Halting the spread of epidemic pseudomonas aeruginosa in an adult cystic fibrosis centre: a prospective cohort study.
Halting the spread of epidemic pseudomonas aeruginosa in an adult cystic fibrosis centre: a prospective cohort study.
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DOI：
10.1258/shorts.2012.012018
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发表时间：
2013-01-01
影响因子：
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通讯作者：
Walshaw, Martin J
中科院分区：
文献类型：
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作者：
Ashish, Abdul;Shaw, Matthew;Walshaw, Martin J
目的：评估队列隔离政策是否有效预防囊性纤维化（CF）诊所的交叉感染。设计：前瞻性队列研究。地点：英格兰西北部的一个大型成人CF中心。参与者：2003- 2009年在利物浦成人CF中心接受治疗的所有CF患者。方法：定期痰液采样并对铜绿假单胞菌（Psa）分离株进行基因分型，从而实现了按微生物组对住院患者和门诊患者进行隔离的政策。2003 - 2009年利物浦成人CF中心成人CF患者中可传播Psa菌株（即利物浦流行株（LES））的患病率和交叉感染/重复感染率。LES患者的比例下降（71-53%），独特菌株（23-31%）和无Psa感染（6-17%）的患者比例增加从2003年到2009年。有2例LES重叠感染和1例新发慢性Psa感染（具有独特菌株）。有以前未感染PSA.CONCLUSIONS：我们的隔离政策已经停止了在英国（LES）在我们的诊所传播的最常见的高传染性菌株，而不会危及以前没有感染PSA的患者。它证实，如果使用基因型监测，没有必要将感染独特菌株的患者与未感染Psa的患者分开。
OBJECTIVES: To assess if cohort segregation policies are effective in preventing cross-infection in cystic fibrosis (CF) clinics.DESIGN: A prospective cohort study.SETTING: A large adult CF centre in Northwest England.PARTICIPANTS: All CF patients cared for at the Liverpool adult CF centre 2003-2009.METHODS: Regular sputum sampling with genotyping of pseudomonas aeruginosa (Psa) isolates led to a policy of inpatient and outpatient segregation by microbiological group.MAIN OUTCOME MEASURES: Prevalence and cross-infection/super-infection rates of a transmissible Psa strain, i.e. the Liverpool epidemic strain (LES) in adult CF patients at the Liverpool adult CF centre from 2003 to 2009.RESULTS: There was a decline in the proportion of patients with LES (71-53%) and an increase in those with unique strains (23-31%) and without Psa infection (6-17%) from 2003 to 2009. There were two cases of LES super-infection and one case of new chronic Psa infection (with a unique strain). There were no cases of transmissible strain infection in patients previously uninfected by Psa.CONCLUSIONS: Our segregation policy has halted the spread of the commonest highly transmissible strain in the UK (LES) in our clinic, without endangering patients who were not previously infected with Psa. It confirms that if genotypic surveillance is used, it is unnecessary to segregate patients infected with unique strains from those without Psa infection.