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Use of pulsed-field gel electrophoresis as an epidemiologic tool during an outbreak ofPseudomonas aeruginosa lung infections in an intensive care unit

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Abstract

Objective

A retrospective study was performed to evaluate the use of DNA polymorphism analysis by pulsed-field gel electrophoresis (PFGE) in assessing the rate of exogenous contamination during an outbreak ofPseudomonas aeruginosa lung infections in an intensive care unit ICU. Another goal was to determine the risk factors, involved in the outbreak.

Design

Rectal swabs and tracheal secretions were cultured from all patients upon admission and there-after once a week throughout their stay in the ICU. Resistance patterns were determined in allP. aeruginosa isolates. We determined the serotypes, pyocin types, plasmid profiles and total DNA macrorestriction patterns for isolates. The restriction fragment length polymorphism (RFLP) ofDra I total DNA digest was studied by PFGE. A retrospective case-control study was performed to determine the risk factors forP. aeruginosa bronchopulmonary colonization.

Setting

The study was carried out in the medical ICU of Besançon University Hospital (France).

Results

The typability, stability and reproducibility of phenotypic markers were not completely satisfactory. Only the RFLP profile satisfied all the criteria for a good typing technique. In four of the 17 patients,P. aeruginosa strains with the same DNA pattern were found. Among the previously reported risk factors for hospital-acquired bronchopulmonary infections, only invasive procedures were determined by multivariate analysis to be significant in our study group. The oropharynx and the bronchial tract are the most likely endogenous sources.

Conclusion

PFGE-RFLP is a valuable tool for the epidemiologic study ofP. aeruginosa. This typing method revealed that exogenous contamination is not always the major source ofP. aeruginosa lung infections in mechanically ventilated patients in ICUs.

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Authors and Affiliations

  1. Laboratoire de Bactériologie, Faculté de Médecine, Hôpital J. Minjoz, Bd. Fleming, F-25030, Basançon, France

    D. Talon & Y. Michel-Briand

  2. Service de Réanimation, Faculté de Médecine, Hôpital J. Minjoz, F-25030, Besançon, France

    G. Capellier & A. Boillot

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  1. D. Talon
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  2. G. Capellier
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  3. A. Boillot
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  4. Y. Michel-Briand
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Talon, D., Capellier, G., Boillot, A. et al. Use of pulsed-field gel electrophoresis as an epidemiologic tool during an outbreak ofPseudomonas aeruginosa lung infections in an intensive care unit. Intensive Care Med 21, 996–1002 (1995). https://doi.org/10.1007/BF01700661

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  • DOI: https://doi.org/10.1007/BF01700661

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