Infection control by point-of-use water filtration in an intensive care unit - a Hungarian case study.

Hospital tap water is a potential source of pathogenic bacteria associated with nosocomial infections. Infection control should include preventive measures to reduce the risk of waterborne infection. The efficiency of point-of-use water filters in infection control was assessed in the intensive care unit of a Hungarian hospital with long history of nosocomial Pseudomonas aeruginosa cases. All taps in the unit were fitted with disposable point-of-use filters. The incidence of nosocomial P. aeruginosa infections decreased from 2.71 to 0 cases/100 patient days when the filters were in place. Legionnaires' disease was not observed either during or outside the study period. Before the application of the filters, both P. aeruginosa and Legionella sp. were shown to colonize five of the seven taps. Filtration eliminated both bacteria completely, though secondary contamination was observed. Total genome restriction profiling of environmental and clinical P. aeruginosa isolates have shown the ubiquitous presence of a single genotype. The same genotype was detected in five of the seven previous nosocomial cases, which supports the assumption of water-derived infection. The results demonstrate that point-of-use filters are effective and cost-efficient measures in reducing health-care associated infections.

[Contribution of microbiology to an effective control of healthcare-associated infections]. / Mikrobiológiai értéktöbblet az infekciókontroll-centrum kialakításához.

An effective control of healthcare-associated infections is not realized without an intensive participation of microbiologic activities. Authors present the model of a centre for healthcare-associated infection control established in 2008 at Semmelweis University. The new model of the surveillance system is based on diagnostic and experimental microbiologic data. Clinical and epidemiological microbiologic examinations are performed in the same laboratory using identical methods, and the results are continually compared. Reports consist of two functional parts; namely list of pathogens isolated and antibiotic sensitivity patterns for clinicians and messages especially for epidemiologists including abbreviated information on bacteria of nosocomial importance. Rapid detection of the most important pathogens both from clinical samples and from those obtained for detecting nasal carriage is carried out by a sensitive and specific method of an automated real time PCR. Biotyping of isolates by detailed biochemical substrate spectrum, genotyping by ready-to-use kits depending on polymorphism of repetitive DNA sequences, and cluster analysis of data are used for up-to-date survey of nosocomial situation. Statistical analysis of reports is performed by the multifactorial software OSIRIS Epidemiology.