The ithree institute, University of Technology Sydney, NSW, Australia.
Microb Drug Resist. 2013 Apr;19(2):104-9. doi: 10.1089/mdr.2012.0104. Epub 2012 Oct 15.
Hospital-acquired infections (HAIs) are a global problem. The widespread use of antibiotics continues to exacerbate the problem giving rise to antibiotic-resistant bacteria both in and outside a clinical context. The general hospital environment is an obvious important focus for the selection and spread of multiresistant bacteria and a potential direct source of HAIs. Despite this, there are few detailed studies that have investigated the relationship between strains mediating HAIs and strains coresident in the hospital. Here we isolated bacteria from patients with HAIs exhibiting resistance to β-lactam antibiotics over a 1-month period in 2011. Three of these isolates were examined in detail by molecular analysis and their multiresistance regions were compared to β-lactam resistant bacteria isolated from the immediate hospital environment over the same period. All sampled patients were in a 14-bed burns unit and the environmental sample sites included shower drains, sinks, trolleys, and door handles. It was found that identical strains carrying the same resistance regions were present in both patients and the hospital environment suggesting HAIs can arise from bacteria resident in the immediate surrounds. The three patient infections were not derived from a single source, since strains could be distinguished by the genotype and spatial location. While it seems unlikely that eradication of multiresistant bacteria from the hospital can be achieved, more effective hospital cleaning and a better hospital design may be able to reduce transmission.
医院获得性感染（HAIs）是一个全球性问题。抗生素的广泛使用继续加剧了这一问题，导致临床内外的抗生素耐药菌不断出现。综合医院环境显然是选择和传播多耐药菌的重要焦点，也是医院获得性感染的潜在直接来源。尽管如此，几乎没有详细研究调查介导医院获得性感染的菌株与医院内共存菌株之间的关系。在这里，我们从 2011 年 1 个月内表现出对β-内酰胺类抗生素耐药的 HAI 患者中分离出细菌。通过分子分析详细检查了其中 3 个分离株，并将其多耐药区域与同期从医院环境中分离出的β-内酰胺类耐药菌进行了比较。所有采样患者均在 14 张烧伤床位的病房中，环境样本采集部位包括淋浴排水口、水槽、手推车和门把手。结果发现，患者和医院环境中均存在携带相同耐药区域的相同菌株，这表明 HAI 可能是由周围环境中的细菌引起的。这 3 例患者感染并非源自单一来源，因为可以通过基因型和空间位置来区分菌株。虽然从医院中消除多耐药菌似乎不太可能实现，但更有效的医院清洁和更好的医院设计可能有助于减少传播。
