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    Investigation of the prevalence of opportunistic gram negative pathogens in the water supply of a haematology unit, and the application of point-of-use filtration as an intervention.

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    Thesis C.L. Wright.pdf (5.367Mb)
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    Publication date
    2013-11-21
    Author
    Wright, Claire Louise
    Supervisor
    Snelling, Anna M.
    Keyword
    Water-associated-pathogens
    Haematology
    Opportunistic
    Gram-negative
    Hospital acquired infections
    Immunocompromised
    Stenotrophomonas maltophilia
    Pseudomonas aeruginosa
    Water microbiology
    Filtration
    Nosocomial pathogens
    Point-Of-Use Filtration (POU-F)
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    Rights
    Creative Commons License
    The University of Bradford theses are licenced under a Creative Commons Licence.
    Institution
    University of Bradford
    Department
    School of Medical Sciences
    Awarded
    2012
    
    Metadata
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    Abstract
    Gram-negative infection has been linked to hospital water although few studies have examined whether water systems are reservoirs of nosocomial pathogens. This study investigated longitudinal recovery of the opportunistic pathogens Pseudomonas aeruginosa, Stenotrophomonas maltophilia and Acinetobacter baumannii from water outlets of a haematology unit and evaluated Point-Of-Use Filtration (POU-F) as a control measure. In a two-year double cross-over trial, water samples and swabs were taken weekly from 39 showers/taps on the unit. Four study phases alternated between non-filtered (Phases 1 & 3), and filtered outlets (Phases 2 & 4) using Pall AquasafeTM 14-day filters. In Phases 1 & 3; 99% of 1396 samples yielded bacterial growth, with colonies generally too numerous to count. Target species were isolated from 22% of water samples (P. aeruginosa 14%; S. maltophilia 10%) and 10% of swabs. P. aeruginosa was particularly associated with handwash stations and S. maltophilia with showers. A. baumannii was not isolated. With POU-F; 22% of 1242 samples yielded bacterial growth (mean CFU/100ml ,4.6). S. maltophilia was isolated only once from water but never from outlet swabs. PCR typing identified clusters of isolates colonizing different outlets over time but no clear association between water and patient isolates was identified. The incidence of Gram negative infections remained low throughout the study. Without POU-F, water from taps/showers represented a source of bacteria including the target species. POU-F substantially reduced the frequency and number of target species from every outlet, and merits further investigation as an intervention to protect immunocompromised patients from opportunistic pathogens.
    URI
    http://hdl.handle.net/10454/5692
    Type
    Thesis
    Qualification name
    PhD
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