Assessment of Bacterial Cross-Transmission as a Cause of Infections in Patients in Intensive Care Units

The prevalence of possible cross-transmission of selected bacteria (Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Pseudomonas aeruginosa, Staphylococcus aureus, and enterococci) among infected patients was evaluated in five intensive care units (ICUs) over 6 months. A total of 284 i...

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Bibliographic Details
Published in:Clinical infectious diseases 1994-06, Vol.18 (6), p.929-937
Main Authors: Chetchotisakd, Ploenchan, Phelps, Charles L., Hartstein, Alan I.
Format: Article
Language:English
Subjects:
Bacteria
Biological and medical sciences
Chromosome Mapping
Chromosomes, Bacterial
Clinical Infectious Disease Articles
Cross Infection - microbiology
Cross Infection - transmission
DNA fingerprinting
DNA Probes
Electrophoresis
Enterobacter cloacae
Epidemiology
Epidemiology. Vaccinations
Escherichia coli
Gels
General aspects
Genetic Markers
Gram-Negative Bacteria - genetics
Gram-Negative Bacteria - isolation & purification
Gram-Negative Bacterial Infections - microbiology
Gram-Negative Bacterial Infections - transmission
Hospital admissions
Humans
Infections
Infectious diseases
Intensive care units
Intensive Care Units - standards
Klebsiella pneumoniae
Medical sciences
Plasmids
Professional cooking
Prospective Studies
Pseudomonas aeruginosa
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Summary:The prevalence of possible cross-transmission of selected bacteria (Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Pseudomonas aeruginosa, Staphylococcus aureus, and enterococci) among infected patients was evaluated in five intensive care units (ICUs) over 6 months. A total of 284 isolates from clinical specimens were typed by plasmid profile analysis (E. coli, K. pneumoniae, and E. cloacae), restriction endonuclease analysis of plasmid DNA (S. aureus), and/or pulse-field gel electrophoresis of chromosomal DNA (P. aeruginosa, enterococci, S. aureus, and other bacteria without plasmid DNA). By typing criteria, only 13% of the 177 isolates obtained after >2 days in an ICU were classified as possibly cross-transmitted. Many patients whose cultures yielded bacteria of an identical type may have been the sources rather than the recipients of these organisms. Episodes of possible cross-transmission were scattered among all ICUs, usually affected only two patients, and were associated with most bacterial species. These data suggest that endemic bacterial cross-transmission in ICUs is relatively infrequent and that cross-transmitted bacteria are not common causes of endemic ICU-related nosocomial infections.
ISSN:1058-4838
1537-6591
DOI:10.1093/clinids/18.6.929