Noone M R, Pitt T L, Bedder M, Hewlett A M, Rogers K B
Br Med J (Clin Res Ed). 1983 Jan 29;286(6362):341-4. doi: 10.1136/bmj.286.6362.341.
Despite the sparsity of Pseudomonas aeruginosa in the environment colonisation and infection with this organism was found at several sites by selective culture in 20 out of 46 patients in an intensive therapy unit. Three patients developed Ps aeruginosa pneumonia. Serial serogrouping and phage typing identified multiple strains in the unit and in the same patient. Rectal carriage occurred in 16 patients but rectal strains did not subsequently appear in tracheal aspirates; strains varied in their affinity for the upper respiratory tract. Colonisation was not directly related to length of stay and was detected in 16 of those colonised within 24 hours of admission. In intubated patients, who were colonised more frequently than those not intubated, upper respiratory tract colonisation correlated strongly with low initial arterial pH values. Personnel were probably responsible for cross infection among patients when the unit was busy. Strain differences and the susceptibility of patients also influenced colonisation and infection. Elimination of major reservoirs of Ps aeruginosa and compliance with procedures to control cross infection remain essential if patients in hospital are to escape colonisation by the organism.
尽管铜绿假单胞菌在环境中较为稀少，但通过选择性培养，在一家重症监护病房的46名患者中的20名患者的多个部位发现了该菌的定植和感染。3名患者发生了铜绿假单胞菌肺炎。连续血清分组和噬菌体分型确定了病房内及同一患者体内的多种菌株。16名患者出现直肠定植，但直肠菌株随后未出现在气管吸出物中；不同菌株对上呼吸道的亲和力各不相同。定植与住院时间长短无直接关系，16名定植患者中有16名在入院后24小时内被检测到。在插管患者中，其定植频率高于未插管患者，上呼吸道定植与初始动脉血pH值低密切相关。当病房繁忙时，医护人员可能是患者之间交叉感染的原因。菌株差异和患者的易感性也影响定植和感染。如果医院的患者要避免被该菌定植，消除铜绿假单胞菌的主要储存源并遵守控制交叉感染的程序仍然至关重要。
