Increasing tolerance of hospital Enterococcus faecium to handwash alcohols
Increasing tolerance of hospital Enterococcus faecium to handwash alcohols
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DOI：
10.1126/scitranslmed.aar6115
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发表时间：
2018-08-01
影响因子：
17.1
通讯作者：
Stinear, Timothy P.
中科院分区：
文献类型：
--
作者：
Pidot, Sacha J.;Gao, Wei;Stinear, Timothy P.
酒精类消毒剂，特别是手部消毒剂，是控制全球医院感染的关键方法。这种消毒剂限制病原体的传播，如耐多药金黄色葡萄球菌和屎肠球菌。尽管取得了这一成功，但由E.粪便正在增加。我们检测了139株医院分离的E. faecium获得，发现E. 2010年以后的屎肠分离株对酒精的耐受性比老的分离株高10倍。利用小鼠肠道定植模型，粪肠菌传播，表明耐酒精E.屎肠球菌抵抗标准的70%异丙醇表面消毒，导致与酒精敏感的E.屎室接下来，我们寻找细菌适应的基因组特征。耐酒精E.屎肠积累了参与碳水化合物吸收和代谢的基因突变。突变证实了这些基因在大肠杆菌耐药性中的作用。粪菌至异丙醇。这些发现表明细菌适应性使感染控制建议复杂化，需要额外的程序来预防E。粪便在医院环境中传播。
Alcohol-based disinfectants and particularly hand rubs are a key way to control hospital infections worldwide. Such disinfectants restrict transmission of pathogens, such as multidrug-resistant Staphylococcus aureus and Enterococcus faecium. Despite this success, health care infections caused by E. faecium are increasing. We tested alcohol tolerance of 139 hospital isolates of E. faecium obtained between 1997 and 2015 and found that E. faecium isolates after 2010 were 10-fold more tolerant to killing by alcohol than were older isolates. Using a mouse gut colonization model of E. faecium transmission, we showed that alcohol-tolerant E. faecium resisted standard 70% isopropanol surface disinfection, resulting in greater mouse gut colonization compared to alcohol-sensitive E. faecium. We next looked for bacterial genomic signatures of adaptation. Alcohol-tolerant E. faecium accumulated mutations in genes involved in carbohydrate uptake and metabolism. Mutagenesis confirmed the roles of these genes in the tolerance of E. faecium to isopropanol. These findings suggest that bacterial adaptation is complicating infection control recommendations, necessitating additional procedures to prevent E. faecium from spreading in hospital settings.