Sources of sporadic Pseudomonas aeruginosa colonizations/infections in surgical ICUs: Association with contaminated sink trap
Sources of sporadic Pseudomonas aeruginosa colonizations/infections in surgical ICUs: Association with contaminated sink trap
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DOI：
10.1016/j.jiac.2016.03.016
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发表时间：
2016-07-01
影响因子：
2.2
通讯作者：
Li, HuaYin
中科院分区：
文献类型：
--
作者：
Zhou, ZhaoYan;Hu, Bijie;Li, HuaYin
背景：许多研究报道了由于患者和水具交叉污染导致的铜绿假单胞菌医院暴发，但水具作为散发铜绿假单胞菌菌落/感染来源的重要性仍不明确。目的：通过临床重症监护监测，调查散发铜绿假单胞菌菌落/感染的来源，并进一步分析重症监护病房（icu）铜绿假单胞菌sink trap传播的可能性。方法：在两个外科重症监护病房（sicu），在没有确认爆发的情况下，前瞻性地对患者进行27周的铜绿假单胞菌监测和靶向环境筛查。所有分离株均通过脉冲场凝胶电泳分析进行基因分型。结果：18.9%（46/244）的配水样本携带铜绿假单胞菌，9.2%（55/595）的住院患者主动筛查样本携带铜绿假单胞菌。根据基因型结果，大约50%的患者的铜绿假单胞菌定植/感染是外源的。64.7%（11/17）的外源病例与受污染的汇集器有关。SICU-2水体中外源定殖/感染发生率与红绿假单胞菌感染率呈显著相关(r(s) = 0.972；P = 0.014)。此外，与其他患者的交叉传播相比，来自sink trap的P. areuginosa对多种抗生素具有更高的耐药性。结论：在SICU患者散发的铜绿假单胞菌传播中，配水装置尤其是水槽陷阱起着重要作用。本报告强调有必要确定潜在的环境水库，如汇，以控制环境耐受性强的多重耐药假单胞菌的感染。(C) 2016年日本化学学会和日本传染病学会。Elsevier Ltd.出版。版权所有。
Background: Many studies have reported the hospital outbreaks of Pseudomonas aeruginosa due to cross contamination between patients and water fittings, but the importance of water fittings as sources of sporadic P. aeruginosa colonizations/infections remains ambiguous.Aim: To investigate the sources of sporadic P. aeruginosa colonizations/infections in a clinical intensive surveillance, and further analysis the potential of sink trap for P. aeruginosa transmission in intensive care units (ICUs).Methods: Patients monitoring and targeted environmental screening for P. aeruginosa was performed prospectively over a 27-week period, in absence of recognized outbreak, in two surgical intensive care units (SICUs). All isolates were genotyped by Pulsed field gel electrophoresis analysis. Findings: 18.9% (46/244) of water fitting samples harbored P. aeruginosa, and active screening samples from 9.2% (55/595) of hospitalized patients carried with P. aeruginosa. According to genotype results, approximately 50% of P. areuginosa colonizations/infections of patients were of exogenous origin. 64.7% (11/17) of exogenous sourced cases were associated with contaminated sink traps. There was a significant correlation between the incidence of exogenous colonization/infection and the prevalence of P. areuginosa in water fitting in SICU-2 (r(s) = 0.972; p = 0.014). Furthermore, P. areuginosa from sink trap possessed a higher level of resistance to multi-antibiotics as opposed to cross-transmission from other patients.Conclusion: Water fitting especially sink trap act as an important role in sporadic P. aeruginosa transmission in SICU patients. This report highlights the necessity of identification of potential environmental reservoirs, such as sinks, for control of infections of environmentally hardy multi-resistant P. areuginosa. (C) 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.