在比利时的四个ICU中发生了五年VIM产生的Pseudomonas aeruginosa疫情,调查报告 (2019-2023)
Marco Moretti1, Robin Vanstokstraeten2, Florence Crombé2
1Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Internal Medicine and Infectious Diseases, Brussels, Belgium.
American journal of infection control
|September 1, 2024
概括
在重症监护病房中,长达5年的维罗纳整合体编码金属β-乳糖酶产生性 Pseudomonas aeruginosa (VIM-PA) 疫情被追溯到受污染的水槽排水. 确定了两个主要的VIM-PA克隆,单位间的发病率各不相同.
科学领域:
- 医学微生物学 医学微生物学
- 传染病流行病学 传染病流行病学
- 公共卫生 公共卫生
背景情况:
- 维罗纳整合子编码的金属β-乳糖酶产生的Pseudomonas aeruginosa (VIM-PA) 疫情经常与受污染的重症监护室 (ICU) 水槽排水有关.
- 这项研究调查了跨越5年的VIM-PA疫情,该疫情发生在比利时大学中心的四个重症监护室.
研究的目的:
- 在多个ICU中调查长期VIM-PA爆发的来源和克隆多样性.
- 分析流行病学趋势并确定与VIM-PA传播相关的风险因素.
- 以告知有针对性的感染控制干预措施.
主要方法:
- 追溯数据收集时间为2019年1月1日至2023年7月30日.
- 全基因组测序 (WGS) 和核心基因组多部位测序类型化 (cgMLST) 用于VIM-PA隔离物克隆性确认.
- 回归建模以根据风险和殖民患者的每周数据估计新病例发生率.
主要成果:
- 51名患者被殖民,其中32人被VIM-PA感染,导致7人死亡.
- 在检查的水槽排水管中,VIM-PA 在47%的水槽排水管中被检测到.
- 确定了两个主要的VIM-PA克隆 (ST111和ST17),其中ST111占主导地位.
- 新病例发病率在ICU之间差异很大.
结论:
- 这5年的疫情是由两个VIM-PA克隆带有最小的遗传进化,与水槽排水污染有关.
- 统计建模揭示了不同ICU的不同发病率,突出了单位特定的传播动态.
- 基于流行病学发现的定制干预措施的优先考虑对于疫情控制至关重要.
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