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Genotyping of Pseudomonas aeruginosa isolates from lung transplant recipients and aquatic environment-detected in-hospital transmission

Journal article
Authors Ewa Johansson
Christina Welinder-Olsson
Marita Gilljam
Published in Apmis
Volume 122
Issue 2
Pages 85-91
ISSN 0903-4641
Publication year 2014
Published at Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Institute of Biomedicine, Department of Infectious Medicine
Pages 85-91
Language en
Links dx.doi.org/10.1111/apm.12243
Keywords Pseudomonas aeruginosa, lung transplant, transmission, surveillance, genotyping, CYSTIC-FIBROSIS PATIENTS, INTENSIVE-CARE-UNIT, FIELD, GEL-ELECTROPHORESIS, INFECTION, STRAINS, CLONE, MORTALITY, OUTBREAK
Subject categories Clinical Medicine

Abstract

Lung infection with Pseudomonas aeruginosa is common in lung transplant recipients and may lead to severe complications. Bacteriological surveillance aims to detect transmission of microbes between hospital environment and patients. We sought to determine whether genotyping of P. aeruginosa isolates could improve identifications of pathways of infection. From 2004 to 2009, we performed genotyping with multiple-locus variable number of tandem repeats analysis (MLVA) and pulsed-field gel electrophoresis (PFGE) of P. aeruginosa isolates cultured from lung transplant recipients at Sahlgrenska University Hospital, Gothenburg. During a small outbreak in 2008, cultivation and genotyping of isolates from sink and drains samples from the hospital ward were performed. Pseudomona aeruginosa from 11/18 patients were genotyped to unique strains. The remaining seven patients were carriers of a P. aeruginosa strain of cluster A genotype. Pseudomona aeruginosa was isolated in 4/8 water samples, typed by MLVA also as cluster A genotype and confirmed by PFGE to be similar or identical to the isolates from four transplanted patients. In conclusion, genotyping of isolates revealed a clonal relationship between patient and water isolates, indicating in-hospital transmission of P. aeruginosa. We suggest genotyping with MLVA for rapid routine surveillance, with the PFGE method used for extended, confirmatory analyses.

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