Question

In July 2015, a report[12] was released indicating the gram-negative bacterium Pseudomonas aeruginosa was found on hospital sinks 10 years after the initial outbreak in a neonatal intensive care unit. P. aeruginosausually causes localized ear and eye infections but can cause pneumonia or septicemia in vulnerable individuals like new born babies. Explain how the current discovery of the presence of this reported P. aeruginosa could lead to a recurrence of nosocomial disease.

Answer 1

Pseudomonas aeruginosa is a Gram negative bacillus. It is non-fermentative. P. aeruginosa is common in hospital acquired infections especially in patients having poor immune system. It is observed in patients suffering pneumonia, meningitis, sepsis and conjunctivitis. It is also a source of infection in neonates and infects the eyes and ears of newborns.

In the year 2005, an intensive care unit with neonates had an outbreak P. aeruginosa. The same hospital had an outbreak after 10 years. The environment of the hospital and poor practices risked the patients and exposed to the bacterium. The newly infected strains were antibiotic resistant especially multi drug resistant. It also produced biofilms so eradicating the P. aeruginosa strains from hospital surfaces was difficult as these strains had a protective covering and was ineffective against antibacterial agents.

Molecular typing of the strains was done using techniques using pulse field gel electrophoresis (PFGE) and qPCR (quantitative PCR). Samples were collected from water, sink surface, drainage area and aerators to check for the outbreak of the bacterium.

Proper water systems, drainage facilities, maintenance works of sinks and proper hygiene during handling of patients are essential to reduce the risk of recurrence of P. aeruginosa infection. Multidrug resistance, biofilm formation along with poor maintanance and improper hygine were important risk factors that lead to a recurrence of P. aeruginosa nosocomial disease.