Role of intensive care unit environment and health-care workers in transmission of ventilator-associated pneumonia
Background: Pseudomonas aeruginosa and Acinetobacter baumannii have been reported to cause outbreaks of ventilator-associated pneumonia (VAP) in several studies. The high prevalence of these pathogens prompted us to study the different strains of these pathogens prevailing in our intensive care units (ICUs) and determine the role of ICU environment and health-care workers (HCWs) in the transmission of infection.
Methodology: A prospective study was performed over a period of 15 months in two ICUs of Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India. Surveillance samples were collected from the HCWs and the ICU environment. Quantitative antibiogram typing and PCR-RFLP were used for comparison of the isolates from the surveillance samples and VAP patients.
Results: Pseudomonas aeruginosa and Acinetobacter baumannii were the most common potential VAP pathogens isolated from the surveillance cultures. Eight strains of Pseudomonas aeruginosa were present in our ICUs, but multi-drug resistant (MDR) strain 2 and strain 4 were the most prevalent strains. Six strains of Acinetobacter baumannii were found in our ICUs, of which MDR strain 1 and strain 3 were the most common. The strains of Pseudomonas aeruginosa and Acinetobacter baumannii observed in the VAP patients were also found in the ICU milieu. Only one HCW was found to be the carrier of a Pseudomonas aeruginosa strain present in a VAP patient.
Conclusions: The ICU environment was observed to be the potential reservoir for VAP pathogens; therefore, strict adherence to environmental infection control measures is essential to prevent health-care-associated infections.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).