Summary: | 碩士 === 國立高雄師範大學 === 環境教育研究所 === 93 === The purpose of this study is to determine the distribution of waterborne pathogens in a hospital water distribution system and its association with nosocomial respiratory tract and bloodstream infections. The waterborne pathogens investigated in this study included Pseudomonas aeruginosa, Stenotrophomonas maltophilia, and Acinetobacter baumannii. The study period was from 1st January 2003 through 31st December 2004. The study was conducted prospectively at a tertiary-care medical center with 1266 beds in Kaohsiung, Taiwan. The environmental surveillance for waterborne pathogens was performed by culturing water tap in the intensive care units (ICUs) periodically. The clinical surveillance of nosocomial respiratory tract and bloodstream infections caused by the waterborne pathogens was on patients who were admitted to ICUs and survived over 48 hours identified by infection control nurses according to our criteria. Three hundred and fifty-six tap swab samples were collected from 45 faucets in 2003, and 225 in 2004. During the same period, the positive rates of cultured sites for P. aeruginosa was 14.3% in 2003 and raised to 64.4% in 2004. The positive rates of cultured sites were between 2.2 and 15.6 % for S. maltophilia and 2.2 and 11.5% for A. baumannii. Genomic DNA typing between patient isolates and environmental isolates was performed by pulsed-field gel electrophoresis. Waterborne pathogens of same genotype could persist at the same faucets for a long period of time and could be found at different faucets of different ICUs at same time and caused nosocomial infections in patients.
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