在重症监护病房内,抗卡巴因的Acinetobacter baumannii的特有性和多样化
Emma L Doughty1, Haiyang Liu2, Robert A Moran1
1Institute of Microbiology and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
The Lancet regional health. Western Pacific
|September 11, 2023
概括
耐卡巴胺的宝曼尼菌 (CRAB) 在ICU中持续存在,主要是由于环境污染而不是患者传播. 这凸显了环境水库在特有龙流行病学中的关键作用.
科学领域:
- 医学微生物学 医学微生物学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 耐卡巴尼姆的宝曼尼菌 (CRAB) 是全球严重的健康威胁,特别是在医院环境中.
- 虽然研究了医院爆发,但CRAB的特有持续性和进化动态仍然不太了解.
研究的目的:
- 在重症监护室 (ICU) 调查耐卡巴耐药的Acinetobacter baumannii (CRAB) 的持久性,进化动态和传播途径.
- 描述CRAB种群结构,并确定有助于其特有性的环境水库.
主要方法:
- 在中国杭州一家28张病床的重症监护室进行了为期三个月的横截面观察研究.
- 从环境,患者和工作人员样本中获得的551个CRAB分离物的全基因组测序.
- 对CRAB分布,持久性和传播途径的流行病学分析.
主要成果:
- 在ICU CRAB种群中,OXA-23生产的全球克隆2占主导地位,包括20个不同的基因组集群.
- 由于定期引入新的集群,CRAB持续存在,环境污染严重 (54.6%的床单).
- CRAB蔓延到邻近地区,并在患者搬迁后传播,有证据表明菌株之间存在横向基因转移.
结论:
- 环境水库在ICU中CRAB的特有流行病学中发挥着至关重要的作用.
- 制CRAB在特有环境中的传播需要解决环境污染问题,与高收入国家爆发情景相比,这提出了独特的挑战.
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