Please note: While some information will still be current in a year, other information may already be out of date in three months time. If you are in any doubt, please feel free to ask.

Pseudomonas prevention

Question
What are the hygiene measures to prevent Pseudomonas infections?

My baby has deltaF508 and R1070W and is almost healthy (details are in a previous question).

Thank you
Answer
Dear Parent
Pseudomonas aeruginosa is a bacteria which is commonly found in lungs of patients with CF. For the majority of patients with CF the source of their infection cannot be determined. It is thought that this bacteria is mostly acquired through environmental sources, however, it can also be transmitted between patients. Some examples of environmental sources include areas of waste water in sink drains and toilets, ineffectively chlorinated swimming pools, and soil. Transmission between patients can be via aerosol (e.g. coughing) or indirectly via hands. The 2005 Standards of Care for patients with CF (Kerem et al) recommend that separate clinics should be held for those with P. aeruginosa and those without to reduce the risk of cross infection. Similarly separate rooms and facilities are recommended for patients who need to be admitted to hospital. It is also important to keep medical devices such as nebulisers clean and dry in between use.

Airway clearance techniques are useful for keeping the lungs clear of mucus. Your physiotherapist at your CF centre should be able to give guidance specific to your child.

Routine testing of sputum (or cough swab if your child is not producing sputum) tested in specialised CF microbiology laboratories can check for any bacteria common in CF, including P. aeruginosa. P. Aeruginosa can be eradicated or kept at bay with early antibiotic treatment.

A publication on the CF Trust website gives a thorough review of sources of P. Aeruginosa infection and some simple precautions www.cftrust.org.uk/aboutcf/publications/Pseudomonas_article_-_Jim__Sept_07_.pdf

Some of the recommendations on this publication include: being aware of what organisms grow in your child’s sputum, avoid close contact with people who have respiratory infections including those without CF, avoid holiday camps for CF people, avoid spa baths, check that swimming pool used is serviced regularly.

I hope this is of some help.


Best wishes
Lisa Kent
Judy Bradley
Belfast

References
Standards of care for patients with cystic fibrosis: A European consensus
Kerem E, Conway S, Elborn S, Heijerman H for the Consensus Committee
Journal of Cystic Fibrosis 2005; 4: 7-26

Early intervention and prevention of lung disease in cystic fibrosis: a European consensus.
Döring G, Høiby N for the Consensus Study Group
Journal of Cystic Fibrosis 2004; 3: 67-91.

www.cftrust.org.uk/aboutcf/publications/Pseudomonas_article_-_Jim__Sept_07_.pdf

24.01.2012
The answer is edited by: PhD Lisa Kent