a procedure to PREVENT Pseudomonas aeruginosa INFECTION

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					WATER MICROFILTRATION
     a procedure to PREVENT
Pseudomonas aeruginosa INFECTION
van der Mee-Marquet N.1,2, Lagarrigue F. 3 , Fenneteau A. 2, Bloc D.2,
            Brulard V. 2, Besnier J.-M.3, Quentin R.1,2
  Département de Microbiologie Médicale et Moléculaire, Unité de Bactériologie,
                 EA 32501, Service de Bactériologie et Hygiène2,
     Service de Réanimation Chirurgicale, Service de Maladies Infectieuses4,
                       Hôpital Trousseau, Tours, France
Teaching Hospital (surgery) 600 beds
build in 1975 (new construction in 2003)




   Intensive Care Unit (surgical)
                 14 beds
Microbiological
quality of water
            Recurrent problem
     P. aeruginosa from potable water
                   2005, neurosurgery unit
2003, new building
   Intensive Care Unit (surgical)
                    2 periods
• 30 months                   • 30 months
• jan 2000-july 2002          • aug 2002-dec 2004
• not filtrated water         • water filtration

      P. aeruginosa recovered from
           environmental samples
           clinical samples (for 1000 hospitalization days)
                     Nb samples + for P. aeruginosa
                         14

Water Quality            12

                         10

      Period 1            8
• each month
                          6
• 14 bedrooms
                          4
• 2 Drinking Water
  samples                 2

                          0


                                                  11

                                                       13

                                                            15

                                                                 17

                                                                      19

                                                                           21

                                                                                23

                                                                                     25

                                                                                          27

                                                                                               29
                              1

                                  3

                                      5

                                          7

                                              9




                                                                                                    3
                                                                                          Months
         Drinking Water Tap           Hand Washing Tap
                      Nb samples + for P. aeruginosa


Water Quality
     Period 2
• each month
 (during 6 months),
 each 3 months
• 14 bedrooms
• 2 Drinking Water
  samples
                          9
                              31

                                   33

                                        35

                                             37

                                                  39

                                                       41

                                                            43

                                                                 45

                                                                      47

                                                                           49

                                                                                51

                                                                                     53

                                                                                          55

                                                                                               57

                                                                                                    59
                                                                                               Months
        Drinking Water Tap                   Hand Washing Tap
      Inprovement in Water Quality
Nb samples + for P. aeruginosa
       14

       12

       10

        8

        6

        4

        2

        0                                                                                                                                                    Months
                                11

                                     13

                                          15

                                               17

                                                    19

                                                         21

                                                              23

                                                                   25

                                                                        27

                                                                             29

                                                                                  31

                                                                                       33

                                                                                            35

                                                                                                 37

                                                                                                      39

                                                                                                           41

                                                                                                                43

                                                                                                                     45

                                                                                                                          47

                                                                                                                               49

                                                                                                                                    51

                                                                                                                                         53

                                                                                                                                              55

                                                                                                                                                   57

                                                                                                                                                        59
            1

                3

                    5

                        7

                            9




                        Drinking Water Tap                                                       Hand Washing Tap
P. aeruginosa from clinical samples
               7
               Incidence/1000 HD
                        6

                        5

     Period 1           4
                                            R
3 to 6.5 / 1000 HD      3
 Pulmonary samples
                        2
                                            S
                        1


                        0
                            2000-1 2000-2 2001-1 2001-2 2002-1
P. aeruginosa from pulmonary samples
 7
Incidence/1000 HD
 6

 5
                                                Period 2
 4
                                          0.5 to 3.5/1000 HD
 3
        R
                                           Pulmonary samples
 2

 1
        S
 0
     2002-2 2003-1 2003-2 2004-1 2004-2
P. aeruginosa from pulmonary samples
  7
Incidence/1000 HD

  6
                                       F
  5


  4


  3                  R

  2

  1                  S
  0
      2000-1 2000-2 2001-1 2001-2 2002-1 2002-2 2003-1 2003-2 2004-1 2004-2
             P. aeruginosa from urine
 6
Incidence/1000 HD

5                                    F
4


3


2                   R
1
                    S
0
    2000-1 2000-2 2001-1 2001-2 2002-1 2002-2 2003-1 2003-2 2004-1 2004-2
               P. aeruginosa from BSI
Incidence/1000 HD
 1,4

1,2                                  F
1,0

0,8

0,6

0,4
                    R
0,2
                    S
0,0
      2000-1 2000-2 2001-1 2001-2 2002-1 2002-2 2003-1 2003-2 2004-1 2004-2
        Conclusion
Positive impact of water filtration


           Laurence Arnault
           Christine Bouvet
            Nathalie Enogat
           Isabelle Gaultier
            Nadège Ménard
          Nathalie Reynouard
        Conclusion
Positive impact of water filtration