Pseudomonas aeruginosa is a Gram-negative bacterium, commonly found in wet or moist environments.
It is commonly associated with disease in humans with the potential to cause infections in almost any organ or tissue. It is an opportunistic pathogen that can colonise and infect vulnerable patients. Several outbreaks of the bacteria have been attributed to contaminated water systems in hospitals.
Common hospital-associated Pseudomonas aeruginosa infections include bloodstream infections, pneumonia (lung infection), urinary tract infections and surgical wound infections.
In the healthcare environment, HTM 04-01 Part C (2016) was introduced to provide specific guidance in managing the risks from water outlets to patients in augmented care settings. Typically, the patient groups in these settings might include:
- Those who are severely immunosuppressed because of disease or treatment
- Those where organ support is necessary (e.g. critical care, renal, respiratory units, PICU and neonatal units)
- Those who have extensive breaches to dermal integrity and require contact with water as part of their care (e.g. caring for burns)
Treatment of severe hospital-associated Pseudomonas aeruginosa infection is becoming more difficult as some strains are showing resistance to nearly all classes of powerful antibiotics.
There are a number of steps outlined in both HSG 274 Part 2 and HTM 04-01 (parts B and C) relating to preventative practices to help reduce the risk of microbial growth.
One of these is the daily flushing of water outlets within augmented care areas. Daily flushing can reduce microbial growth by disrupting the production of biofilm (a nutrient source for bacteria) – either through preventing stagnation or also by drawing water treated with disinfectants through the water system and outlets.
As with Legionnaires’ disease, if flushing is to be used as a control method, flushing activity must be documented and failures to flush identified and managed. L8guard provides a specific module for daily pseudomonas flushing to provide the easy documentation, along with escalations and reminders at key points in the day to help ensure completion.
HTM 04-01: Safe water in healthcare premises
HSG 274 (Part 2): The control of legionella bacteria in hot and cold water systems