Department of Microbiology, Harrogate District Hospital, Lancaster Park Road, Harrogate, North Yorkshire HG2 7SX, UK.
J Hosp Infect. 2009 Dec;73(4):338-44. doi: 10.1016/j.jhin.2009.04.020. Epub 2009 Aug 21.
Pseudomonas aeruginosa is a versatile pathogen associated with a broad spectrum of infections in humans. In healthcare settings the bacterium is an important cause of infection in vulnerable individuals including those with burns or neutropenia or receiving intensive care. In these groups morbidity and mortality attributable to P. aeruginosa infection can be high. Management of infections is difficult as P. aeruginosa is inherently resistant to many antimicrobials. Furthermore, treatment is being rendered increasingly problematic due to the emergence and spread of resistance to the few agents that remain as therapeutic options. A notable recent development is the acquisition of carbapenemases by some strains of P. aeruginosa. Given these challenges, it would seem reasonable to identify strategies that would prevent acquisition of the bacterium by hospitalised patients. Environmental reservoirs of P. aeruginosa are readily identifiable, and there are numerous reports of outbreaks that have been attributed to an environmental source; however, the role of such sources in sporadic pseudomonal infection is less well understood. Nevertheless there is emerging evidence from prospective studies to suggest that environmental sources, especially water, may have significance in the epidemiology of sporadic P. aeruginosa infections in hospital settings, including intensive care units. A better understanding of the role of environmental reservoirs in pseudomonal infection will permit the development of new strategies and refinement of existing approaches to interrupt transmission from these sources to patients.
铜绿假单胞菌是一种多功能病原体，与人类广泛的感染有关。在医疗保健环境中，该细菌是易感染人群（包括烧伤或中性粒细胞减少症患者或接受重症监护的患者）感染的重要原因。在这些人群中，归因于铜绿假单胞菌感染的发病率和死亡率可能很高。由于铜绿假单胞菌固有地对许多抗菌药物具有耐药性，因此感染的管理很困难。此外，由于对少数仍然作为治疗选择的药物出现和传播耐药性，治疗变得越来越成问题。最近一个显著的发展是一些铜绿假单胞菌菌株获得了碳青霉烯酶。鉴于这些挑战，似乎可以合理地确定策略来防止住院患者获得该细菌。铜绿假单胞菌的环境储库很容易识别，并且有许多报道称暴发归因于环境来源；然而，这些来源在散发性假单胞菌感染中的作用尚未得到很好的理解。然而，来自前瞻性研究的新证据表明，环境来源，尤其是水，可能在医院环境中散发性铜绿假单胞菌感染的流行病学中具有重要意义，包括重症监护病房。更好地了解环境储库在假单胞菌感染中的作用将允许开发新策略并改进现有方法，以从这些来源中断对患者的传播。
