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Pediatr Infect Dis J. 1998 Jun;17(6):509-13.

Multiresistant Pseudomonas aeruginosa outbreak in a pediatric oncology ward related to bath toys.

Author information

1
Department of Microbiology and Infectious Diseases, Royal Children's Hospital, Melbourne, Victoria, Australia. jim.buttery@paediatrics.oxford.ac.uk

Erratum in

  • Pediatr Infect Dis J 1999 Jan;18(1):9.

Abstract

BACKGROUND:

Nosocomial outbreaks of Pseudomonas aeruginosa in pediatric hospitals frequently involve neonates and immunosuppressed patients and can cause significant morbidity and mortality.

OBJECTIVE:

To describe the investigation of a multidrug-resistant P. aeruginosa outbreak in a pediatric oncology ward at the Royal Children's Hospital, Melbourne, Australia.

DESIGN AND METHODS:

Specimens were collected from infected patients and the ward environment. Bacterial isolates were characterized by antibiotic susceptibility patterns and bacterial DNA fingerprinting performed by pulsed-field gel electrophoresis (PFGE). A case-control study was carried out to assess possible risk factors for infection.

RESULTS:

Eight patients had clinical illnesses including bacteremia (n = 5) and infections of skin (n = 2), central venous catheter site (n = 1) and urinary tract (n = 1). The environmental ward survey yielded isolates of multiresistant P. aeruginosa from a toy box containing water-retaining bath toys, as well as from three of these toys. Pulsed-field gel electrophoresis of bacterial DNA demonstrated identical band patterns of the isolates from patients, toys and toy box water. A case-control study involving the 8 cases and 24 disease-matched controls demonstrated a significant association between P. aeruginosa infection and use of bath toys (P = 0.004), use of bubble bath (P = 0.014), duration of stay (P = 0.007) and previous antibiotic exposure (P = 0.026). Cultures from the bubble bath liquid were negative.

CONCLUSION:

This is the first description of a nosocomial outbreak associated with toys. We caution against the use of water-retaining bath toys in wards treating immunocompromised children.

[Indexed for MEDLINE]

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