Gbaguidi-Haore H, Talon D, Thouverez M, Menget A, Bertrand X
Service d'Hygiène Hospitalière et d'Epidémiologie moléculaire, Centre Hospitalier Universitaire Besançon, Besançon cedex, France.
Eur J Clin Microbiol Infect Dis. 2008 Aug;27(8):643-8. doi: 10.1007/s10096-008-0484-8. Epub 2008 Mar 5.
A surveillance program was implemented to investigate the molecular epidemiology of Enterobacter cloacae in neonatal units. This program ran for 2 years and involved screening for E. cloacae intestinal colonization of all infants at admission and weekly thereafter. In addition, mothers whose children were admitted to neonatal units were also screened. Pulsed-field gel electrophoresis analysis was used to establish genetic relationships between strains and to identify mother-to-child transmission. During the survey period, 166 (22.6%) of the 735 included children had E. cloacae intestinal colonization, and 29 (3.9%) patients gave clinical samples positive for E. cloacae. Genotyping revealed 90 different pulsotypes in the 199 clinical and screening isolates from neonates, including three major epidemic clones. Mother-to-child transmission of E. cloacae was directly responsible for 8.8% of intestinal colonization of the neonates. This surveillance program reveals a major contribution of patient-to-patient transmission and the rarity of mother-to-child transmission in the spread of E. cloacae in neonates. This highlights the importance of good compliance with infection control procedures by health-care workers.
实施了一项监测计划，以调查新生儿病房中阴沟肠杆菌的分子流行病学。该计划持续了2年，包括在所有婴儿入院时以及此后每周对阴沟肠杆菌肠道定植情况进行筛查。此外，对其子女入住新生儿病房的母亲也进行了筛查。采用脉冲场凝胶电泳分析来确定菌株之间的遗传关系，并识别母婴传播情况。在调查期间，735名纳入研究的儿童中有166名（22.6%）存在阴沟肠杆菌肠道定植，29名（3.9%）患者的临床样本阴沟肠杆菌检测呈阳性。基因分型显示，从新生儿中分离出的199株临床和筛查菌株中有90种不同的脉冲型，包括三个主要的流行克隆。阴沟肠杆菌的母婴传播直接导致了8.8%的新生儿肠道定植。该监测计划揭示了患者之间传播在新生儿阴沟肠杆菌传播中的主要作用以及母婴传播的罕见性。这凸显了医护人员严格遵守感染控制程序的重要性。
