Cross-infection

[Guest guest]

Oh, and here is a very last one for those who just love it, when docs

publish contradictionary articles and we have to decide whom to

trust :-(((

If anyone has access to the full text article from Dr. Ramsey

mentioned below, I would be VERY interested in that one.

Peace

Torsten

Original Articles

Detection of a Widespread Clone of Pseudomonas aeruginosa in a

Pediatric Cystic Fibrosis Clinic

S. Armstrong, Gillian M. Nixon, Rosemary Carzino,

Bigham, B. Carlin, Roy M. Robins-Browne and Grimwood

Departments of Respiratory Medicine and Microbiology and Infectious

Diseases, Royal Children's Hospital; Clinical Epidemiology and

Biostatistics Unit, Murdoch Children's Research Institute, Parkville,

; Department of Paediatrics, Monash Medical Centre, Monash

University, Clayton, , Australia; and Department of

Paediatrics and Child Health, Wellington School of Medicine and

Health Sciences, University of Otago, Wellington, New Zealand

Correspondence: Correspondence and requests for reprints should be

addressed to Dr. Armstrong, Department of Paediatrics, Monash

University, Monash Medical Centre, Clayton Road, Clayton,

3168, Australia. E-mail: d.armstrong@...

Cross-infection by Pseudomonas aeruginosa between unrelated patients

with cystic fibrosis (CF) is believed to be uncommon. After detecting

a genotypically identical strain of P. aeruginosa in five unrelated

children with CF dying from severe lung disease, we determined its

prevalence within a large CF clinic using pulsed-field gel

electrophoresis and random amplified polymorphic DNA assays. The

clinical status of P. aeruginosa–infected patients was also

determined. Between September and December 1999, 152 patients, aged

3.9–20.7 years, provided sputum for culture. P. aeruginosa was

detected in 118 children of mean (SD) age 13.5 (3.8) years. The

genotyping techniques were concordant, showing that 65 (55%) infected

patients carried an indistinguishable or closely related strain. No

distinctive antibiogram or environmental reservoir was found.

Patients with the clonal strain were more likely than those with

unrelated isolates to have been hospitalized in the preceding 12

months for respiratory exacerbations. This study demonstrates

extensive spread of a single, clonal strain of P. aeruginosa in a

large pediatric CF clinic. Whether this strain is also more virulent

than sporadic isolates remains to be determined. As transmissible

strains could emerge elsewhere, other CF clinics may also need to

consider molecular methods of surveillance for cross-infection.

Key Words: Pseudomonas aeruginosa • cross-infection • cystic fibrosis

This article has been cited by other articles:

Ramsey, B. W. (2002). To Cohort or Not to Cohort: How Transmissible

Is Pseudomonas aeruginosa?. Am J Respir Crit Care Med 166: 906-907

[Full Text]

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Original Articles

Epidemiology of Pseudomonas aeruginosa in Cystic Fibrosis in British

Columbia, Canada

P. Speert, Maureen E. , Deborah A. Henry, Ruth Milner,

Fatma Taha, Gravelle, A. F. son, Lawrence T. K. Wong

and Eshwar Mahenthiralingam

Divisions of Infectious and Immunological Diseases and Biochemical

Diseases, Department of Pediatrics, University of British Columbia;

and British Columbia Institute for Children's and Women's Health and

Cystic Fibrosis Clinic, Children's and Women's Hospital of British

Columbia, Vancouver, British Columbia, Canada

Correspondence: Correspondence and requests for reprints should be

addressed to Dr. P. Speert, Research Centre, 950 West 28th

Avenue, Vancouver, BC, V5Z 4H4 Canada. E-mail:

speert@...

Pseudomonas aeruginosa is the most common respiratory pathogen in

patients with cystic fibrosis (CF), but the predominant mechanism by

which it is acquired is controversial. To determine the frequency of

patient-to-patient spread, we evaluated P. aeruginosa isolates from

174 patients treated at the CF clinics in Vancouver, BC, Canada,

since 1981. Multiple isolates were obtained from each patient and

genetically typed by random amplified polymorphic DNA and pulsed

field gel electrophoresis analyses. A total of 157 genetic types of

P. aeruginosa was identified, 123 of which were unique to individual

patients. A total of 34 types was shared by more than one patient;

epidemiologic evidence linked these individuals only in the cases of

10 sibships and 1 pair of unrelated patients. We conclude that there

is an extremely low risk in Vancouver for patients with CF to acquire

P. aeruginosa from other patients. It appears that prolonged close

contact, such as occurs between siblings, is necessary for patient-to-

patient spread. The major source of acquisition of P. aeruginosa in

CF appears to be from the environment. Considering these

observations, we do not recommend segregation of patients with CF on

the basis of their colonization status with P. aeruginosa.

Key Words: cystic fibrosis • epidemiology • Pseudomonas aeruginosa

This article has been cited by other articles:

Ramsey, B. W. (2002). To Cohort or Not to Cohort: How Transmissible

Is Pseudomonas aeruginosa?. Am J Respir Crit Care Med 166: 906-907

[Full Text]