BACKGROUND Pseudomonas aeruginosa remains one of the most common nosocomial pathogens in intensive care units (ICUs). Although exogenous acquisition has been widely documented in outbreaks, its importance is unclear in non-epidemic situations. AIM To elucidate the role of exogenous origin of P. aeruginosa in ICU patients. METHODS A chronological analysis of the acquisition of P. aeruginosa was performed using samples collected in 2009 in the DYNAPYO cohort study, during which patients and tap water were screened weekly. Molecular relatedness of P. aeruginosa isolates was investigated by pulsed-field gel electrophoresis. Exogenous acquisition was defined as identification of a P. aeruginosa pulsotype previously isolated from another patient or tap water in the ICU. FINDINGS The DYNAPYO cohort included 1808 patients (10,402 samples) and 233 water taps (4946 samples). Typing of 1515 isolates from 373 patients and 375 isolates from 81 tap water samples identified 296 pulsotypes. Analysis showed exogenous acquisition in 170 (45.6%) of 373 patients. The pulsotype identified had previously been isolated from another patient and from a tap water sample for 86 and 29 patients, respectively. The results differed according to the ICU. CONCLUSION Exogenous acquisition of P. aeruginosa could be prevented in half of patients. The overall findings of this survey support the need for studies on routes of transmission and risk assessment approach to better define how to control exogenous acquisition in ICUs.

中文翻译：

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重症监护病房中铜绿假单胞菌的外源性获取：一项前瞻性多中心研究（DYNAPYO研究）。

背景技术铜绿假单胞菌仍然是重症监护病房（ICU）中最常见的医院病原体之一。尽管外源性收购已在暴发中得到广泛记录，但在非流行情况下其重要性尚不清楚。目的阐明外源性铜绿假单胞菌在ICU患者中的作用。方法使用DYNAPYO队列研究中2009年收集的样本对铜绿假单胞菌的获取进行时间顺序分析，在此期间每周对患者和自来水进行筛查。铜绿假单胞菌分离物的分子相关性通过脉冲场凝胶电泳进行了研究。外源性采集定义为鉴定先前从另一名患者或ICU中的自来水中分离出的铜绿假单胞菌脉冲型。研究结果DYNAPYO队列包括1808例患者（10例，402个样本）和233个水龙头（4946个样本）。对373例患者的1515株分离株和81种自来水样品的375种分离株进行了分型，确定了296种脉冲型。分析显示，在373例患者中有170例（45.6％）获得了外源性获取。先前已从另一名患者和自来水样本中分别分离出鉴定出的脉冲型，分别用于86名和29名患者。结果根据ICU有所不同。结论一半患者可以预防铜绿假单胞菌的外源性获取。这项调查的总体结果支持对传播途径和风险评估方法进行研究的需要，以更好地定义如何控制重症监护病房中的外源性获取。分析显示，在373例患者中有170例（45.6％）获得了外源性获取。先前已从另一名患者和自来水样本中分别分离出鉴定出的脉冲型，分别用于86名和29名患者。结果根据ICU有所不同。结论一半患者可以预防铜绿假单胞菌的外源性获取。这项调查的总体结果支持对传播途径和风险评估方法进行研究的需要，以更好地定义如何控制重症监护病房中的外源性获取。分析显示，在373例患者中有170例（45.6％）获得了外源性获取。先前已从另一名患者和自来水样本中分别分离出鉴定出的脉冲型，分别用于86名和29名患者。结果根据ICU有所不同。结论一半患者可以预防铜绿假单胞菌的外源性获取。这项调查的总体结果支持对传播途径和风险评估方法进行研究的需要，以更好地定义如何控制重症监护病房中的外源性获取。