|
Eastern Regional Meeting - 2008 Program & Abstracts
Back to 2008 Program
HOSPITAL WATER: A POSSIBLE SOURCE OF HEALTHCARE-ASSOCIATED INFECTIONS IN BONE MARROW TRANSPLANT RECIPIENTS
J.S. Cervia, B. Farber, D. Armellino, Division of Infectious Diseases, North Shore University Hospital, Manhasset, NY; J.S. Cervia, F.P. Canonica, G.A. Ortolano, Pall Medical, East Hills, NY
Purpose of Study: Infections with Gram-negative bacteria (GNB), such as Pseudomonas aeruginosa and Stenotrophomonas maltophilia are major contributors to serious morbidity and mortality in hospitalized patients. Immunocompromised individuals, such as recipients of bone marrow transplants (BMT) are known to be at particularly high risk. Recent literature indicates that infections with GNB are increasing in incidence, and that GNB clinical isolates are becoming increasingly resistant to antimicrobial therapy, and thus more difficult to treat. In addition, it has been recognized that outbreaks of infection with GNB have been linked to hospital water. We sought to determine whether water filtration at the point of use (POU) might result in a diminished risk of infection in hospitalized bone marrow transplant recipients in the absence of any recognized outbreak of GNB infection.
Methods Used: Unfiltered water was sampled from taps in the BMT unit of a major U.S. teaching hospital, and cultured at a reference laboratory (Special Pathogens Laboratory, Pittsburgh, PA). Specially adapted 0.2 micron filters (Aquasafe, Pall Medical, East Hills, NY) were installed at the POU (sinks, showers, ice machines) throughout that unit. Filters were replaced every 14 days as per instructions for use. Infection rates in the unit were tracked over a 9-month period, and compared using a one-tail t-test with rates for the same months in the prior year.
Summary of Results: Unfiltered water samples from 25% of taps cultured in the BMT unit grew P. aeruginosa and S. maltophilia. Clinical infection rates in the unit were significantly reduced from 50% in the period prior to POU filtration to 6% (p = 0.02) in the 9-month period for which filters were in place. In fact, no infections were noted in 8 of those 9 months.
Conclusions: Recognized waterborne pathogens, such as P. aeruginosa and S. maltophilia may be recovered from cultures of hospital tap water, and pose a particularly high risk to immunocompromised BMT recipients. POU filtration may significantly reduce infection rates in such high-risk patient populations.
|
