Pseudomonas aeruginosa v2 - PCD Family Support Group...
Transcript of Pseudomonas aeruginosa v2 - PCD Family Support Group...
Risks of getting Pseudomonas aeruginosa (PsA)
from the environment
Presentation byTess James
Respiratory Paeds ANPMKUH
What is Pseudomonas Aeruginosa?• Common bacteria found in soil and water
• Relatively harmless to most, but can cause infections in people with a weakened immune system or with a chronic lung condition
• Treatment usually requires nebulised antibiotics for approximately 3 months
Things to definitely avoid
Tropical greenhouses, butterfly houses
Misting systems to water plants in tropical green houses and butterfly houses have been shown to contain PsA, so there is a risk of the fine droplets being easily inhaled
Hot tubs, Whirlpools, Spa pools, Jacuzzis,
Hydrotherapy pools There is strong evidence of the presence of PsA in warm water that is aerolised, when the persons head is just above the water.PsA has been isolated from culture plates held 6 inches above the water surface when the tub was turned on
Outdoor misting systems
Some restaurants or other public areas have outdoor misting systems to keep people cool.There is a theoretical risk that the mist may contain PsA
Squirting bath toys Bath toys that have a valve on the base, that squirts water can be a problem as they are often left with residual water sitting in it for a long time.It might be less fun, but remove the squeak, so water can run out.There is evidence of an outbreak of PsA on a children's oncology ward from a toy box containing water retaining bath toys
Swimming in stagnant ponds and canals
Fish tanks (especially warm tanks for tropical
fish) Pathogens (disease producing organisms) have been isolated from fish tanks, causing infections in patients with CF.
US guidelines suggest wearing gloves may be sufficient!
Compost (heaps and bags)
Compost is decayed vegetation.It can contain aspergillus spores and PsA species.When opening bags, let a parent/someone without PCD open it, as that is when spores are most likely to be inhaled.
Things to Take Precautions With
Digging in the garden soil, playing in the park, playing outdoor sport
We know PsA resides in soil.
Soil that is contaminated by organic fertiliser or manure is best avoided
Soil present in gardens is a potential risk if the child gets soil on their hands, and then touches their nose, or face. Ideally they should wear gloves.
Caution should be taken, but strict hand washing should be sufficient after gardening.
Us guidelines suggest limiting exposure to activities that generates dust from soil, e.g. lawn mowing, to reduce the risk of exposure to aspergillus, and B cepacia
Older children should be encouraged to exercise‐football, rugby etc, ensuring they wash hands and faces afterwards‐ maybe carrying gel sanitiser in their gym bags
Mud kitchens
Toy kitchens made from wood, plastic and metal, where mud is used as the food to be made. (Yuk!!!).
The same applies to gardening, so as long as hands and face are thoroughly cleaned, the risk should be minimal.
Muddy puddles Mud is a mixture of compressed soil and water. Although there may be PsA present in the puddle, it wont be aerolised by the child jumping in, so should be safe.
Pavement puddles dry so fast, water does not have a chance to stagnate, so can be happily splashed in.
Sandpits Sand pits can be contaminated, as can some beaches, as PsA is found in the sea from human faecal matter.
In a sand pit with clean dry sand the risk is minimal, but when sand gets damp or wet the risk increase. It is worth keeping a lid on the sandpit, to reduce rain water collection.
The CF trust advises schools to change sand regularly.
Sandpits in the park are less likely to be clean, but risks frm Toxocara from dog and cat faeces are greater.
Swimming Although PsA is an aquatic organism, as long as the water is not aerolised‐ e.g. waterfalls, swimming should have minimal risks, but washing afterwards would seem sensible.
If using inflatable toys, they should be well drained and dried after each use.
The sea, lakes and rivers should not be a problem as they are free flowing
Ponds and canals are stagnant, and more likely to contain rotting vegetation‐leaves etc, so more risky.
Swimming pools should be chlorinated, but again caution should be taken with hotels and rented accommodation with private pools to ensure they have been adequately treated.
Paddling pools
Should be fine as long as they are emptied after each use, and dried out after each use.
Water amusement parks Water will be aerolised on some rides, and the spray may be inhaled.
As long as the uses treated disinfected water to industry standards, which may be checked in advance, this should be safe.
Pond‐dipping This is collecting pond life in a jar, a net is dragged through the water.It is likely that the stagnant water will get on children's hands, and flicked about.It is likely to be safe, but should be supervised by an adult, and again thorough hand washing , but proceed with caution!
Touch pools in a public aquarium
It is most likely that will be bacteria in the water, including non‐tuberculosis bacteria.However, the water will not be aerolised, so thorough hand washing should be sufficient.
Petting zoos and farm visits Caution should be taken with
chicken coops, and petting animals such as rabbits, and guinea pigs etc, as aspergillus spores will be found in the hayTransmission of pathogens have not been reported fromfarm animals, but it is known that PsA have been found in horses, and MRSA from pigsAgain strict hand washing is advisable.
Caves
Although caves have water dripping down the sides, the water isn't aerolised, so these should be safe.
Showers
Shower heads are a potential source of PsA, as the shower head will contain aerolised droplets that can be inhaled, it is best to run the shower for 1‐2 minutes before showering.
Sink and Bath taps
Although sinks and taps may be colonised with PsA, it is unlikely that to be an issue in your own home, as it won’t be aerolised.
Water pistols and ‘super‐soakers’
Similar to squirting bath toys, again, empty and dry after each use
Flower vases
Change water before it smells, don’t let leaves stagnate in the water.
Humidifiers and vaporisers
Water sits in a reservoir, which isevaporated and blown into the air. Always empty reservoirs, and put fresh water in before use.
Flushing toilets
Water is aerolised when flushing, so gents, put the lid down before flushing.Many people carry PsA in their faeces
Things that must not be avoided
Dentist It is important to visit the dentist regularly, despite previous concerns that suctioning equipment may harbour pathogens.A lot of antibiotics may discolour teeth.Rotten teeth can promote PsA in the mouth which can infect the airways.
Drinking waterPsA has been isolated from tap water, drinking water dispensers, bottled water, And distilled water, but not in high enough levels to cause a problem to the airways or gut.
However, many people use refillable water bottles, again these should be washed thoroughly and dried in between uses.
Bottles or jugs with carbon filters are often left damp, even with no water in the container. These should be avoided‐ such as Brita, other makes are obtainable!