Rogues A-M, Boulestreau H, Lashéras A, Boyer A, Gruson D, Merle C, Castaing Y, Bébear C M, Gachie J-P
Unité INSERM 657, Université Victor Segalen Bordeaux 2, Bordeaux, France.
J Hosp Infect. 2007 Sep;67(1):72-8. doi: 10.1016/j.jhin.2007.06.019. Epub 2007 Aug 28.
This study examined tap water as a source of Pseudomonas aeruginosa in a medical intensive care setting. We prospectively screened specimens of patients, tap water and hands of healthcare workers (HCWs) over a six-month period in a 16-bed medical intensive care unit. Molecular relatedness of P. aeruginosa strains was investigated by pulsed-field gel electrophoresis. A total of 657 tap water samples were collected from 39 faucets and 127 hands of HCWs were sampled. P. aeruginosa was found in 11.4% of 484 tap water samples taken from patients' rooms and in 5.3% of 189 other tap water samples (P<0.01). P. aeruginosa was isolated from 38 patients. Typing of 73 non-replicate isolates (water samples, hands of HCWs and patients) revealed 32 major DNA patterns. Eleven (52.4%) of the 21 faucets were contaminated with a patient strain, found before isolation from tap water in the corresponding room in nine cases, or from the neighbouring room in two cases. Among seven P. aeruginosa strains isolated from HCW hands, the genotype obtained was the same as that from the last patient they had touched in six cases, and in the seventh with the last tap water sample used. More than half of P. aeruginosa carriage in patients was acquired via tap water or cross-transmission. Carriage of P. aeruginosa by patients was both the source and the consequence of tap water colonisation. These results emphasise the need for studies on how to control tap water contamination.
本研究调查了在医疗重症监护环境中自来水作为铜绿假单胞菌来源的情况。我们在一个拥有16张床位的医疗重症监护病房中，对患者标本、自来水和医护人员的手部进行了为期6个月的前瞻性筛查。通过脉冲场凝胶电泳研究了铜绿假单胞菌菌株的分子相关性。共从39个水龙头采集了657份自来水样本，并对127名医护人员的手部进行了采样。从患者病房采集的484份自来水样本中，11.4%检测出铜绿假单胞菌；在189份其他自来水样本中，5.3%检测出该菌（P<0.01）。从38名患者中分离出了铜绿假单胞菌。对73株非重复分离株（水样、医护人员手部和患者样本）进行分型，发现了32种主要DNA模式。21个水龙头中有11个（52.4%）被患者菌株污染，其中9例在相应房间的自来水分离出该菌株之前就已被污染，2例是在相邻房间的自来水中分离出该菌株之前被污染。在从医护人员手部分离出的7株铜绿假单胞菌中，6例的基因型与他们接触的最后一名患者的基因型相同，第7例与最后使用的自来水样本的基因型相同。超过一半的患者铜绿假单胞菌携带是通过自来水或交叉传播获得的。患者携带铜绿假单胞菌既是自来水定植的来源，也是其结果。这些结果强调了对如何控制自来水污染进行研究的必要性。
