The impact of environmental Pseudomonas aeruginosa genotypes on skin infections in occupational saturation diving systems

Skin infection caused by Pseudomonas aeruginosa is the most frequent health problem associated with occupational saturation diving on the Norwegian co ntinental shelf. In the course of 14-y surveillance of infection and enviro nmental control in occupational offshore saturation diving systems, a colle ction of approximate to 1000 P. aeruginosa isolates has been amassed. Retro spective genomic analyses using restriction enzyme fragmentation and pulsed -field gel electrophoresis have identified 24 of 76 environmental P. aerugi nosa genotypes as being of significance for single infections, outbreaks of infections and recurrent skin infections in occupational diving systems. I n addition, these genomic analyses have made it possible to separate outbre aks of infection into outbreaks with 1 single genotype and clusters of infe ctions where different genotypes are involved. We conclude that the establi shed, assumed diver-to-diver contagion vector ought to be replaced by a env ironmental contagion vector as the most likely vector within these specific occupational environments. Furthermore, consecutive presence of the freque nt environmental/infections genotypes demands specific improvement of infec tion prevention and control in these systems.