Pseudomonas aeruginosa

Question

How can you avoid Pseudomonas aeruginosa infection? What should be avoided? Sinks and flower vases?

Answer

Hello, Because Pseudomonas aeruginosa is so common in external environments, it is practically impossible to rule out the possibility of avoiding contact with this bacteria in everyday life. Traditionally, the highest risk of infection is connected with heated pools, hot tubs, showers, WCs, sinks and dentists’ instruments, but of course a potential reservoir of P. aeruginosa can essentially be any moist environment in which bacteria can survive without problems. The intentionally-chosen phrase „survive without problems“ is used in defense of pools that are sufficiently chlorinated, prohibiting the growth of P. aeruginosa; in reality these do not represent an increased risk.
So what is the real risk posed by moist environments? Although the definition of P. aeruginosa occurrence states that the bacteria massively occurs in patients’ close environments, the probability of infection does not seem to be high at all. Studies that have compared the genetic profiles of P. aeruginosa bacteria types, there has been no correspondence between the strains isolated from external environments and strains cultivated from patients with CF. Such a result indicates that the population of „outdoor“ P. aeruginosa bacteria is very diverse and most of its members are unable to colonise a patient and cause infections.
The source of infections in external enviroments (if such a specific source exists) and their factor of severity has still not been described. However, the danger of being infected by contact with another P. aeruginosa positive patient has been clearly defined. The basic rule to prevent infection is to maintain a system of separation as well as anti-epidemic precautions in CF centres.
There is essentially no objection to other activities that patients carry out in good faith to avoid infection, although their effectiveness and advisability is disputable. Patients (and especially their families) frequently significantly overestimate the possibility of being infected by the external environment; many precautions carried out in households are essentially unnecessary and only further burden the patient. The exception is the correct care for inhalation devices which are in daily contact with the patient and which could serve as a gateway to infection if not sterilised properly.
The recommendation remains to respect a separation regime and hygienic rules at CF centers. In everyday life, one must rationally consider every household measure – especially from the patient’s point of view – so that the activity in question does not prove to be a psychological burden. Best regards, Pavel Drevinek and Jitka Brazova

15.02.2008