Department of Microbiology, Queen Elizabeth University Hospital, Glasgow, UK.
Walker on Water, Bishopdown, Salisbury, UK.
J Hosp Infect. 2023 Aug;138:60-73. doi: 10.1016/j.jhin.2023.05.011. Epub 2023 Jun 7.
Bone marrow transplant and haemato-oncology patients are at risk of healthcare-associated infections due to waterborne pathogens. We undertook a narrative review of waterborne outbreaks in haemato-oncology patients from 2000 to 2022. Databases searched included PubMed, DARE and CDSR, and were undertaken by two authors. We analysed the organisms implicated, sources identified and infection prevention and control strategies implemented. The most commonly implicated pathogens were Pseudomonas aeruginosa, non-tuberculous mycobacteria and Legionella pneumophila. Bloodstream infection was the most common clinical presentation. The majority of incidents employed multi-modal strategies to achieve control, addressing both the water source and routes of transmission. This review highlights the risk to haemato-oncology patients from waterborne pathogens and discusses future preventative strategies and the requirement for new UK guidance for haemato-oncology units.
骨髓移植和血液肿瘤患者由于水传播病原体而面临医源性感染的风险。我们对 2000 年至 2022 年血液肿瘤患者中水传播暴发的情况进行了叙述性综述。检索的数据库包括 PubMed、DARE 和 CDSR，并由两名作者进行。我们分析了所涉及的病原体、确定的来源以及实施的感染预防和控制策略。最常涉及的病原体是铜绿假单胞菌、非结核分枝杆菌和嗜肺军团菌。血流感染是最常见的临床表现。大多数事件采用多模式策略来实现控制，同时解决水源和传播途径。本综述强调了血液肿瘤患者面临的水传播病原体的风险，并讨论了未来的预防策略以及血液肿瘤病房对英国新指南的需求。
