877.10.1136/adc.65.8.874CrossRefGoogle Scholar
9. Taylor, RFH, Dalla Costa, L, Kaufmann, ME, Pitt, JL, Hudson, ME. Pseudomonas cepacia pulmonary infection in adults with cystic fibrosis: is nosocomial acquisition occurring? J Hosp Infect. 1992;21:199–204.10.1016/0195-6701(92)90076-XCrossRefGoogle ScholarPubMed
10. Lipuma, JJ, Dasen, SE, Nielson, DW, Stern, RC, Stall, TL. Person-to-person transmission of Pseudomonas cepacia between patients with cystic fibrosis. Lancet. 1990;336:1094–1096.CrossRefGoogle ScholarPubMed
11. Thomassen, MJ. Demko, CA, Doershuk, CR Stern, RC, Klinger, JD. Pseudomonas cepacia: decrease in colonization in patients with cvstic fibrosis. Am Rev Resbir Dis. 1986:134:669–671.Google Scholar
12. Senior, BW. Examination of water, soil, food and air. In: Collee, JG, Duguid, JP, Marmion, BP, Fraser, AG, eds. Practical Medical Microbiology. Edinburgh: Churchill Livingston; 1989:204–230.Google Scholar