Seeking the source of Pseudomonas aeruginosa infections in a recently opened hospital: an observational study using whole-genome sequencing.
Bottom Line: Screening patients who subsequently developed a positive P. aeruginosa microbiology result were subject to enhanced environmental surveillance.Isolates from three patients had identical genotypes compared with water isolates from the same room.This study reveals that WGS can be used for source tracking of P. aeruginosa in a hospital setting, and that acquisitions can be traced to a specific source within a hospital ward.
Affiliation: Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK.Show MeSH
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Mentions: When placed in the context of a global collection of P. aeruginosa strains, phylogenetic reconstruction demonstrated isolates in our study fell into eight clades (figure 1A). As has been reported previously, there was no strong association between ecological context and position in the phylogenetic tree.28 Isolates in this study are most closely related to strains from a variety of settings. The majority of isolates (52%) belong to Clade E (figure 1B), whose nearest sequenced relative is the Liverpool Epidemic Strain, a clone often isolated from patients in the UK and Canada with cystic fibrosis. 3637 Isolates from Clade E were found in the burns unit's water and the ward environment, as well as from two patient's wounds. However it was never detected in the critical care unit. Clade E was detected throughout the study in a total of 10 different rooms (figure 2).
Affiliation: Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK.