DISTRIBUTION AND TRANSMISSION OF PSEUDOMONAS-AERUGINOSA AND BURKHOLDERIA-CEPACIA IN A HOSPITAL WARD

Genotyping and antibiotic susceptibility testing were used to analyze Pseudomonas aeruginosa and Burkholderia cepacia strains from sink drai n from 14 pediatric patients with cystic fibrosis (CF) and from hospit al personnel as part of a 4 week prospective study of strain transmiss ion in a pediatric ward. A total of 87.5% of all washbasin drains were contaminated with P. aeroginosa [10(2) to 10(5) colony forming units (CFU)/ml sink fluid], whereas B. cepacia was found only once in a sink drain. From the eight CF patients already infected with P. aeruginosa upon entering the ward, we isolated six genotypes that were identical with strains found in sink drains of the ward. Four of the 16 members of the personnel had one positive P. aeruginosa hand culture. B. cepa cia was never found in patients or on personnel hands. Hand washing in contaminated sinks (greater than or equal to 10(3) CFU/ml) led to pos itive P. aeruginosa or B. cepacia hand cultures. P. aeruginosa or B. c epacia embedded in sputum were transmissable by hand shaking for up to 180 min, whereas both pathogens suspended in physiological saline wer e transmissable to other hands only up to 30 min. Genotyping of P. aer uginosa revealed strain transmission from CF patients or the environme nt to other patients or the personnel, as well as one transmission fro m the environment to a CF patient. The ability of Cf sputum to prolong survival of Fl aeruginosa and B. cepacia may be important for strain transmission. The results suggest that improved hygienic measures are required to prevent routes of bacterial transmission via the hands and sink drains. (C) 1996 Wiley-Liss, Inc.