在严重残疾患者之间传播Mycobacterium的Fomite传播
Shiomi Yoshida1, Yuki Matsumoto2, Aya Kajihara3
1Clinical Research Center, NHO Kinki Chuo Chest Medical Center, Sakai, Osaka, Japan; Department of Mycobacterium Reference and Research, the Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose, Tokyo, Japan.
概括
使用基因组分析追踪了Mycobacterium abscessus亚种massiliense (MAM) 的医院爆发. 该研究发现,MAM可以在干燥环境中持续存在,并通过医疗设备等虫间接传播.
科学领域:
- 医学微生物学 医学微生物学
- 基因组流行病学 基因组流行病学
- 传染病爆发调查调查传染病爆发调查
背景情况:
- 在医疗保健环境中,非结核病爆发带来了重大风险,特别是那些由非结核菌根菌引起的疾病.
- 菌根 (Mycobacterium abscessus) 亚种massiliense (MAM) 是一种新兴的机会性病原体,可以引起严重的感染.
研究的目的:
- 在日本的一家医院调查一场医院内MAM疫情.
- 通过全基因组测序和环境调查来确定MAM的传播途径.
- 识别可能导致MAM间接传播的虫.
主要方法:
- 使用单核酸变异 (SNV) 分析对52个MAM分离物 (11个临床,41个环境) 的基因组分析.
- 患者护理区域的环境采样,包括手套,医疗器械和室内设备.
- 多阶段研究设计,在34个月内进行干预以控制疫情爆发.
主要成果:
- 临床和环境MAM分离物表现出几乎相同的基因组,SNV在61个SNV中总体分布.
- 一个特定的亚克隆集群,涉及患者M2和从一辆货车中分离出来的细胞,作为传播的中心枢纽.
- 即使在干预后,MAM菌株也被从环境来源中分离出来,包括护理手套和医疗设备.
结论:
- 在干燥的医院环境中,Mycobacterium abscessus亚种massiliense可以持续存在.
- 在医疗机构中,通过虫间接传播MAM是一种合理的途径.
- 基因组流行病学对于跟踪和控制MAM的医院爆发至关重要.
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