Korean J Nosocomial Infect Control.  1999 Jun;4(1):1-6.

Outbreak of Nosocomial Urinary Tract Infections caused by Multidrug-Resistant Pseudomonas aeruginosa

• Park YJ
• Oh EJ
• Kim GB
• Kim SY
• Kim ST
• Yoo SY
• Kim YR
• Kang MW
• Kim BK

Abstract

BACKGROUND
Nosocomial urinary tract infection (UTI) accounts for 35% of the nosocomial infection and 80-90% of them are associated with urethral catheters. Recently, we experienced an outbreak of nosocomial UTI caused by multidrug-resistant Pseudomonas aeruginosa in neurosurgical intensive care unit (NSICU).
METHODS
We investigated clinical records of the patients and observed the methods of care of urethral catheters in NSICU. Identification of P. aeruginose was done by API NE (API system; bioMerieux, France) and antibiotic susceptibility tests were done by disk diffusion method. Random Amplification of Polymorphic DNA (RAPD) assay was used as a genotyping method.
RESULTS
Between November 1997 and January 1998, 11 P. aeruginosa strains were isolated from the urine of 11 patients hospitalized in NSICU of Kangnam St. Mary's Hospital. Routine regular bladder irrigation, and emptying urine with common urinal had been done falsely. Antibiogram of the isolates showed resistance to multiple antibiotics including imipenem, gentamicin. amikacin, piperacillin, ciprofloxacin, ceftazidime, and cefoperazone/sulbactam. RAPD of the outbreak strains showed clonal relatedness, which was different from those of other clinical strains, We instructed all the health care workers to stop bladder Irrigation, and to use the separate urinals for each patient. Thereafter, no further case of P. aeruginosa UTI has occurred.
CONCLUSION
An outbreak of UTI, caused by a single clone of P. aeruginosa, was confirmed by RAPD and was eradicated after correction of false practice on care-of urinary catheter.

Keyword

Pseudomonas aeruginosa; Nosocomial outbreak; Multi-drug resistance; Random Amplification of Polymorphic DNA (RAPD) assay

MeSH Terms

Amikacin
Anti-Bacterial Agents
Ceftazidime
Ciprofloxacin
Clone Cells
Cross Infection
Delivery of Health Care
Diffusion
DNA
Drug Resistance, Multiple
Gentamicins
Humans
Imipenem
Intensive Care Units
Microbial Sensitivity Tests
Piperacillin
Pseudomonas aeruginosa*
Pseudomonas*
Urinary Bladder
Urinary Catheters
Urinary Tract Infections*
Urinary Tract*
Amikacin
Anti-Bacterial Agents
Ceftazidime
Ciprofloxacin
DNA
Gentamicins
Imipenem
Piperacillin