长期重症监护病房的长期重症监护病房爆发了与受污染的水槽下水道相关的碳酶产生生物的爆发
A Anantharajah1, F Goormaghtigh2, E Nguvuyla Mantu3
1Department of Clinical Microbiology, Cliniques universitaires Saint-Luc, Brussels, Belgium; Medical Microbiology Unit, Institute of Experimental and Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium.
The Journal of hospital infection
|January 31, 2024
概括
碳酶产生生物 (CPO) 由于环境水库,特别是水槽排水,在ICU中持续存在. 新的消毒策略防止了重新定居,突出了对抗医院感染的创新方法的需要.
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
- 医院流行病学 医院流行病学
背景情况:
- 比利时一家医院在2018年至2022年期间,在成年重症监护室 (ICU) 患者中,卡巴酶产生生物体 (CPO) 的增加,特别是VIM产生Pseudomonas aeruginosa (PA-VIM) 和NDM产生肠杆菌 (CPE-NDM) 的增加.
- 这涉及长期的CPO疫情与多种物种和持续的环境储备.
研究的目的:
- 为了调查在重症监护室 (ICU) 长期爆发的碳烯酶产生生物体 (CPO) 疫情.
- 确定持续环境储存在ICU内的CPO传输中的作用.
主要方法:
- 发现卡巴酶生成生物 (CPO) 的活跃病例.
- 环境采样和患者和环境菌株的全基因组测序 (WGS).
- 实施和评估控制策略,包括消毒协议.
主要成果:
- 37名患者在2018-2022年期间在ICU住院期间被PA-VIM和/或CPE-NDM殖民或感染.
- 全基因组测序 (WGS) 证实了从水槽下水道的克隆传播,通过等离子体和转子体进行横向基因转移.
- 标准消毒失败了;一种新的生物膜降解和酸/过氧化基消毒剂策略阻止了CPO重新定居水槽排水管.
结论:
- 在医院环境中持续存在的抗生素和消毒剂耐药细菌对ICU患者构成重大威胁.
- 这些生物体转移移动基因元素的能力可能会导致本土性.
- 创新策略对于管理持久性环境水库和防止碳烯酶产生生物体 (CPO) 传播至关重要.
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