21 February 2019

Researchers at Radboudumc have discovered a new way of how resistant hospital bacteria can spread. In a case study on JAMA Network Open, physician microbiologist Joost Hopman describes how the rare bacterium Pseudomonas aeruginosa could spread infection from shower drains in patient rooms. He recommends measures be taken in the design of hospital rooms to minimize the risk of spreading from drainage points.

Worldwide, the problem of pathogenic bacteria becoming resistant to carbapenems is increasing. This is a category of antibiotics that is used against serious bacterial infections when regular antibiotics no longer work. If the bacterium also becomes resistant to carbapenems, the infection is very difficult to treat. The spread of carbapenem-resistant bacteria has been identified by the World Health Organization (WHO) as a current major public health problem.
 
Hopman and the interdisciplinary team involved in the risk assessment identified the new infection route of Pseudomonas aeruginosa after a patient became infected with this carbapenem-resistant bacterium after lung surgery. The infection was remarkable because resistant Pseudomonas is rare in the Netherlands. In developing countries, the bacterium is much more common, but the patient had not travelled at all. The infection would probably have to come from the hospital itself.
 
After examination of various possible sources of infection, the sanitary facilities in the hospital proved to be the most likely source. The stagnant water in shower wells and drains turned out to be a growth medium for the resistant bacteria. Air measurements showed that the bacteria could move through the air when the shower was switched on. Hopman's research exposes a hitherto unknown mechanism for the spread of such resistant bacteria.
 
“The hospital environment is part of the puzzle of the spread of this bacterium,” says Hopman. “Now that we know that, we have to consider this in the new building plans for our hospital. We will work together with our building department to reduce the risk of infection. For example, we could consider moving the sinks from the patient rooms.”
 
“It is important to look for solutions in multidisciplinary fields,” emphasizes Hopman, “and collaborate with builders, engineers and infection experts. Of course, patients should be able to shower in the hospital. It is important to ensure that infections with resistant bacteria are kept to a minimum. This year we are planning a meeting in Nijmegen, where we will work with several national and international experts to find solutions, enabling other hospitals also to take the right measures to minimize the spread of resistant bacteria.”

publication
Risk Assessment After a Severe Hospital-Acquired Infection Associated With Carbapenemase-Producing Pseudomonas aeruginosa.
Hopman J, Meijer C, Kenters N, Coolen JPM, Ghamati MR, Mehtar S, van Crevel R, Morshuis WJ, Verhagen AFTM, van den Heuvel MM, Voss A, Wertheim HFL.


Joost Hopman and Heiman Wertheim are members of theme Infectious diseases and global health.

Related news items


Extended deadlines grant proposals

31 March 2020

The deadlines to submit grant proposals has been extended by most funding agencies.

read more

HFSP Grant for Johannes Textor

30 March 2020

Johannes Textor, theme Cancer development and immune defense, has been awarded a program grant of 1 million US dollars by The Human Frontier Science Program (HFSP) to investigate how T cells navigate extremely dense environments using experiments, modeling and methods from pedestrian dynamics.

read more

Ritalin enhances your ability to do tasks by making you more motivated

26 March 2020

A new study uncovers how stimulants like Ritalin work in the brain, and it challenges some misconceptions for its recreative use. The collaboration between Radboudumc and Brown University (USA) was published in the journal Science.

read more

Dealing with COVID-19 in low- and middle-income countries

26 March 2020

RIHS researcher Joost Hopman believes that low-and middle-income countries should intensify their preparedness for a possible COVID-19 outbreak. This was the core message of an opinion article that he wrote at the request of the medical journal JAMA.

read more

Physiotherapy is important to the recovery of patients with the coronavirus

26 March 2020

Patients who have been infected with the coronavirus and admitted to the hospital for this reason should receive physiotherapy as soon as their condition allows. This is the view expressed by physiotherapists and researchers from the Radboudumc in a set of joint treatment recommendations.

read more

Healthcare utilization and regional variation of end-of-life hospital care in Dutch cancer patients

26 March 2020

In International Journal of Quality Health Care RIHS researcher Femke Atsma showed high healthcare utilization and medical variation in End of Life care in Cancer patients, which was not associated with GP care or long term care.

read more