REVIEW ARTICLE


Molecular Epidemiology of Pseudomonas aeruginosa in the Intensive Care Units – A Review



D.S Blanc*, P Francioli, G Zanetti
Hospital Preventive Medicine, University Hospital of Lausanne, Switzerland


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2007 Bentham Science Publishers Ltd

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/), which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Division Autonome de Médecine Préventive Hospitalière, Centre Hospitalier Universitaire, Vaudois, 1011 Lausanne, Switzerland; Tel: +41 21 314 02 59; Fax: +41 21 314 02 62; E-mail: Dominique.Blanc@chuv.ch


Abstract

Pseudomonas aeruginosa is one of the leading nosocomial pathogens in intensive care units (ICU). This opportunist pathogen is commonly recovered from moist environments, and is also found colonizing 2.6 to 24% of hospitalized patients. We reviewed the recent literature that used highly discriminatory typing methods to precisely identify the reservoirs and modes of transmission of this microorganism in the ICU setting. In most ICUs, the endogenous flora was suspected to be the main source of infection compared to exogenous sources (other patients, the contaminated environment such as sinks or taps). However, the percentage of endogenous versus exogenous sources might vary considerably from one setting to another. Reasons for this include the compliance of health care workers to infection control measures, the contamination of the environment, and probably also the biology of the pathogen (intrinsic fitness factors). As P. aerugi-nosa is ubiquitous in the environment and colonizes up to 15% of hospitalized patients, eradication of the reservoir is difficult, if not impossible. Therefore, efforts should primarily focus on reinforcement of infection control measures to limit its transmission.

Keywords: Pseudomonas aeruginosa, molecular epidemiology, intensive care unit.