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Failure of a hollow-fibre shower filter device to prevent exposure of patients to Pseudomonas aeruginosa

Yetiş, Özge; Ali, Shanom; Karia, Kush; Wilson, Peter; (2022) Failure of a hollow-fibre shower filter device to prevent exposure of patients to Pseudomonas aeruginosa. Journal of Hospital Infection 10.1016/j.jhin.2022.08.007. (In press). Green open access

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Abstract

BACKGROUND: Pseudomonas aeruginosa in hospital waters is a risk for invasive infection. Point-of-use filters (POU) are used to reduce patient exposure to the organism; hollow-fibre filters are becoming more popular. However retrograde colonisation of the filter mechanism may contaminate the effluent. AIMS: To assess the efficacy of POU filter head (polysulfone; hollow-fibre matrix) shower filters in preventing P. aeruginosa exposure to high-risk patient groups. METHODS: Pre-flush (opening the outlet and collecting the first 100 mL of water) samples were analysed to measure P. aeruginosa contamination from 25 shower outlets (∼21% of the total showers on the 6 wards), with and without a hollow-fibre filter. P. aeruginosa was measured in a subset of outlets harbouring P. aeruginosa (sampling period August 19th 2019 to January 10th 2020). FINDINGS: All twenty-five shower waters were heavily colonized (>300CFU/mL) with P. aeruginosa at the showerhead. P. aeruginosa was found in 32% (8/25) of post-filter shower water effluent with a (geometric mean =4x106(n=4) (6.8x10ˆ4 – 2x10ˆ8). Filters were sampled at (15 – 150) days of usage (median =15) with 26% (6/23) of filter units becoming colonized before the expiry date. CONCLUSION: POU filter showerhead units may not be effective in preventing exposure of vulnerable patients to P. aeruginosa in hospital waters due to retrograde contamination (external contamination of the shower head passed back to the filter cartridge itself) or failure of the hollow-fibre filter-matrix. Reliance should not be placed on the use of hollow fibre filters to protect patients from exposure to P. aeruginosa without repeated microbiological monitoring while they are used.

Type: Article
Title: Failure of a hollow-fibre shower filter device to prevent exposure of patients to Pseudomonas aeruginosa
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jhin.2022.08.007
Publisher version: https://doi.org/10.1016/j.jhin.2022.08.007
Language: English
Additional information: © 2022 The Author(s). Published by Elsevier Ltd on behalf of The Healthcare Infection Society Under a Creative Commons license (https://creativecommons.org/licenses/by/4.0/).
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10155044
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