Pseudomonas aeruginosa intensive care unit outbreak: winnowing of transmissions with molecular and genomic typing
Pseudomonas aeruginosa intensive care unit outbreak: winnowing of transmissions with molecular and genomic typing
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DOI：
10.1016/j.jhin.2017.12.005
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发表时间：
2018-03-01
影响因子：
6.9
通讯作者：
Gillespie, S. H.
中科院分区：
文献类型：
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作者：
Parcell, B. J.;Oravcova, K.;Gillespie, S. H.
背景：铜绿假单胞菌卫生保健爆发可能是耗时和难以调查。指南没有具体说明哪种分型技术对决策最实用。目的：探讨全基因组测序（WGS）在铜绿假单胞菌疫情调查中的有用性，描述它与脉冲场凝胶电泳（PFGE）和可变数目串联重复序列（VNTR）分析的比较。方法：对两年多来铜绿假单胞菌阳性的重症监护病房（ICU）的6个患者分离株和6个环境样本进行了VNTR、PFGE和WGS。要求VNTR和PFGE充分确定潜在感染源并排除其他感染源。WGS结果明确区分链接的分离株，洗手盆水和两个病人之间的传播途径提供更大的保证，支持的控制措施employed.Conclusion：WGS提供了详细的信息，而不需要进一步分型。当与流行病学信息相结合时，WGS可用于快速和确定地了解疫情情况。实时实施WGS将是日常实践的一个重大进步。由于其可重复性和较低的成本，它可能成为一种标准的护理，因为它变得更加普遍。(C)2017作者由Elsevier Ltd代表The Healthcare Infection Society出版。
Background: Pseudomonas aeruginosa healthcare outbreaks can be time consuming and difficult to investigate. Guidance does not specify which typing technique is most practical for decision-making.Aim: To explore the usefulness of whole-genome sequencing (WGS) in the investigation of a P. aeruginosa outbreak, describing how it compares with pulsed-field gel electrophoresis (PFGE) and variable number tandem repeat (VNTR) analysis.Methods: Six patient isolates and six environmental samples from an intensive care unit (ICU) positive for P. aeruginosa over two years underwent VNTR, PFGE and WGS.Findings: VNTR and PFGE were required to fully determine the potential source of infection and rule out others. WGS results unambiguously distinguished linked isolates, giving greater assurance of the transmission route between wash-hand basin water and two patients, supporting the control measures employed.Conclusion: WGS provided detailed information without the need for further typing. When allied to epidemiological information, WGS can be used to understand outbreak situations rapidly and with certainty. Implementation of WGS in real-time would be a major advance in day-to-day practice. It could become a standard of care as it becomes more widespread due to its reproducibility and lower costs. (C) 2017 The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society.