Reducing the urine collection rate could prevent hospital-acquired horizontal transmission of multidrug-resistant Pseudomonas aeruginosa |
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| Affiliation: | 1. Department of Clinical Laboratory Medicine, Shin Koga Hospital, Kurume, Japan;2. Graduate School of Medicine, Kurume University, Kurume, Japan;3. Department of Infection Control and Prevention, Kurume University School of Medicine, Kurume, Japan;4. Division of Infection Control and Prevention, Kurume University Hospital, Kurume, Japan;5. Department of Pediatrics, Kurume University Medical Center, Kurume, Japan;6. Department of Clinical Laboratory Medicine, Kurume University Hospital, Kurume, Japan;7. Department of Pharmacy, Kurume University Hospital, Kurume, Japan;8. Biostatistics Center, Kurume University, Kurume, Japan;1. Division of Bacteriology, Chiba Prefectural Institute of Public Health, 666-2, Nitona, Chuo, Chiba, 260-8715, Japan;2. Center for Emergency Preparedness and Response, National Institute of Infectious Diseases, 4-7-1, Gakuen, Musashi-murayama, Tokyo, 208-0011, Japan;1. Division of General Pediatrics, Department of Pediatrics, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan;2. Division of Pediatric Infectious Diseases, Department of Pediatrics, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan;3. Department of Pediatrics, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan;4. Department of Otorhinolaryngology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan;1. Department of Pharmacy, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino-city, Fukuoka, 818-8502, Japan;2. Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino-city, Fukuoka, 818-8502, Japan;3. Department of Clinical Laboratory, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino-city, Fukuoka, 818-8502, Japan;4. Department of Infection Control, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino-city, Fukuoka, 818-8502, Japan;5. Department of Pharmacy, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan;1. Department of Pharmacy, Kitasato University Hospital, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0375, Japan;2. Pharmacy Practice and Science I, Research and Education Center for Clinical Pharmacy, Kitasato University School of Pharmacy, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0375, Japan;3. Department of Infection Control and Infectious Diseases, Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0375, Japan;4. Department of Pharmacy, Tokyo Medical And Dental University Hospita, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan;5. Laboratory of Clinical Pharmacokinetics, Research and Education Center for Clinical Pharmacy, Kitasato University School of Pharmacy, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0375, Japan;6. Department of Colorectal Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0375, Japan;7. First Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan;8. Departments of Pharmacology and Anesthesiology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0375, Japan;9. Infection Control Research Center, Kitasato Institute for Life Sciences, Kitasato University, 5-9-1 Shirogane, Minato-ku, Tokyo, 108-8641, Japan;1. Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan;2. Department of Gastroenterology, Mitoyo General Hospital, Kannonji, Japan;3. Department of Gastroenterology, Asahi General Hospital, Asahi, Japan;4. Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan;5. Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan;6. Department of Internal Medicine, Division of Gastroenterology and Hepatology, Nippon Medical School, Tokyo, Japan;7. Department of Hepatology, Saiseikai Niigata Hospital, Niigata, Japan;8. Department of Internal Medicine, Division of Gastroenterology, Kikkoman General Hospital, Noda, Japan;9. Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan;10. Center of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan;11. Department of Gastroenterology and Core Research Facilities for Basic Science, The Jikei University School of Medicine, Tokyo, Japan;12. Gastroenterology Center, Yokohama City University Medical Center, Yokohama, Japan;13. Department of Internal Medicine, Division of Gastroenterology and Hepatology, Shinmatusdo Central General Hospital, Matsudo, Japan;14. Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Suita, Japan;15. Department of Nursing, Gifu Kyoritsu University, Ogaki, Japan;p. Department of Epidemiology, Infectious Disease Control, and Prevention, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan;1. School of Medicine, Zhejiang University, Hangzhou, PR China;2. Department of Hematology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, PR China |
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| Abstract: | IntroductionMultidrug-resistant Pseudomonas aeruginosa (MDRP) is a waterborne pathogen that occasionally causes hospital-acquired infection in immunocompromised or critically ill patients. Urine is frequently collected to evaluate renal function or to perform hormonal examinations, but the procedure involves risk due to the possibility of healthcare workers with contaminated hands. Our objective was to evaluate the association between the urine collection and hospital-acquired horizontal transmission of MDRP.MethodsWe monitored the urine collection rate from 2011 to 2017, as part of ongoing efforts to reduce the need to collect urine. The urine collection rate and the frequency of isolation of MDRP, Methicillin resistant S. aureus (MRSA) and extended spectrum β-lactamases (ESBL)-producing E. coli were analyzed during the same period. PFGE and MLST were also performed to analyze the identity of 5 MDRP strains detected on the same ward in 2014–2015.ResultsThe urine collection rate was dramatically decreased from 4.8% in 2011 to less than 0.5% in 2017, because the isolation rate of MDRP was significantly positively associated (RR = 1.72, 95%CI:1.03–2.85) with the urine collection rate. Isolations of MRSA and ESBL-producing E. coli showed no significant. Molecular typing showed the PFGE patterns of 3 of 5 MDRP strains were closely related as did MLST (ST17), and the remaining 2 MDRP strains had different PFGE and MLST patterns (ST14, ST655). Our data implicated the urine collection as one of the causes of hospital-acquired MDRP infections.ConclusionsWe concluded that a reducing the urine collection rate could contribute to preventing hospital-acquired horizontal transmission of MDRP. |
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| Keywords: | Urine collection Multilocus sequence typing |
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