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水龙头作为重症监护病房中地方性铜绿假单胞菌定植/感染的储存源。

Faucets as a reservoir of endemic Pseudomonas aeruginosa colonization/infections in intensive care units.

作者信息

Blanc D S, Nahimana I, Petignat C, Wenger A, Bille J, Francioli P

机构信息

Division autonome de médecine préventive hospitalière, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland.

出版信息

Intensive Care Med. 2004 Oct;30(10):1964-8. doi: 10.1007/s00134-004-2389-z. Epub 2004 Jul 15.

Abstract

OBJECTIVE

To evaluate the role of faucets as a reservoir for Pseudomonas aeruginosa colonization/infection of patients hospitalized in intensive care units (ICUs).

DESIGN

Prospective epidemiological investigation performed during a nonepidemic period of 1 year. The inner part of the ICU faucets were swabbed for P. aeruginosa. Data were recorded on all patients with at least one culture of a clinical specimens positive for P. aeruginosa. Pulsed-field gel electrophoresis was used to characterize the strains.

SETTING

Five ICUs of a university hospital which are supplied by two separate water distribution networks.

PATIENTS

During a 1-year period 132 cases were investigated.

RESULTS

In 42% of cases (56/132) there were isolates identical to those found in the faucets, with a total of nine different genotypes. Among the nine genotypes isolated from both patients and faucets one of them, the most prevalent, was isolated in the two networks and in 30 cases. The other eight genotypes were recovered almost exclusively from either one (three genotypes in 12 cases) or the other (five genotypes in 12 cases) network and from the patients in the corresponding ICUs.

CONCLUSIONS

These results suggest that the water system of the ICUs was the primary reservoir of patient's colonization/infection with P. aeruginosa in a substantial proportion of patients, although the exact mode of acquisition could not be determined.

摘要

目的

评估水龙头作为重症监护病房(ICU)住院患者铜绿假单胞菌定植/感染源的作用。

设计

在为期1年的非流行期进行的前瞻性流行病学调查。对ICU水龙头内部进行铜绿假单胞菌拭子采样。记录所有临床标本培养至少一次铜绿假单胞菌呈阳性的患者的数据。采用脉冲场凝胶电泳对菌株进行分型。

地点

一所大学医院的5个ICU,由两个独立的供水网络供水。

患者

在1年期间共调查了132例患者。

结果

42%的病例(56/132)中分离出的菌株与水龙头中发现的菌株相同,共有9种不同基因型。在从患者和水龙头中分离出的9种基因型中,其中一种最常见的基因型在两个供水网络中均有发现,且有30例患者感染该基因型。其他8种基因型几乎仅从其中一个网络(12例中有3种基因型)或另一个网络(12例中有5种基因型)以及相应ICU的患者中分离得到。

结论

这些结果表明,在相当一部分患者中,ICU的水系统是患者铜绿假单胞菌定植/感染的主要来源,尽管确切的感染途径尚无法确定。

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