Pseudomonas aeruginosa bacteria inhabit moist environments due to their ability to form ‘biofilm’.
Speaking at a recent waterborne infection conference sponsored by Pall Medical, Dr Mike Weinbren, consultant microbiologist at the Royal Chesterfield Hospital, described how Pseudomonas cases appeared in the neonatal intensive care unit (NICU) at the (then new) PFI Coventry and Warwickshire University Hospital (UHCW), where he was previously director of Infection Control, soon after the hospital opened in 2005. Eighteen months later, further cases appeared in the general critical care unit.
Because patients themselves can carry Pseudomonas into hospital, there is no ‘acceptable’ baseline for infection rates in adult ICUs. But, he stressed, ‘because the organism is rarely part of the normal flora in neonates, the finding of babies colonised / infected with P. aeruginosa will invariably indicate a problem – and that problem might be in the water’.
UHCW’s NICU outbreak was tracked down to swan neck taps. These were replaced, and, along with use of sterile water for bathing babies, this ended the outbreak. On the adult ICU the culprits were TMVs and flexible hoses. Dr Weinbren said: “Although not at the time clear if the risk of biofilm formation could be engineered out, it was crucial to block the routes of transmission by ensuring contaminated water couldn’t get to patients. The only way to ensure safe water on our NICU was to use sterile water, and, for our adult ICUs, to fit pointof-use filters on the outlets, ideally on a temporary basis. However, on the adult ICU, we were unable to remove the risk, so POU filters are used long term.”
Dr Weinbren’s presentation can be viewed at: www.specialistmasterclasses.com
