Pseudomonas aeruginosa is ubiquitous in water. It can be carried by touch contamination⁽¹⁾. As an opportunistic microorganism, it rarely causes harm to the immune competent individual. However, P. aeruginosa is commonly recognized as one of the more virulent microorganisms among immunocompromised patients both in and out of the hospital setting⁽²⁾. It has been shown to be responsible for fatality rates approximating 30% among those with pneumonia and septicemia⁽³⁾, and when the causative agent of ventilator-associated pneumonia, mortality may be as high as 38%⁽⁴⁾. Among AIDS patients, P. aeruginosa is associated with 50% fatality rates⁽⁵⁾, and it is lethal in 60% of the highly susceptible burn patient population⁽⁴⁾. Cystic fibrosis patients are a particularly susceptible group, with virulence and antibiotic resistance having been well studied⁽⁶⁾.

Pseudomonas Facts:

• The U.S. National Nosocomial Infection Surveillance system report issued in 2000, comprising data from 205 medical and surgical intensive care units collected over a seven-year period and involving 500,000 patients with 29,000 healthcare-associated infections, stated that P. aeruginosa ranked among the top five most frequently encountered organisms responsible for healthcare-associated infections⁽⁷⁾.
• A principal factor in the establishment and maintenance of virulence in P. aeruginosa is its resistance to antibiotics⁽²⁾.
• P. aeruginosa is a common constituent of biofilms⁽²⁾.
• Studies in the scientific literature have linked healthcare-associated infections to drug-resistant P. aeruginosa in the hospital water supply⁽⁸⁾.
• Recent German, Swiss, and Spanish data suggest that P. aeruginosa found in hospital water is a significant source of healthcare-associated infections⁽⁹⁾.
• During a six-month period in a 16-bed surgical intensive care unit, Trautmann et al. demonstrated through DNA-based typing techniques that 5/17 (29%) of invasive Pseudomonas infections were caused by strains isolated from the tap water in the intensive care unit⁽¹⁰⁾.

Pseudomonas and Point-Of-Use Filtration:

• Exposure to P. aeruginosa can be managed with point-of-use bacterial retention filters at faucets and showerheads as an adjunct to or replacement for existing systemic water disinfection regimens.

References:
1. Foca, M.D. 2002. Pseudomonas aeruginosa infections in the neonatal intensive care unit. Seminar Pernatol. 26(5): 332-339.
2. Ortolano, G.A., J.H. Angelbeck, F.P. Canonica, and J.S. Cervia. 2004. Waterborne Pseudomonas aeruginosa, a controllable source of healthcare-acquired infection. Pall Clinical Update.
3. Osmon, S., S. Ward, V.J. Fraser, and M.H. Kollef. 2004. Hospital mortality for patients with bacteremia due to Staphylococcus aureus or Pseudomonas aeruginosa. Chest. 125(2): 607-616.
4. http://www.drlera.com/bacterial_diseases/pseudomonas_aeruginosa.htm Accessed Dec. 2004.
5. Shepp, D.H., I.T. Tang, M.B. Ramundo, and M.K. Kaplan. 1994. Serious Pseudomonas aeruginosa infection in AIDS. J. Acquir. Immune Defic. Syndr. 7(8):823-831.
6. Ong, C.T., J.L. Kuti, C.H. Nightingale, and D.P. Nicolau. Emerging Pseudomonas aeruginosa resistance: implications in clinical practice. Conn. Med. 68(1):11-15.
7. Richards, M.J., J.R. Edwards, D.H. Culver, and R.P. Gaynes. 2000. Nosocomial infections in combined medical-surgical intensive care units in the United States. Infect. Cont. Hosp. Epidemiol. 21(8):510-515.
8. Anaissie, E.J., S.R. Penzak, and M.C. Dignani. 2002. The hospital water supply as a source of nosocomial infections: a plea for action. Arch. Intern. Med. 162(13):1483-1492.
9. Reuter et al., Crit. Care Med., 2002.  Blanc et al., Intensive Care Med., 2004.  Vallés et al., Crit. Care Med., 2004.
10. Trautmann, M., T. Michalsky, H. Wiedeck, H. Radosavljevic, and M. Ruhnke. 2001. Tap water colonization with Pseudomonas aeruginosa in a surgical intensive care unit (ICU) and relation to Pseudomonas infections of ICU patients. Infect. Cont. Hosp. Epideniol. 22(1):49-52.