Environmental Investigations and Molecular Typing of Aspergillus in a Chinese Hospital
Environmental Investigations and Molecular Typing of Aspergillus in a Chinese Hospital
复制标题
中国某医院曲霉菌环境调查及分子分型
DOI：
10.1007/s11046-013-9697-1
复制
发表时间：
2014-02-01
期刊：
影响因子：
5.5
通讯作者：
Yang, Rong-ya
中科院分区：
文献类型：
--
作者：
Ao, Jun-hong;Hao, Zhen-feng;Yang, Rong-ya
曲霉属真菌引起的侵袭性真菌感染已成为免疫功能低下患者发病和死亡的主要原因。为明确曲霉菌污染与侵袭性曲霉病发生的可能关系，在中国某三级医院进行了为期1年的前瞻性研究。在骨髓移植（BMT）科、重症监护室（ICU）、神经外科重症监护室（NICU）和室外，每月进行两次空气、地表水和自来水采样。从高危患者中采集鼻、咽和痰样本。采用随机扩增多态性DNA（RAPD）技术对环境和患者中分离的曲霉菌进行基因分型，以调查感染的来源。骨髓移植科、重症监护室、新生儿重症监护室和室外的平均曲霉菌总数分别为7.73、8.94、13.19和17.32 cfu/m3。用R108引物进行RAPD分析，NICU患者分离的菌株与环境菌株完全一致。从ICU患者中分离的菌株与环境菌株不同。在BTM部门、NICU和ICU中发现曲霉菌污染。NICU的临床和环境菌株具有相同的基因型。这些发现表明曲霉菌存在于医院环境中，包括空气、地面和自来水。患者和环境中曲霉菌的基因型一致，提示临床感染可能来源于医院环境。
Invasive fungal infections due to Aspergillus species have become a major cause of morbidity and mortality among immunocompromised patients. In order to determine the possible relationship between environmental contamination by Aspergillus and the occurrence of invasive aspergillosis, a 1-year prospective study was carried out in a tertiary hospital in China. Air, surface, and tap water sampling was performed twice monthly at the bone marrow transplant (BMT) department, intensive care unit (ICU), neurosurgery intensive care unit (NICU), and outdoors. Nose, pharynx, and sputum samples were collected from high-risk patients. Isolates of Aspergillus from the environment and patients were genotyped by random amplification of polymorphic DNA (RAPD) assay to investigate the origin of infection. Mean total Aspergillus count was 7.73, 8.94, 13.19, and 17.32 cfu/m(3) in the BMT department, ICU, NICU, and outdoors, respectively. RAPD analysis by R108 primer demonstrated that strains isolated from patients in NICU were identical to the environmental strain. Strains isolated from patients in ICU differed from the environmental strain. Aspergillus contamination was found in the BTM department, NICU, and ICU. Clinical and environmental strains from NICU had identical genotypes. These findings suggest that Aspergillus is found in the hospital environment including the air, surface, and tap water. The genotypes of Aspergillus were identical from patients and the environment, suggesting that clinical infection may originate from the hospital environment.