Dunowska M, Morley P S, Traub-Dargatz J L, Davis M A, Patterson G, Frye J G, Hyatt D R, Dargatz D A
Animal Population Health Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
J Appl Microbiol. 2007 Jun;102(6):1527-36. doi: 10.1111/j.1365-2672.2006.03198.x.
To compare Salmonella enterica serotype Infantis isolates obtained from patients or the environment of a veterinary teaching hospital over a period of 9 years following a nosocomial outbreak to determine whether isolates were epidemiologically related or represented unrelated introductions into the hospital environment.
Fifty-six S. Infantis isolates were compared based on their phenotypic (antimicrobial drug [AMD] susceptibility pattern) and genotypic (pulsed-field gel electrophoresis [PFGE] pattern and presence of integrons) characteristics. Epidemiologically unrelated S. Infantis isolates clustered separately from all but two of the hospital isolates, and several isolates from different years and various sources were indistinguishable from each other in cluster analysis of two-enzyme PFGE results. A high percentage of isolates (80.3%) were resistant to at least one AMD, with 67.8% showing resistance to >5 AMD. The majority (74.1%) of isolates tested contained type 1 integrons.
Results strongly suggest that there was nosocomial transmission of S. Infantis during the initial outbreak, and that contamination arising from this outbreak persisted across years despite rigorous hygiene and biosecurity precautions and may have led to subsequent nosocomial infections.
Evidence of persistence and transmission of Salmonella clones across years, even in the face of rigorous preventive measures, has important implications for other facilities that have experienced outbreaks of Salmonella infections.
比较在一次医院感染暴发后的9年期间,从一家兽医教学医院的患者或环境中分离出的肠炎沙门氏菌婴儿亚种菌株,以确定这些菌株在流行病学上是否相关,或是否代表无关的医院环境引入。
基于56株婴儿亚种菌株的表型(抗菌药物[AMD]敏感性模式)和基因型(脉冲场凝胶电泳[PFGE]模式和整合子的存在)特征进行比较。在流行病学上不相关的婴儿亚种菌株与除两株医院菌株外的所有菌株分别聚类,并且在双酶PFGE结果的聚类分析中,来自不同年份和各种来源的几株菌株彼此无法区分。高比例(80.3%)的菌株对至少一种AMD耐药,67.8%的菌株对>5种AMD耐药。大多数(74.1%)测试菌株含有1型整合子。
结果强烈表明,在最初的暴发期间存在婴儿亚种的医院内传播,并且尽管采取了严格的卫生和生物安全预防措施,但此次暴发引起的污染多年来一直存在,可能导致了随后的医院感染。
即使面对严格的预防措施,沙门氏菌克隆多年来持续存在和传播的证据,对其他经历过沙门氏菌感染暴发的机构具有重要意义。