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Molecular Characterization of Stenotrophomonas maltophilia Isolates from Cystic Fibrosis Patients and the Hospital Environment

Published online by Cambridge University Press:  02 January 2015

Carolina Marzuillo
Affiliation:
Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy Department of Public Health Sciences, Sapienza University of Rome, Rome, Italy
Maria De Giusti
Affiliation:
Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
Daniela Tufi
Affiliation:
Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
Alessandra Giordano
Affiliation:
Department of Public Health Sciences, Sapienza University of Rome, Rome, Italy
Angela Del Cimmuto
Affiliation:
Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
Serena Quattrucci
Affiliation:
Regional Cystic Fibrosis Center, Department of Pediatrics, Sapienza University of Rome, Rome, Italy
Carlo Mancini
Affiliation:
Department of Public Health Sciences, Sapienza University of Rome, Rome, Italy
Paolo Villari*
Affiliation:
Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
*
Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy (paolo.villari@uniromal.it)

Abstract

Objectives.

To ascertain whether cystic fibrosis (CF) patients are colonized or infected with unique or multiple strains of Stenotrophomonas maltophilia; to understand whether some strains colonize or infect more than 1 patient, indicating clonal spread; and to explore the molecular heterogeneity of hospital water isolates and their correlation with clinical isolates.

Setting.

The regional CF center of Policlinico “Umberto I” of Rome, Italy.

Methods.

The study was carried out on a random sample of S. maltophilia isolates (n = 110) collected from CF patients (n = 50) during the period 2002–2005 and on 24 water isolates obtained during a monitoring program in the first 6 months of 2005. Home environmental samplings were not performed. All isolates, which were recovered from cultures of specimens obtained in both inpatient and outpatient settings, were genotyped with DNA macrorestriction analysis with the restriction enzyme Xbal and pulsed-field gel electrophoresis.

Results.

One-third of the patients with repeated episodes of S. maltophilia infection or colonization hosted more than 1 strain. A potential transmission, defined as the isolation of the same strain in 2 or more patients, occurred 5 times, showing a frequency of potential transmission episodes slightly higher than previously reported. Water, taps, and sinks of the different rooms of the CF center tended to be persistently colonized with the same strain of S. maltophilia, with no correlation between clinical and water-associated isolates.

Conclusions.

The study does not provide sufficient data to conclude definitively that isolation of colonized or infected CF patients and control of hospital water systems contamination would be beneficial infection control measures. Epidemiologic analytical studies that correlate the presence of S. maltophilia with clinical outcomes are strongly needed.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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