POSSIBLE NOSOCOMIAL TRANSMISSION OF PSEUDOMONAS-CEPACIA IN PATIENTS WITH CYSTIC-FIBROSIS

被引:28
作者
PEGUES, DA
SCHIDLOW, DV
TABLAN, OC
CARSON, LA
CLARK, NC
JARVIS, WR
机构
[1] CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,HOSP INFECT PROGRAM,ATLANTA,GA 30333
[2] ST CHRISTOPHERS HOSP CHILDREN,PEDIAT PULM SECT,PHILADELPHIA,PA 19133
[3] TEMPLE UNIV,SCH MED,PHILADELPHIA,PA 19122
来源
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE | 1994年 / 148卷 / 08期
关键词
D O I
10.1001/archpedi.1994.02170080035006
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective: To determine whether nosocomial transmission of Pseudomonas cepacia occurred at a hospital with endemic P cepacia infection of patients with cystic fibrosis. Design: Two retrospective case-control studies. Setting: A large pediatric cystic fibrosis center. Participants: To assess risk factors for acquisition of P cepacia, 18 cases, defined as any patient with cystic fibrosis with first documented isolation of P cepacia in 1988 or 1989, were compared with 18 matched P cepacia-negative controls with cystic fibrosis. To assess potential modes of nosocomial P cepacia transmission, 14 cases with a hospitalization(s) between their last P cepacia-negative culture and first P cepacia-positive culture were compared with 14 hospitalized P cepacia-negative controls with cystic fibrosis. Methods: Handwiping cultures (N=68) and selective environmental cultures were performed. Main Results: Cases tended to be more likely than controls to have been hospitalized at the cystic fibrosis center in the 3 months before their first P cepacia-positive culture (P=.08). In addition, cases tended to be more likely than hospitalized controls with cystic fibrosis to have had a P cepacia-positive roommate (P=.06) before becoming colonized with P cepacia organisms. Pseudomonas cepacia was cultured from the hands of two individuals: a P cepacia-colonized patient who had just undergone chest physiotherapy and consequent coughing and the investigator who shook the P cepacia-positive patient's hand after the patient's procedure. Conclusions: These results suggest that in this cystic fibrosis center, hospitalization is a risk factor for P cepacia acquisition and that person-to-person transmission of P cepacia may occur in the hospital via hand contact.
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页码:805 / 812
页数:8
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