Ecology and Epidemiology of Pseudomonas aeruginosa

  • Konrad Botzenhart
  • Gerd Döring
Part of the Infectious Agents and Pathogenesis book series (IAPA)


The first description of Pseudomonas aeruginosa as a distinct bacterial species was made at the end of the nineteenth century, after Pasteur’s development of sterile culture media. Screening for dyes provided the stimulus for the first scientific study on P. aeruginosa published by pharmacist Carle Gessard in 1882 and entitled “On the blue and green coloration of bandages.”1 This characteristic pigmentation, later attributed to a phenazine derivative, pyocyanine, is reflected in the old names Bacillus pyocyaneus, Pseudomonas polycolor, Bakterium aeruginosa and Pseudomonas pyocyaneus. Although the ability of P. aeruginosa to produce infections was noticed by 1889,2 its pathogenicity was doubted,3 and P. aeruginosa was regarded mainly as a source of potent antimicrobial substances.4 Before 1947 only 91 cases of septicemia attributable to P. aeruginosa were reported in the literature.5 Its importance as a human pathogen, especially in hospitalized patients, did not emerge until the second half of the twentieth century,6 although the organism was certainly present in the inanimate and human environment before then. Because P. aeruginosa is easy to culture and identify it is unlikely that it was missed by clinical microbiologists. Thus, the considerable change in the significance of P. aeruginosa as a nosocomial pathogen probably reflects advances made in the life sciences as well as changes in the susceptibility of patients.


Cystic Fibrosis Pseudomonas Aeruginosa Nosocomial Infection Acute Leukemia Cystic Fibrosis Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Gessard, C., 1982, Sur les colorations bleue et verte des lignes à pansements, C. R. Acad. Sci. Serie D 94: 536–538.Google Scholar
  2. 2.
    Bouchard, C., 1889, Influence qu’exerce sur la maladie charbonneuse l’inoculation du Bacille pyocyanique, C. R. Acad. Sci. Serie D 108: 713–714.Google Scholar
  3. 3.
    Fraenkel, E., 1917, Über die Menschenpathogenität des Bacillus pyocyaneus. Weitere 13 Fälle, Z. Hyg. 84: 367–424.CrossRefGoogle Scholar
  4. 4.
    Schoenthal, B., 1941, The nature of the antibacterial agents present in Pseudomonas pyocyanea cultures, BE J. Exp. Pathol. 22: 137–147.Google Scholar
  5. 5.
    Stanley, M. M.,1947,Bacillus pyocyaneus infections: A review of cases and discussion of newer therapy including streptomycin, Am. J. Med. 2: 253–277, 347–367.Google Scholar
  6. 6.
    Finland, M., 1980, Experiences with Pseudomonas aeruginosa at Boston City Hospital over the last half-century, in: Pseudomonas aeruginosa, the Organism, Diseases It Causes, and Their Treatment (L. D. Sabath, ed.), Hans Huber Publishers, Bern, pp. 244–264.Google Scholar
  7. 7.
    Rhame, F. S., 1980, The ecology and epidemiology of Pseudomonas aeruginosa, in: Pseudomonas aeruginosa, the Organism, Diseases It Causes, and Their Treatment (L. D. Sabath, ed.), Hans Huber Publishers, Bern, pp. 31–51.Google Scholar
  8. 8.
    Botzenhart, K., and Rüden, H., 1987, Hospital infections caused by Pseudomonas aeruginosa, Antibiot. Chemothe: 39:1–15.Google Scholar
  9. 9.
    Finlay, B. B., and Falkow, S., 1989, Common themes in microbial pathogenicity, Microbiol. Rev. 53:210–230.PubMedGoogle Scholar
  10. 10.
    Higgins, C. E, Hinton, J. C. D., Hulton, C. S. J., Owen-Hughes, T., Pavitt, G. D., and Seirafi, A., 1990, Protein HI: A role for chromatin structure in the regulation of bacterial gene expression and virulence?, Mol. Microbiol. 4:2007–2012.PubMedCrossRefGoogle Scholar
  11. 11.
    Miller, J. E, Mekalanos, J. J., and Falkow, S., 1989, Coordinate regulation and sensory transduction in the control of bacterial virulence, Science 243:916–922.PubMedCrossRefGoogle Scholar
  12. 12.
    Fletscher, M., and Floodgate, G. D., 1973, An electron-microscopic demonstration of an acidic polysaccharide involved in the adhesion of a marine bacterium to solid surfaces, J. Gen. Microbiol. 74:325–334.CrossRefGoogle Scholar
  13. 13.
    Costerton, J. W, Cheng, K.-J., Geesey, G. G., Ladd, T. I., Nickel, J. C., Dasgupta, M., and Marrie, T. J., 1987, Bacterial biofilms in nature and disease, Ann. Rev. Microbiol. 41: 435–464.CrossRefGoogle Scholar
  14. 14.
    Cheung, W. H. S., Chang, K. C. K., and Hung, R. P. S., 1991, Variations in microbial indicator densities in beach water and health-related assessment of bathing water quality, Epidemiol. Infect. 106:329–344.PubMedCrossRefGoogle Scholar
  15. 15.
    Botzenhart, K., Wolf, R., and Thofern, E., 1975, Das Verhalten von Pseudomonas aeruginosa in Oberflächenwasser, Kühlwasser und Abwasser, Zentralbl. Bakteriol, Hyg. I. Abt. Orig. B, 161:72–83.Google Scholar
  16. 16.
    Hoadley, A. W, McCoy, E., and Rohlich, G. A., 1968, Untersuchungen über Pseudomonas aeruginosa in Oberflächengewässern. I. Quellen, Arch. Hyg. 152:328–338.Google Scholar
  17. 17.
    Hoadley, A. W, McCoy, E., and Rohlich, G. A., 1968, Untersuchungen über Pseudomonas aeruginosa in Oberflächengewässern. II. Auftreten und Verhalten, Arch. Hyg. 152: 339–345.Google Scholar
  18. 18.
    Döring, G., Bareth, H., Gairing, A., Wolz, C., and Botzenhart, K., 1989, Genotyping of Pseudomonas aeruginosa sputum and stool isolates from cystic fibrosis patients: Evidence for intestinal colonization and spreading into toilets. Epidem. Infect. 103:555–564.CrossRefGoogle Scholar
  19. 19.
    Van Saene, H. K. E, Van Putte, J. C., Van Saene, J. J. M., Van de Gromde, T. W, and Van Warmerdam, E. G. A., 1989, Sink flora in a long-stay hospital is determined by the patients’ oral and rectal flora, Epidemiol. Infect. 102:231–238.PubMedCrossRefGoogle Scholar
  20. 20.
    Botzenhart, K., Thofern, E., and Külpmann, W. R., 1974, Schwimmbadfilter und bakteriologische Qualität des Badewassers, Öff. Gesundh.-Wesen 36:326–331.Google Scholar
  21. 21.
    Exner, M., Tuschewitzki, G. J., and Haun, E, 1982, Rasterelektronenoptische Darstellung der Wandbesiedlung wasserführender Kunststoffschläuche, Zentralbl. Bakteriol. Hyg. I. Abt. Orig. B 176:425–434.Google Scholar
  22. 22.
    Katz, T, Hahn, T., Netuschil, L. and Botzenhart, K., 1990, Keimbesiedlung von zahnärztlichen Behandlungseinheiten ohne und mit Desinfektionseinrichtung, Quintessenz 8:1345–1355.Google Scholar
  23. 23.
    Botzenhart, K., and Thofern, E., 1967, Bakteriologische Untersuchungen an Reihenwaschmaschinen, Das Krankenhaus 59:322–330.Google Scholar
  24. 24.
    Vanhaecke, E., Remon, J.-P, Moors, M., Raes, E, De Rudder, D., and van Peteghem, A., 1990, Kinetics of Pseudomonas aeruginosa adhesion to 304 and 316-L stainless steel: Role of cell surface hydrophobicity, Appl. Environ. Microbiol. 56 :788–795.PubMedGoogle Scholar
  25. 25.
    Favero, M. S., Carson, L. A., Bond, W. W, and Petersen, N. J., 1971, Pseudomonas aeruginosa: Growth in distilled water from hospitals, Science 173:836–838.PubMedCrossRefGoogle Scholar
  26. 26.
    Höfte, M., Mergeay, M., and Verstraete, W, 1990, Marking the rhizopseudomonas strain 7NSK2 with a Mu d(lac) element for ecological studies, Appl. Environ. Microbial. 56:1046–1052.Google Scholar
  27. 27.
    Mitcherlich, E., and Marth, E. H., 1984, Microbial survival in the environment,Springer, Berlin.CrossRefGoogle Scholar
  28. 28.
    Botzenhart, K., Egler, W, Attar, Y., Ernst, G., Fischer, P, Krizek, L., and Wurz, D., 1979, Microbial emission, immision and changes in the germ count in the cooling water during operation of wet cooling towers. IV. Communication: Microbial immision in the vicinity of wet cooling towers, Zentralbl. Bacterial. Hyg. I. Abt. Orig. B 169:164–205.Google Scholar
  29. 29.
    Döring, G., Ulrich, M., Müller, W, Bitzer, J., Schmidt-Koenig, L., Münst, L., Grupp, H., Wolz, C., Stern, M., and Botzenhart, K., 1991, Generation of Pseudomonas aeruginosa aerosols during handwashing from contaminated sink drains, transmission to hands of hospital personnel, and its prevention by use of a new heating device. Zentralbl. Hyg. 191: 494–505.Google Scholar
  30. 30.
    Hambleton, P., Dennis, P. J., and Fitzgeorge R., 1984, Survival of airborne Legionella pneumophila,in: Legionella. Proceedings of the 2nd International Symposium (C. Thornesberry, A. Balows, J. C. Feeley, and W. Jakuboski, eds.), American Society for Microbiology, pp. 301–302, Washington, D.C.Google Scholar
  31. 31.
    Müller, W, Gröning, K., and Hartmann, E, 1981, De Tenazität von Bakterien im luftgetragenen Zustand I. Mitteilung: Experimentelle Untersuchungen zur Bestimmung der Absterbekonstante ßbiol für E. coli, Salmonella spp. und P. mutocida,Zentralbl. Bakteriol. Hyg. I. Abt. Orig. B 172:367–376.Google Scholar
  32. 32.
    Lebeda, A., Kudela, V, and Jedlickova, Z., 1984, Pathogenicity of Pseudomonas aeruginosa for plants and animals, Acta Phytophathol. Acad. Sci. Hung. 19:271–284.Google Scholar
  33. 33.
    Fett, W. E, Osman, S. E, Fishman, M. L., and Siebles III T. S., 1986, Alginate production by plant-pathogenic pseudomonads, Appt. Environ. Microbiol. 52:466–473.Google Scholar
  34. 34.
    Golovleva, L. A., Pertsova, R. N., Boronin, A. M., Travkin, V. M., and Kozlovsky, S. A., 1988, Kelthane degradation by genetically engineered Pseudomonas aeruginosa BS827 in a soil ecosystem, Appl. Environ. Microbiol. 54:1587–1590.PubMedGoogle Scholar
  35. 35.
    Higson, F. K., and Focht, D. D., 1990, Degradation of 2-bromobenzoic acid by a strain of Pseudomonas aeruginosa, Appl. Environ. Microbiol. 56:1615–1619.PubMedGoogle Scholar
  36. 36.
    Hickey, W. J., and Focht, D. D., 1990, Degradation of mono-, di, and trihalogenated benzoid acids by Pseudomonas aeruginosa JB2, Appl. Environ. Microbiol. 56:3842–3850.PubMedGoogle Scholar
  37. 37.
    Leathen, W. W, and Kinsel, N. A., 1963, The identification of microorganisms that utilize jet fuel, Rev. Ind. Microbiol. 4:9–16.Google Scholar
  38. 38.
    Ribbons, D. W, 1970, Specificity of monohydric phenol oxidations by meta cleavage pathways in Pseudomonas aeruginosa T 1, Arch. Microbiol. 74:103–115.Google Scholar
  39. 39.
    O’Morchoe, S. B., Ogunseitan, O., Sayler, G. S., and Miller, R. V, 1988, Conjugal transfer of R68.45 and FP5 between Pseudomonas aeruginosa strains in a freshwater environment, Appl. Environ. Microbiol. 54:1923–1929.PubMedGoogle Scholar
  40. 40.
    Saye, D. J., Ogusseitan, O. A., Sayler, G. S., and Miller, R. V, 1990, Transduction of linked chromosomal genes between Pseudomonas aeruginosa strains during incubation in situ in a freshwater habitat, Appl. Environ. Microbiol. 56 :140–145.PubMedGoogle Scholar
  41. 41.
    Morgan, J. A. W, Winstanley, C., Pickup, R. W, and Saunders, J. R., 1991, Rapid immunocapture of Pseudomonas putida cells from lake water by using bacterial flagella, Appl. Environ. Microbiol . 57:503–509.PubMedGoogle Scholar
  42. 42.
    Adair, F. W., Geftic, S. G., and Gelzer, J., 1969, Resistance of Pseudomonas to quaternary ammonium compounds, Appl. Microbiol. 18:299–302.PubMedGoogle Scholar
  43. 43.
    Bean, H. S., and Farrell, R. C., 1967, The persistence of Pseudomonas aeruginosa in aqueous solutions of phenols, J. Pharm. Pharmacol. 19:183–188.Google Scholar
  44. 44.
    Carlson, L. A., Favero, M. S., Bond,W.W,Petersen,N. J. 1972, Factors affecting comparative resistance of naturally occurring and subcultured Pseudomonas aeruginosa to disinfectants, Appl. Microbiol. 23:863–869.Google Scholar
  45. 45.
    Lowbury, E. J. L.1951, Contamination of cetrimide and other fluids with Pseudomonas pyocyanea, Br. J. Ind. Med. 8:22–25.PubMedGoogle Scholar
  46. 46.
    Botzenhart, K., and Thofern, E., 1969, Pseudomonas aeruginosa an ärztlichem Instrumentarium, Der Chirurg 40:40–43.Google Scholar
  47. 47.
    Fierer J. Taylor, P. M., and Gezon, H. M., 1967, Pseudomonas aeruginosa epidemic traced to delivery-room resuscitators, New Engl. J. Med. 276: 991–996.PubMedCrossRefGoogle Scholar
  48. 48.
    Lanyi, B., Gregacs, M., and Adam, M. M., 1966, Incidence of Pseudomonas aeruginosa serogroups in water and human faeces. Acta Microbiol. Acad. Sci. Hung. 13:319–326.PubMedGoogle Scholar
  49. 49.
    Linde, K., and Kittlick, M., 1963, Zum Nachweis von Bacterium pyocyaneum in menschlichem Untersuchungsmaterial. Arch. Hyg. 146:126–138.Google Scholar
  50. 50.
    Botzenhart, K., 1974, Zur Okologie fakultativ-pathogener Bakterien mit geringen Nährstoffansprüchen im Krankenhaus, Immun. Infekt. 2:110–113.PubMedGoogle Scholar
  51. 51.
    Remington, J. S., and Schimpff, S. C., 1981, Please don’t eat the salads. New Engl. J. Med. 304:433–435.PubMedCrossRefGoogle Scholar
  52. 52.
    Levison, M. E., 1977, Factors influencing colonization of the gastrointestinal tract with Pseudomonas aeruginosa, in: Pseudomonas aeruginosa: Ecological Aspects and Patient Colonization (V. M. Young, ed.), Raven Press, New York, pp. 97–109.Google Scholar
  53. 53.
    Buck, A. C., and Cooke, E. M., 1969, The fate of ingested Pseudomonas aeruginosa in normal persons, J.Med. Microbiol 2:521–525.PubMedCrossRefGoogle Scholar
  54. 54.
    Hentges, D.J., Stein, A.J., Casey, S. W, and Que, J. U., 1985, Protective role of intestinal flora against infection with Pseudomonas aeruginosa in mice: Influence of antibiotics on colonization resistance, Infect. Immun. 47:118–122.PubMedGoogle Scholar
  55. 55.
    Murthy, S. K., Baltch, A. L., Smith, R. P, Desjardins, E. K., Hammer, M. C., Conroy, J. V, and Michelsen, P. B., 1989, Oropharyngeal and fecal carriage of Pseudomonas aeruginosa in hospital patients, J. Clin. Microbial. 27:35–40.Google Scholar
  56. 56.
    McBride, M. E., Duncan, W. C., and Knox, J. M., 1975, Physiological and environmental control of gram-negative bacteria on skin, Br. J. Dermatol. 93:191–199.PubMedCrossRefGoogle Scholar
  57. 57.
    Botzenhart, K., Puhr, O. E, and Döring, G., 1985, Pseudomonas aeruginosa in the oral cavity of healthy adults: Frequency and age distribution, Zentralbl. Bakteriol. Hyg. I. Abt. Orig. B 180:471–479.Google Scholar
  58. 58.
    Horan, T. C., White, J. W, Jarvis, W. R., Emori, T. G., Culver, D. H., Munn, V. E, Thornsberry, C., Olson, D. R., and Hughes, D. E, 1986, Nosocomial infections surveillance, Morbid. Mortal. Wkly. Rep. 35:17–29.Google Scholar
  59. 59.
    Brawley, R. L., Weber, D. J., Samsa, G. E, and Rutala, W. A., 1989, Multiple nosocomial infections, an incidence study, Am. J. Epidemiol. 130:769–780.PubMedGoogle Scholar
  60. 60.
    Horan, T. C., Culver, D., Jarvis, W. R., Emori, G., Banerjee, S., Martone, W, and Saunsberry, C., 1988, Pathogens causing nosocomial infections, Antimicrobic Newsletter 5 :65–67.CrossRefGoogle Scholar
  61. 61.
    Olson, B., Weinstein, R. A., Nathan, C., Chamberlin, W, and Kabins, S. A., 1985, Occult aminoglycoside resistance in Pseudomonas aeruginosa: Epidemiology and implications for therapy and control, J. Infect. Dis. 152:769–774.PubMedCrossRefGoogle Scholar
  62. 62.
    Mulgrave, L., 1991, The changing ecology of hospital bacteria and the selective role of cephalosporins, Epidemiol. Infect. 106:121–132.PubMedCrossRefGoogle Scholar
  63. 63.
    Iyobe, S., Hirai, K., and Hashimoto, H., 1991, Drug resistance of Pseudomonas aeruginosa with special reference to new quinolones, Antibiot. Chemother. 44:209–214.PubMedGoogle Scholar
  64. 64.
    McManus, A. T., 1989, Pseudomonas aeruginosa: A controlled burn pathogen? Antibiot. Chemother. 42:103–108.PubMedGoogle Scholar
  65. 65.
    Tümmler, B., Koopmann, U., Grothues, D., Weissbrodt, H., Steinkamp, G., and von der Hardt, H., 1991, Nosocomial acquisition of Pseudomonas aeruginosa by cystic fibrosis patients, J. Clin. Microbiol. 29:1265–1267.PubMedGoogle Scholar
  66. 66.
    Høiby, N., and Pedersen, S. S., 1989, Cro.,s-infection with Pseudomonas aeruginosa in Danish cystic fibrosis patients, Antibiot. Chemother. 42: 124–129.PubMedGoogle Scholar
  67. 67.
    Maki, D. G., Alvarado, C. J., Hassemer, C. A., Zilz, M. A., 1982, Relation of the inanimate hospital environment to endemic nosocomial infection, New Engl. J. Med. 307:1562–1566.PubMedCrossRefGoogle Scholar
  68. 68.
    MacArthur, R. D., Lehman, M. H., Currie-McCumber, C. A., and Shlaes, D. M., 1988, The epidemiology of gentamicin-resistant Pseudomonas aeruginosa on an intermediate care unit, Am. J. Epidemiol. 128:821–827.PubMedGoogle Scholar
  69. 69.
    Ogle, J. W, Janda, J. M., Woods, D. E., and Vasil, M. L., 1987, Characterization and use of a DNA probe as an epidemiological marker for Pseudomonas aeruginosa. J. Infect. Dis. 155: 119–126.PubMedCrossRefGoogle Scholar
  70. 70.
    Vasil, M., Chamberlain, C., and Grant, C. R., 1986, Molecular studies of Pseudomonas exotoxin A gene, Infect. Immun. 52:538–548.PubMedGoogle Scholar
  71. 71.
    Wolz, C., Kiosz, G., Ogle, J. W, Vasil, M. L., Schaad, U., Botzenhart, K. and Döring, G., 1989, Pseudomonas aeruginosa cross-colonization and persistence in patients with cystic fibrosis. Use of a DNA probe. Epidemiol. Infect. 102:205–214.PubMedCrossRefGoogle Scholar
  72. 72.
    Römling, U., Grothes, D., and Tümmler, B., 1991, Whole DNA genome typing, Antibiot. Chemother. 44:1–7.PubMedGoogle Scholar
  73. 73.
    Ojeniyi, B., Wolz, C., Döring, G., Lam, J. S., Rosdahl, V. T., and Høiby, N., 1990, Typing of polyagglutinable Pseudomonas aeruginosa isolates from cystic fibrosis patients. Acta Pathol. Microbiol. Immunol. Scand. 98:423–431.Google Scholar
  74. 74.
    Ojeniyi, B., and Høiby, N., 1991, Comparison of different typing methods ofPseudomonas aeruginosa, Antibiot. Chemother. 44:13–22.PubMedGoogle Scholar
  75. 75.
    Speert, D. P, Campbell, M. E., Farmer, S. W, Volpel, K., Joffe, A. M., and Paranchych, W, 1989, Use of a pilin gene probe to study molecular epidemiology of Pseudomonas aeruginosa, J. Clin. Microbiol. 27:2589–2593.PubMedGoogle Scholar
  76. 76.
    Habs, J., 1957, Untersuchungen über 0-Antigene von Pseudomonas aeruginosa, Z. Hyg. Infektionskr. 144:218–228.PubMedCrossRefGoogle Scholar
  77. 77.
    Lanyi, B., and Bergan, T., 1978, Serological characterization of Pseudomonas aeruginosa, in:Methods of Microbiology (T. Bergan, and J. R. Norris, eds.), Academic Press, London, vol. 10, pp. 93–168.Google Scholar
  78. 78.
    Ansorg, R., 1978, Flagella-spezifisches H-Antigenschema von Pseudomonas aeruginosa, Zentralbl. Bakteriol. Microbiol. Hyg. A, 242:228–238.Google Scholar
  79. 79.
    Lam, J. S., MacDonald, L. A., Kropinski, A. M., and Speert, D. E, 1988, Characterization of non-typable strains of Pseudomonas aeruginosa from cystic fibrosis patients by means of monoclonal antibodies and SDS-polyacrylamide gel electrophoresis, Serodiag. Immunother. Infect. Dis. 2:365–374.CrossRefGoogle Scholar
  80. 80.
    Govan, J. W. R., 1978, Pyocin typing of Pseudomonas aeruginosa,in: Methods of Microbiology (T. Bergan, and J. R. Norris, eds.), Academic Press, London, Vol. 10, pp. 61–91.Google Scholar
  81. 81.
    Bergan, T., 1978, Phage typing of Pseudomonas aeruginosa, in: Methods of Microbiology (T. Bergan, and J. R. Norris, eds.), Academic Press, London, vol. 10, pp. 169–199.Google Scholar
  82. 82.
    Ojeniyi, B., Baek, L., and Høiby, N., 1985, Polyagglutinability due to loss of 0-antigenic determinants in Pseudomonas aeruginosa strains isolated from cystic fibrosis patients, Acta Pathol. Microbiol. Scand. [B] 93:7–13.Google Scholar
  83. 83.
    Ojeniyi, B., 1988, Bacteriophages in sputum of cystic fibrosis patients as a possible cause of in vivo changes in serotypes of Pseudomonas aeruginosa, Acta Pathol. Microbiol. Immunol. Scand. 96:294–298.Google Scholar
  84. 84.
    Pitt, T. L., Epidemiological typing of Pseudomonas aeruginosa, Eur. j Clin. Microbiol. Infect. Dis. 7:238–247.Google Scholar
  85. 85.
    Thomassen, M. J., Demko, C. A., Doershuk, C. E, and Root, J. M., 1985, Pseudomonas aeruginosa isolates: Comparison of isolates from campers and from sibling pairs with cystic fibrosis, Pediat. Pulmonol. 1:40–45.CrossRefGoogle Scholar
  86. 86.
    Kern, W, Wolz, C., and Döring, G., 1990, Molecular epidemiological study of Pseudomonas aeruginosa isolates from patients with acute leukemia, Eur. j Clin. Microbiol. Infect. Dis. 9:257–261.PubMedCrossRefGoogle Scholar
  87. 87.
    Worlitzsch, D., Wolz, C., Botzenhart, K., Hansis, M., Burgdörfer, H., Ogle, J. W, and Döring, G., 1989, Molecular epidemiology of Pseudomonas aeruginosa urinary tract infections in paraplegic patients. Zentralbl. Hyg. 189:175–184.Google Scholar
  88. 88.
    Griffith, S. J., Nathan, C., Selander, R. K., Chamberlin, W, Gordon, S., Kabins, S., and Weinstein, R. A., 1989, The epidemiology of Pseudomonas aeruginosa in oncology patients in a general hospital, J. Infect. Dis. 160 :1030–1036.PubMedCrossRefGoogle Scholar
  89. 89.
    Brown, D. G., and Baublis, J., 1977, Reservoirs of Pseudomonas in an intensive care unit for newborn infants: mechanisms of control, J. Pediatr . 90:453–457.PubMedCrossRefGoogle Scholar
  90. 90.
    Chadwick, P, 1973, Relative importance of airborne and other routes in the infection of tracheostomised patients with Pseudomonas aeruginosa, in: Airborne Transmission and Airborne Infection,6th Intern. Symp. on Aerobiology, (J. F. Hers and K. C. Winkler, eds.), Oosthock Publ. Co., Utrecht, The Netherlands, pp. 481–489.Google Scholar
  91. 91.
    Noone, M. R., Pitt, T. L., Bedder, M., Hewlett, A. M., and Rogers, K. B., 1983, Pseudomonas aeruginosa colonization in an intensive therapy unit: Role of cross infection and host factors, Br. Med. J. 286:341–344.CrossRefGoogle Scholar
  92. 92.
    Levin, M. H., Olson, B., Nathan, C., Kabins, S. A., and Weinstein, R. A., 1984, Pseudomonas in the sinks in an intensive care unit in relation to patients, J. Clin. Pathol. 37:424–427.PubMedCrossRefGoogle Scholar
  93. 93.
    Ayliffe, G. A., Babb, J. R., Collins, B. J., Lowbury, E. J. L., and Newsom, S. W. B., 1974, Pseudomonas aeruginosa in hospital sinks, Lancet i :578–581.CrossRefGoogle Scholar
  94. 94.
    Gerba, C. P, Wallis, C., and Melnick, J. L., 1975, Microbiological hazards of household toilets: Droplet production and the fate of residual organisms, Appl. Microbiol. 30:229–237.PubMedGoogle Scholar
  95. 95.
    Darlow, H. M., and Bale, W. R., 1959, Infective hazards of water-closets. Lancet i:1196–1200.CrossRefGoogle Scholar
  96. 96.
    Kohn, J. A., 1970, A waste-trap-sterilizing method. Lancet ii:550–551.CrossRefGoogle Scholar
  97. 97.
    Teres, D., Schweers, E, Bushnell, L. S., Hedley-Whyte, P., and Feingold, D. S., 1973, Sources of Pseudomonas aeruginosa infection in a respiratory/surgical intensive-therapy unit, Lancet i:415–417.CrossRefGoogle Scholar
  98. 98.
    Mäkelä, E, Ojajärvi, J., and Salminen, E., 1972, Decontaminating waste-trap, Lancet ii: 1216–1217.CrossRefGoogle Scholar
  99. 99.
    Olson, B., Weinstein, R. A., Nathan, C., and Kabius, S. A., 1984, Epidemiology of endemic Pseudomonas aeruginosa: why infection control efforts have failed, J. Infect. Dis. 150: 808–816.PubMedCrossRefGoogle Scholar
  100. 100.
    Craven, D. E., and Daschner, E D., 1989, Nosocomial pneumonia in the intubated patient: Role of gastric colonization, Ear. J Clin. Microbiol. Infect. Dis. 8:40–50.CrossRefGoogle Scholar
  101. 101.
    Tancrede, C. H., and Andremont, A. 0., 1985, Bacterial translocation and gram-negative bacteremia in patients with hematological malignancies, J. Infect. Dis. 152:99–103.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1993

Authors and Affiliations

  • Konrad Botzenhart
    • 1
  • Gerd Döring
    • 1
  1. 1.Department of General Hygiene and Environmental Hygiene, Hygiene-InstitutUniversity of TübingenTübingenGermany

Personalised recommendations