Tap out: reducing waterborne Pseudomonas aeruginosa transmission in an intensive care unit

Research output: Contribution to journalArticle

Authors

  • Martyn A. C. Wilkinson
  • Kerry Holden
  • Tracey Martin
  • Jane Parkes
  • Elisabeth Holden

Colleges, School and Institutes

External organisations

  • University Hospitals Birmingham NHS Foundation Trust

Abstract

Background: Pseudomonas aeruginosa is a ubiquitous and important opportunistic pathogen in immunocompromised or critically ill patients. Nosocomial P. aeruginosa outbreaks have been associated with hospital water sources. Here we describe engineering interventions to minimise contamination of water outlets and the subsequent clinical impact.


Methods: New tap outlets were fitted at selected outlets across the intensive care unit (ICU). Laboratory testing demonstrated that, following artificial contamination with P. aeruginosa, these taps could be effectively decontaminated using a thermal washer disinfector. Water samples were collected weekly from new outlets on the ICU over an 8-month period and tested for the enumeration of P. aeruginosa via membrane filtration. surveillance of P. aeruginosa from clinical specimens was routinely undertaken.


Results: Prior to the interventions, water sampling on ICU indicated that 30% of the outlets were positive for P. aeruginosa at any one time and Whole Genome Sequencing data suggested at least 30% transmission from water to patient. Since their installation, weekly sampling of the new tap outlets has been negative for P. aeruginosa, and the number of P. aeruginosa clinical isolates has fallen by 50%.


Conclusions: Installation and maintenance of tap outlets free of P. aeruginosa can substantially reduce the number of P. aeruginosa clinical isolates in an ICU.

Details

Original languageEnglish
JournalThe Journal of hospital infection
Early online date31 Jul 2018
Publication statusE-pub ahead of print - 31 Jul 2018

Keywords

  • pseudomonas aeruginosa, water testing frequency, intensive care unit, tap outlets, infection control, waterborne transmission