Outbreak of Pseudomonas aeruginosa Infections Associated With Contaminated Water in a University Hospital in Tunisia

Abstract

To the Editor—Pseudomonas aeruginosa is a major pathogen that causes nosocomial infections, particularly in ventilated and/or immunocompromised patients. This organism is ubiquitous in moist environments and is frequently found in various hospital sites. Strains involved may be spread via the hands of healthcare workers or by an environmental source, such as contaminated water.15 The installation of surveillance systems that detect outbreaks of nosocomial infection is im- portant; sources of infection may be characterized and iso- lated, and modifications in procedures made to stop further infections from occurring. Infection is a frequent event in surgical wards, such as the urology ward, where endoscopy and surgical procedures are common. We describe an outbreak of P. aeruginosa infection that occurred between July and September 2005 in the urology ward in the University Hospital Sahloul in Tunisia, a 548- bed hospital. An investigation of the environment was done to determine the potential source of infection and to imple- ment control measures to stop the outbreak. The urology ward is a 60-bed unit situated in the third floor of the hospital. Endoscopic procedures are performed using an ultraviolet water disinfection system; this technology has been in place since the hospital opened in 1990. Endoscopes were disin- fected with a quaternary ammonium compound and gluter- aldehyde and rinsed with water.