Are There Bad ICU Rooms? Temporal Relationship between Patient and ICU Room Microbiome, and Influence on Vancomycin-Resistant Enterococcus Colonization.
Are There Bad ICU Rooms? Temporal Relationship between Patient and ICU Room Microbiome, and Influence on Vancomycin-Resistant Enterococcus Colonization.
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DOI：
10.1128/msphere.01007-21
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发表时间：
2022-02-23
期刊：
影响因子：
4.8
通讯作者：
Wang HH
中科院分区：
文献类型：
--
作者：
Freedberg DE;Richardson M;Nattakom M;Cheung J;Lynch E;Zachariah P;Wang HH
个体的肠道微生物组可以塑造局部环境表面微生物组。我们试图确定重症监护病房（ICU）患者肠道微生物组如何塑造ICU房间表面微生物组，重点是万古霉素耐药肠球菌（VRE），一种常见的ICU病原体。这是一项基于ICU的前瞻性队列研究。在ICU入院时立即对成人ICU患者进行直肠拭子检查，并在5个预定时间点进行环境表面拭子检查。所有拭子均进行16 S rRNA基因测序和VRE培养。对304名ICU患者和24个ICU房间进行采样（每个ICU房间5个纵向样本）。空间相邻的ICU病房与非相邻病房的微生物相似性并不高。随着时间的推移，房间内的微生物特征迅速分化：在14天内，ICU房间与其他ICU房间相似，就像它们与之前的自己一样。随着时间的推移，这种差异在患者周转率较高的房间中更为明显。通过培养检查VRE状态，患者VRE肠道定植与房间表面VRE具有适度一致性（kappa统计值0.36）。没有ICU病房持续培养出VRE阳性，包括居住VRE阳性患者的ICU病房。个别ICU患者对ICU房间表面微生物组的影响有限，并且无论患者如何，房间都随着时间的推移而类似地分化。患者VRE肠道定植可能对房间表面VRE有适度影响，但没有持续培养为VRE阳性的“坏房间”。这些结果可能有助于规划感染控制措施。重要性这项研究发现，重症监护病房（ICU）房间的微生物特征迅速偏离基线：在2周内，个别ICU房间失去了区别特征，与其他ICU房间一样相似，就像他们以前的自我一样。房间内的患者周转加速了这种漂移。患者肠道定植万古霉素耐药肠球菌（VRE）与ICU病房表面VRE污染相关;同样，在2周内，这种相关性显著降低。这些结果提供了关于患者如何控制当地医院房间表面上的微生物群的动态信息，并可能有助于针对VRE或其他生物体的感染预防和控制措施的决策。
The gut microbiome of an individual can shape the local environmental surface microbiome. We sought to determine how the intensive care unit (ICU) patient gut microbiome shapes the ICU room surface microbiome, focusing on vancomycin-resistant Enterococcus (VRE), a common ICU pathogen. This was an ICU-based prospective cohort study. Rectal swabs were performed in adult ICU patients immediately at the time of ICU admission and environmental surface swabs were performed at five predetermined time points. All swabs underwent 16S rRNA gene sequencing and culture for VRE. 304 ICU patients and 24 ICU rooms were sampled (5 longitudinal samples per ICU room). Spatially adjacent ICU rooms were no more microbially similar than nonadjacent rooms. Microbial signatures within rooms diverged rapidly over time: in 14 days, ICU rooms were as similar to other ICU rooms as they were to their prior selves. This divergence over time was more pronounced in rooms with higher patient turnover. Examining VRE status by culture, patient VRE gut colonization had modest agreement with room surface VRE (kappa statistic 0.36). There were no ICU rooms that consistently cultured positive for VRE, including those that housed VRE positive patients. Individual ICU patients had a limited impact on ICU room surface microbiome, and rooms diverged similarly over time regardless of patients. Patient VRE gut colonization may have a modest influence on room surface VRE but there were no “bad rooms” that consistently cultured positive for VRE. These results may be useful in planning infection control measures. IMPORTANCE This study found that intensive care unit (ICU) room microbial signatures diverged from their baseline quickly: within 2 weeks, individual ICU rooms had lost distinguishing characteristics and were as similar to other ICU rooms as they were to their former selves. Patient turnover within rooms accelerated this drift. Patient gut colonization with vancomycin-resistant Enterococcus (VRE) was associated with ICU room surface contamination with VRE; again, within 2 weeks, this association was substantially diminished. These results provide dynamic information regarding how patients control the microbiota on local hospital room surfaces and may facilitate decision making for infection prevention and control measures targeting VRE or other organisms.
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影响因子：
2.7
作者：
Meadow JF;Altrichter AE;Bateman AC;Stenson J;Brown GZ;Green JL;Bohannan BJ
通讯作者：
Bohannan BJ
影响因子：
17.1
作者：
Lax S;Sangwan N;Smith D;Larsen P;Handley KM;Richardson M;Guyton K;Krezalek M;Shogan BD;Defazio J;Flemming I;Shakhsheer B;Weber S;Landon E;Garcia-Houchins S;Siegel J;Alverdy J;Knight R;Stephens B;Gilbert JA
通讯作者：
Gilbert JA
影响因子：
48
作者：
Callahan BJ;McMurdie PJ;Rosen MJ;Han AW;Johnson AJ;Holmes SP
通讯作者：
Holmes SP
影响因子：
3.7
作者：
Ramos T;Dedesko S;Siegel JA;Gilbert JA;Stephens B
通讯作者：
Stephens B
DOI：
10.1093/bioinformatics/btq706
发表时间：
2011-02-15
期刊：
Bioinformatics (Oxford, England)
影响因子：
--
作者：
Schliep KP
通讯作者：
Schliep KP