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Original Research

Open Access

Outbreak of Pseudomonas aeruginosa in a Neonatal Intensive Care Unit: Are Point-of-Use Filters Useful?


1Department for Microbiology, University Hospitals of Morecabe bay, NHS Trust Lancaster, UK

2 Department of Clinical and Molecular Microbiology, Clinical Hospital Center Zagreb, Zagreb, Croatia

3 Research Department, Children’s Hospital Srebrnjak, Zagreb, Croatia

DOI: 10.22514/SV131.042017.20 Vol.13,Issue 1,March 2017 pp.75-79

Published: 20 March 2017

*Corresponding Author(s): LIDIJA ZELE STARCEVIC E-mail:


Pseudomonas aeruginosa, in intensive care units (ICUs), causes infections with high morbidity and mortality rates. Tap water outlets are often contaminated with P.aeruginosa and may represent a source of endemic infections in ICUs.

The aim of this study was to explore the role of point-of-use (POU) filters in neo-natal intensive care unit (NICU) in reduc-ing P.aeruginosa colonizations/infections. Routine surveillance cultures, environ-mental cultures and samples from the hands of healthcare personnel, were taken and cultivated. P.aeruginosa isolates were identified according to standard proce-dures. For epidemiological purposes, anti-microbial susceptibility testing and pulse-field gel electrophoresis were performed. Data regarding use of antibiotics, disin-fectants, antiseptics, gloves and gowns from 2006 to 2012 were investigated.

In March 2008, in the NICU of the Clini-cal Hospital Centre Zagreb (CHC Zagreb), we observed an increase in the total num-ber of pseudomonas infections compared to the previous months. This higher num-ber remained the same until October, de-spite rigorous infection control measures. Pseudomonas isolates were found in tap water, but not on the hands of healthcare workers. In that moment POU filters were introduced. The number of P.aeruginosa isolates in surveillance cultures dropped significantly.

The number of positive cultures of P.aeruginosa in two consecutive periods (before and after installation of POU fil-ters) showed a statistically significant dif-ference.

After the implementation of all infection control measures, we managed to stop the spread of pseudomonas colonization/infection. POU filters contributed only as one of these measures, resulting in a reduc-tion of chronically endemic P.aeruginosa infection/colonisation in the NICU.


P.aeruginosa, neonatal intensive care unit, point of use filters, infection con-trol

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VANDA PLECKO,VESNA TRIPKOVIC,LIDIJA ZELE STARCEVIC,DIJANA VARDA BRKIC,ALEKSANDRA PRESECKI STANKO,SANJA PLESKO,DAVOR PLAVEC. Outbreak of Pseudomonas aeruginosa in a Neonatal Intensive Care Unit: Are Point-of-Use Filters Useful?. Signa Vitae. 2017. 13(1);75-79.


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