Pseudomonas aeruginosa in cystic fibrosis: cross-infection and the need for segregation

Evidence-based reasons for segregation of patients colonized with Pseudomon as aerugionsa in the outpatient setting are unclear. To clarify local decis ions, Pseudomonas genotyping of the local environment, patients and patient contacts was undertaken in 1993. The hospital environment was re-swabbed i n 1997. Pseudomonas genotyping of old and new patients attending the North Staffordshire cystic fibrosis clinic has subsequently been undertaken and m ore recently been repeated on an annual basis to assess whether the same Ps eudomonas genotypes can be found in both the environment and in patients, a nd whether the same Pseudomonas genotype can be transferred from one patien t to another. No Pseudomonas genotype found in the local environment in 1993 or in 1997 h as been found in any of our patients. Nine children attending the. same spe cial school for many years and sharing the same physiotherapy facilities sh owed no evidence of cross-infectivity. Except for siblings living in the sa me household our cross-infectivity rate is very low and where cross-infecti on has potentially occurred the level of contact between these patients has been minimal. This study does not support the suggestion that patients wit h cystic fibrosis attending the North Staffordshire clinic and colonized wi th Pseudomonas aeruginosa should be segregated from non-colonized patients.