Tracking the spread routes of opportunistic premise plumbing pathogens in a haematology unit with water points-of-use protected by antimicrobial filters
Tracking the spread routes of opportunistic premise plumbing pathogens in a haematology unit with water points-of-use protected by antimicrobial filters
复制标题
DOI：
10.1016/j.jhin.2017.07.028
复制
发表时间：
2018-01-01
影响因子：
6.9
通讯作者：
Romano-Bertrand, S.
中科院分区：
文献类型：
--
作者：
Baranovsky, S.;Jumas-Bilak, E.;Romano-Bertrand, S.
背景资料：医院的供水网络经常受到机会性前提管道病原体（OPPPs）的污染，导致在用水点（POU）安装抗菌过滤器，以限制患者的暴露。目的：评估通过二次供水路线推广的公私营伙伴关系（管道系统外）在一个成人血液科病房，73个水中POU中有52个对患者有高风险，并受到抗菌过滤器的保护。一项观察性审计确定了六条二级供水路线，在315个地表取样点进行了细菌跟踪和分型。细菌分离株进行了鉴定基质辅助激光解吸/电离飞行时间质谱和比较的种下水平的多重重复元件序列为基础的聚合酶链反应和/或限制性片段长度多态性在pulsefield gel electrophoresis.Findings：铜绿假单胞菌和嗜麦芽窄食单胞菌，以及非致病性OPPP指标，在水中收集的抗菌过滤器的上游检测。铜绿假单胞菌是从测试表面回收的唯一OPPP（5.1%）。同一株铜绿假单胞菌从水源传播到同一房间的干燥表面，并交叉污染不同房间的两个水槽。三个克隆的非致病性OPPP指标传播更广泛，在不同的rooms.Conclusion：一个策略的基础上过滤的大多数（但不是所有）水POU在血液学单位可能足以限制传播的OPPPs的环境，提供了一个功能映射的“高风险”POU已进行。与非过滤水POU相关的OPPP和OPPP指标的剩余分布表明，应仔细监测非过滤水的使用。(C)2017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: Water networks in hospitals are frequently contaminated by opportunistic premise plumbing pathogens (OPPPs) leading to installation of antimicrobial filters on water points-of-use (POU) in order to limit patients' exposure.Aim: To assess the spread of OPPPs through secondary water routes (outside the plumbing system) in an adult haematology unit in which 52 out of 73 water POU were high risk for patients and protected by antimicrobial filters.Methods: An observational audit identified six secondary water routes for which bacteria tracking and typing were performed in 315 surface samplings. Bacterial isolates were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and compared to the infra-species level by multiplex repetitive element sequence-based polymerase chain reaction and/or by restriction fragment length polymorphism in pulsefield gel electrophoresis.Findings: Pseudomonas aeruginosa and Stenotrophomonas maltophilia, as well as nonpathogenic OPPP indicators, were detected in water collected upstream of antimicrobial filters. P. aeruginosa was the sole OPPP retrieved from tested surfaces (5.1%). The same clone of P. aeruginosa spread from water source to dry surfaces in the same room and cross-contaminated two sinks in different rooms. Three clones of non-pathogenic OPPP indicators spread more widely in different rooms.Conclusion: A strategy based on filtration of most (but not all) water POU in a haematology unit could be sufficient to limit the spread of OPPPs to the environment, provided a functional mapping of 'high-risk' POU has been undertaken. The residual spread of OPPPs and OPPP indicators linked to non-filtered water POU argues for careful monitoring of non-filtered water use. (C) 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.