F. Bert et al., MULTIRESISTANT PSEUDOMONAS-AERUGINOSA OUTBREAK ASSOCIATED WITH CONTAMINATED TAP WATER IN A NEUROSURGERY INTENSIVE-CARE UNIT, The Journal of hospital infection, 39(1), 1998, pp. 53-62
From July 1995 to November 1996, multi-resistant Pseudomonas aeruginos
a O11 was isolated from 36 patients admitted to a neurosurgery intensi
ve care unit. The strain was resistant to ticarcillin, ceftazidime, im
ipenem, gentamicin and ciprofloxacin, and susceptible to amikacin. Nin
e patients were colonized only; the remaining 27 patients had at least
one infected site (17 urinary infections, 10 pneumonias and four with
sinusitis), P. aeruginosa O11 with the same resistance pattern was is
olated from tap water. The strain was also cultured from enteral nutri
tion solutions given to two infected patients. DNA macrorestriction an
alysis with XbaI established the similarity of the isolates from patie
nts, tap water and solutions. The outbreak was controlled after reinfo
rcement of isolation procedures for infected patients, changing the mo
de of enteral nutrition and replacement of all sinks in the unit. The
sinks were presumably the main source of P. aeruginosa during this out
break, via the hands of the nursing staff or nutrition solutions conta
minated with tap water.