基因组分析医院管道揭示了不同储层的细菌质粒赋予碳青霉烯抵抗。
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温嘉顿RA,约翰逊RC Conlan年代,Ramsburg,德克JP,刘房颤,Khil P,奥多姆RT,戴明C,公园,托马斯•PJ亨德森DK, Palmore TN,塞格雷是的,弗兰克公里
基因组分析医院管道揭示了不同储层的细菌质粒赋予碳青霉烯抵抗。
MBio。2018年2月6日,9 (1)。pii: mBio.02011-17。doi: 10.1128 / mBio.02011-17。
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29437920 (在PubMed]
- 文摘
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医院的环境是一个潜在的水库提供碳青霉烯抵抗细菌的质粒。我们医院流行病学服务经常执行广泛的抽样,个性化的表面,水槽,在医院和其他地方。在两年的时间里,额外的取样是在更广泛的地方进行的,包括客房壁橱,废水从医院内部管道,和外部的人孔。我们将这些数据与以前收集的信息从5年的患者临床和监视隔离。全基因组测序和分析108年的隔离提供全面表征blaKPC / blaNDM-positive隔离,使遗传比较深入。引人注目的是,尽管发病率非常低的病人感染blaKPC-positive生物,所有样品从重症监护室污水管和外部人孔包含carbapenemase-producing生物体(手机),显示一个巨大的,有弹性的水库。我们观察到一组不同的物种和质粒,我们指出物种和磁化率剖面不同环境和患者群体的手机。然而,有质粒骨干共同群体,强调潜在环境热源移动的元素可能导致抗性基因的传播。清晰的病人之间的关联和环境隔离不常见的基于序列分析和流行病学,建议合理的感染控制合规制度。然而,一个可能的院内传播Leclercia sp.从管家环境对病人是探测到这广泛的监视。 These data and analyses further our understanding of CPOs in the hospital environment and are broadly relevant to the design of infection control strategies in many infrastructure settings.IMPORTANCE Carbapenemase-producing organisms (CPOs) are a global concern because of the morbidity and mortality associated with these resistant Gram-negative bacteria. Horizontal plasmid transfer spreads the resistance mechanism to new bacteria, and understanding the plasmid ecology of the hospital environment can assist in the design of control strategies to prevent nosocomial infections. A 5-year genomic and epidemiological survey was undertaken to study the CPOs in the patient-accessible environment, as well as in the plumbing system removed from the patient. This comprehensive survey revealed a vast, unappreciated reservoir of CPOs in wastewater, which was in contrast to the low positivity rate in both the patient population and the patient-accessible environment. While there were few patient-environmental isolate associations, there were plasmid backbones common to both populations. These results are relevant to all hospitals for which CPO colonization may not yet be defined through extensive surveillance.