The cycle of Pseudomonas aeruginosa in the healthcare setting

The goal of this thesis is to define the cycle of carbapenem-resistant
P. aeruginosa in the healthcare setting based on existing data and by
investigating the culture methods, the contact investigations performed
after a newly detected CRPA, and the follow-up of patients colonised with
CPPA including the assessment of carriage loss. In Chapter 2, the culture
methods to detect carriage with carbapenem-resistant Pseudomonas aeruginosa
are assessed by a systematic review of the literature. Chapter 3 describes
outbreak investigations performed after a new CPPA carrier was detected.
Chapter 3.1 analyses current evidence by a systematic literature review.
Chapter 3.2 and 3.3 analyse the investigations performed at Erasmus MC
in both general hospital wards and the ICU setting. Chapter 4 focuses
on the follow-up of known carriers. Chapter 4.1 describes the currently
applied follow-up strategies for carriers of carbapenemase-producing
Gram-negatives, including Enterobacterales, Acinetobacter baumannii, and
Pseudomonas aeruginosa, in European countries by an international scoping
survey. Chapter 4.2 aims to improve the follow-up for CPPA carriers at
the Erasmus MC by retrospectively analysing the active follow-up strategy
applied over more than a decade.
The main findings of the studies included in this thesis are summarised and
discussed in Chapter 5 including their implications for clinical practice and
suggestions for future research.
For sustainability reasons, only selected supplementary material tables
and figures are included in the thesis book. The complete supplementary
material are available via the corresponding links at the end of each chapter/
publication.