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  • Writer's picturePedro Duarte

Pseudomonas aeruginosa, what is it, and what we can do to prevent contamination.

During this difficult time is hard to talk about anything other than the COVID-19 virus. However, we cannot forget that all other infections continue to exist, and they haven't gone away. In fact, it has never been more important to make sure compliance is fully achieved and guidelines are adhered to in the most effective and safest possible way. One bacteria who hasn't got much publicity is Pseudomonas aeruginosa - however it is extremely dangerous and often fatal so this is an infection you want to avoid at all costs. If you manage a site with showers this is one area you want to be in full control of, with a robust prevention system that leaves absolutely no space for any fails.

But first of all, what is Pseudomonas aeruginosa and what are its dangers?

Pseudomona species refers to a group of free-living bacteria who often occur naturally in the environment, both in soil and water.

The major pathogen is the Pseudomonas aeruginosa, which can cause severe and frequently deadly infections in individuals with highly compromised immune systems.

P.aeruginosa is however not dangerous to healthy individuals and is rarely found naturally in new-borns - it is usually a sign of infection if found in a neonate.

P. aeruginosa has now become even more dangerous to those affected because it has developed resistance to multiple antibiotics, with few options left for treatment.

In the UK, Pseudomonas aeruginosa causes an estimated 10% of all UK hospital-acquired infections!Pseudomonas aeruginosa is particularly dangerous in healthcare and care environments because hospital and nursing home populations include a high percentage of individuals who are most vulnerable to serious infections.

Water is now recognised as a potential source of Pseudomonas aeruginosa outbreaks in intensive care units (ICU's).

Those most at risk of becoming infected with severe Pseudomonas aeruginosa infections are:

  • those with a weekend immune system due to long term health conditions;

  • patients taking immune-suppressant drugs such as chemotherapy and steroids

  • patients who have had surgery or another invasive procedure

  • patients fitted with invasive devices

  • patients with severe burns or wounds

  • the elderly

  • alcoholics

Symptoms of Pseudomonas aeruginosa

The most severe Pseudomonas aeruginosa infections generally occur in the blood and lungs. Blood infections, known as bacteremia, cause a high fever. Bacteremia caused by Pseudomonas aeruginosa can lead to low blood pressure, which in turn leading to failure of the heart, kidneys and liver. Lung infections with Pseudomonas aeruginosa also cause high fevers, as well as coughs and difficulty with breathing. In the UK, Pseudomonas aeruginosa can also cause very mild illnesses such as skin rashes and ear infections in healthy individuals, often after exposure to hot tubs and swimming pools who have not been properly chlorinated.

Where can Pseudomonas aeruginosa grow?

Pseudomonas aeruginosa can easily grow in potable water, taps, wash hand basins, sinks, sink drains, baths, shower heads and hoses - and many more!

If it has water or even slightly damp, it can grow Pseudomonas aeruginosa!

Pseudomonas aeruginosa inhabits damp environments because of its ability to form biofilm, an intricate colony of micro-organisms that can glue itself to inanimate surfaces such as metal and plastic.

Biofilm provides a safe harbour for the bacteria living in it because the sticky glue it produces also protects the bacteria from chemicals designed to attack biofilm.

As biofilm grows, sections will continually break off to contaminate water with free-living bacteria that can emerge in water flowing from taps and showers, as well as seeding new biofilm colonies.

Biofilm occurs throughout nature: black mould in a damp bathroom is a biofilm!

The reason we need to clean our teeth is to remove biofilm built up by the bacteria living in our mouths.

Biofilm grows best in certain conditions:

  • stagnant water or slow flowing water, such as water trapped in dead legs, dead end areas of a water system (where an out of use pipe, basin or shower has been blocked off or removed).

  • anywhere with even a tiny amount of organic matter to provide nutrients, for example, trapped debris inside tap fixtures such as tap outlets, flow straighteners and aerators.

  • deposits of soap and shampoo around basins, baths and showers

  • anywhere with limescale deposits

  • basin and sink seals

Pseudomonas aeruginosa can be spread to patients and nursing home residents in the following ways:

  • on the hands of healthcare and care workers and visitors

  • contaminated equipment

  • contact with contaminated water

What can be done to protect patients from Pseudomonas aeruginosa infections by the Estate Teams?

  • keep hot water circuit at high temperatures, to discourage bacterial growth

  • ensure the water is moving through all parts of the plumbing system by maintaining flushing regimes

  • maintain cleaning routines to prevent biofilm growth on taps, showers* and surfaces

  • decontaminate and/or replace contaminated fixtures when cleaning fails to resolve contamination

  • installing point of use (POU) filters (also known as Legionella filters) on infected taps and showers while contamination problemas are being resolved.

* We suggest a full replacement shower head and hose scheme as the safest and most compliant regime.


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