The movement of patients between cystic fibrosis centres is an important risk factor for acquiring P aeruginosa strain infections, Australian researchers say.
Led by Scott Bell from the Child Health Research Centre at The University of Queensland, Brisbane the research team used social network analysis* to assess the movement of patients attending 18 CF centres who were infected with P aeruginosa.
They discovered that patients with cystic fibrosis in more connected centres in terms of patient movement are more likely to have common shared P aeruginosa infections(AUST-01 and AUST-02) .
Whereas infection with a unique (non-transmissible) strain was associated with lower connectivity within centres.
These findings were significant in the adult population, but not in children, found the study published in The Lancet Respiratory Medicine.
“[the results] show the importance of prioritising infection control interventions (eg, prospective molecular surveillance for shared P aeruginosa strains, strict universal infection control precautions, and hospital design and ventilation) to limit P aeruginosa cross-infection between patients with cystic fibrosis, the study authors concluded.
Writing in an accompanying editorial David Taylor-Robinson and colleagues from the Department of Public Health and Policy and the University of Liverpool in the UK said the cross-sectional nature of the study meant it was not possible to rule out that the findings were because patients with shared P aeruginosa end up being treated in more connected centres.
“Clearly, this alternative explanation is possible, since sicker patients with transmissible strains are potentially more likely to be treated at larger, more connected centres,” they wrote.
Nevertheless the authors were to be applauded for the first application of SNA to study P aeruginosa risk in cystic fibrosis and for the questions that it raises, they said.
“Epidemiology in general, and methods such as SNA in particular, offer powerful analytical approaches and methods for identifying and measuring patterns of infectious disease arising as a result of increased population mobility,” they concluded.
* By asking a patient with cystic fibrosis which treatment centres they have visited, SNA seeks to represent visually and analyse quantitatively the web of relations that link cystic fibrosis centres.