Exogenous acquisition of Pseudomonas aeruginosa in intensive care units: a prospective multi-centre study (DYNAPYO study)
Exogenous acquisition of Pseudomonas aeruginosa in intensive care units: a prospective multi-centre study (DYNAPYO study)
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DOI：
10.1016/j.jhin.2019.08.008
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发表时间：
2020-01-01
影响因子：
6.9
通讯作者：
Rogues, A-M
中科院分区：
文献类型：
--
作者：
Coppry, M.;Leroyer, C.;Rogues, A-M
背景：铜绿假单胞菌仍然是重症监护病房（ICU）最常见的医院感染病原体之一。虽然外源性收购已被广泛记录在爆发，其重要性是不清楚在非流行性situations.Aim：为了阐明外源性来源的铜绿假单胞菌在ICU patients.Methods的作用：铜绿假单胞菌收购的时间顺序分析使用的样本收集在2009年的DYNAPYO队列研究，在此期间，患者和自来水进行筛选每周。通过脉冲场凝胶电泳研究铜绿假单胞菌分离株的分子相关性。外源性获得被定义为铜绿假单胞菌脉型鉴定以前从另一个病人或水中分离在ICU.Findings：DYNAPYO队列包括1808例患者（10,402个样本）和233水龙头（4946个样本）。对373例患者的1515株分离株和81份自来水样品的375株分离株进行分型，鉴定出296个脉型。分析显示373例患者中有170例（45.6%）为外源性获得。所确定的脉型先前已分别从另一名患者和86名和29名患者的自来水样本中分离出来。结论：在半数患者中，外源性铜绿假单胞菌的获得是可以预防的。这项调查的总体结果支持需要对传播途径和风险评估方法进行研究，以更好地确定如何控制ICU中的外源性感染。(C)2019年，卫生保健感染协会。由爱思唯尔有限公司出版。保留所有权利。
Background: Pseudomonas aeruginosa remains one of the most common nosocomial pathogens in intensive care units (ICUs). Although exogenous acquisition has been widely documented in outbreaks, its importance is unclear in non-epidemic situations.Aim: To elucidate the role of exogenous origin of P. aeruginosa in ICU patients.Methods: A chronological analysis of the acquisition of P. aeruginosa was performed using samples collected in 2009 in the DYNAPYO cohort study, during which patients and tap water were screened weekly. Molecular relatedness of P. aeruginosa isolates was investigated by pulsed-field gel electrophoresis. Exogenous acquisition was defined as identification of a P. aeruginosa pulsotype previously isolated from another patient or water in the ICU.Findings: The DYNAPYO cohort included 1808 patients (10,402 samples) and 233 water taps (4946 samples). Typing of 1515 isolates from 373 patients and 375 isolates from 81 tap water samples identified 296 pulsotypes. Analysis showed exogenous acquisition in 170 (45.6%) of 373 patients. The pulsotype identified had previously been isolated from another patient and from a tap water sample for 86 and 29 patients, respectively. The results differed according to the ICU.Conclusion: Exogenous acquisition of P. aeruginosa could be prevented in half of patients. The overall findings of this survey support the need for studies on routes of transmission and risk assessment approach to better define how to control exogenous acquisition in ICUs. (C) 2019 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.