Outbreak of Nosocomial Urinary Tract Infections caused by Multidrug-Resistant Pseudomonas aeruginosa.
- Author:
Yeon Joon PARK
;
Eun Jee OH
;
Gi Bum KIM
;
So Yeon KIM
;
Sung Taek KIM
;
So Yeon YOO
;
Yang Ree KIM
;
Moon Won KANG
;
Byung Kee KIM
- Publication Type:Original Article
- Keywords:
Pseudomonas aeruginosa;
Nosocomial outbreak;
Multi-drug resistance;
Random Amplification of Polymorphic DNA (RAPD) assay
- MeSH:
Amikacin;
Anti-Bacterial Agents;
Ceftazidime;
Ciprofloxacin;
Clone Cells;
Cross Infection;
Delivery of Health Care;
Diffusion;
DNA;
Drug Resistance, Multiple;
Gentamicins;
Humans;
Imipenem;
Intensive Care Units;
Microbial Sensitivity Tests;
Piperacillin;
Pseudomonas aeruginosa*;
Pseudomonas*;
Urinary Bladder;
Urinary Catheters;
Urinary Tract Infections*;
Urinary Tract*
- From:Korean Journal of Nosocomial Infection Control
1999;4(1):1-6
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Nosocomial urinary tract infection (UTI) accounts for 35% of the nosocomial infection and 80-90% of them are associated with urethral catheters. Recently, we experienced an outbreak of nosocomial UTI caused by multidrug-resistant Pseudomonas aeruginosa in neurosurgical intensive care unit (NSICU). METHODS: We investigated clinical records of the patients and observed the methods of care of urethral catheters in NSICU. Identification of P. aeruginose was done by API NE (API system; bioMerieux, France) and antibiotic susceptibility tests were done by disk diffusion method. Random Amplification of Polymorphic DNA (RAPD) assay was used as a genotyping method. RESULTS: Between November 1997 and January 1998, 11 P. aeruginosa strains were isolated from the urine of 11 patients hospitalized in NSICU of Kangnam St. Mary's Hospital. Routine regular bladder irrigation, and emptying urine with common urinal had been done falsely. Antibiogram of the isolates showed resistance to multiple antibiotics including imipenem, gentamicin. amikacin, piperacillin, ciprofloxacin, ceftazidime, and cefoperazone/sulbactam. RAPD of the outbreak strains showed clonal relatedness, which was different from those of other clinical strains, We instructed all the health care workers to stop bladder Irrigation, and to use the separate urinals for each patient. Thereafter, no further case of P. aeruginosa UTI has occurred. CONCLUSION: An outbreak of UTI, caused by a single clone of P. aeruginosa, was confirmed by RAPD and was eradicated after correction of false practice on care-of urinary catheter.
