Pseudomonas in the sinks in an intensive care unit: relation to patients

• Published in: Journal of clinical pathology Vol. 37; no. 4; pp. 424 - 427
• Main Authors: Levin, M H, Olson, B, Nathan, C, Kabins, S A, Weinstein, R A
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Association of Clinical Pathologists 01.04.1984; BMJ; BMJ Publishing Group LTD
• Subjects: Aminoglycosides - pharmacology; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anti-Bacterial Agents - pharmacology; Biological and medical sciences; Chlorhexidine - pharmacology; Cross Infection - transmission; Emergency and intensive care: infection, septic shock; Humans; Intensive care medicine; Intensive Care Units; Medical sciences; Microbial Sensitivity Tests; Prospective Studies; Pseudomonas aeruginosa; Pseudomonas aeruginosa - drug effects; Pseudomonas aeruginosa - isolation & purification; Pseudomonas Infections - transmission; Sanitary Engineering; Human; Pseudomonas; Contamination; Resuscitation; Intensive care unit
• ISSN: 0021-9746; 1472-4146
• DOI: 10.1136/jcp.37.4.424

Sink drains in a medical-surgical intensive care unit (ICU) were cultured during six consecutive weeks as part of a seven month prospective study of acquisition of Pseudomonas aeruginosa by ICU patients. Isolates were typed serologically and by aminoglycoside and chlorhexidine susceptibility patterns. All 11 sinks contained multiple strains of P aeruginosa; some strains persisted for weeks while others were isolated once. Of the sink isolates 56% had high level resistance to gentamicin and tobramycin whereas none of the strains found in patients. In sink isolates chlorhexidine resistance correlated with aminoglycoside resistance and with the presence of a chlorhexidine dispenser at a sink. The sequence of recovery of phenotypically similar isolates suggested that sinks were the source of at most two acquisitions of P aeruginosa by patients during the six weeks. Our study confirms that sinks may be reservoirs for large numbers of highly resistant P aeruginosa but are rarely the source of organisms colonising patients in our ICU.