Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA; Department of Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, NY, USA.
Sci Total Environ. 2017 Oct 1;595:35-40. doi: 10.1016/j.scitotenv.2017.03.174. Epub 2017 Apr 1.
Coagulase negative staphylococci (CoNS) are leading causes of nosocomial infections and community-acquired methicillin-resistant CoNS (MRCoNS) infections are increasing. CoNS have been previously detected in reclaimed water. To date, no studies have evaluated the prevalence of CoNS carriage among humans exposed to reclaimed water in the U.S. We examined the prevalence and odds of CoNS and antibiotic-resistant CoNS carriage in spray irrigators exposed to reclaimed water compared to controls. We collected nasal and dermal swab samples from 19 reclaimed water spray irrigation workers (n=96 total samples) and 24 controls (n=92 total samples). Samples were analyzed for CoNS using culture-based assays. Isolates were confirmed using biochemical tests and PCR. Antimicrobial susceptibility testing was performed using disk diffusion. Data were analyzed by two-sample proportion tests, logistic regression, and generalized linear mixed effects models. The prevalence of CoNS, antibiotic-resistant CoNS, and MRCoNS carriage among spray irrigation workers was 79% (15/19), 32% (6/19), and 16% (3/19), compared to 13% (3/24), 4% (1/24), and 0% (0/24) of controls. Spray irrigators were more likely to be carriers of CoNS (p<0.01), antibiotic-resistant CoNS (p<0.01), and MRCoNS (p=0.02) compared to controls. The odds of CoNS carriage significantly increased with exposure to reclaimed water (p=0.04) even accounting for changes over time (p=0.05). Our data highlight the need to further examine the potential dissemination of CoNS and antibiotic-resistant CoNS from reclaimed water into the environment and human communities and related public health implications.
凝固酶阴性葡萄球菌（CoNS）是医院感染和社区获得性耐甲氧西林凝固酶阴性葡萄球菌（MRCoNS）感染的主要原因，而 CoNS 以前曾在再生水中被检测到。迄今为止，尚无研究评估在美国接触再生水的人群中 CoNS 携带率。我们研究了暴露于再生水中的喷雾灌溉器中 CoNS 和抗生素耐药性 CoNS 携带率与对照组相比的流行率和比值比。我们收集了 19 名再生水喷雾灌溉工人（n=96 总样本）和 24 名对照者（n=92 总样本）的鼻腔和皮肤拭子样本。使用基于培养的方法分析样本中的 CoNS。使用生化试验和 PCR 确认分离株。使用圆盘扩散法进行抗生素药敏试验。通过两样本比例检验、逻辑回归和广义线性混合效应模型分析数据。与对照组相比，喷雾灌溉工人的 CoNS、抗生素耐药性 CoNS 和 MRCoNS 携带率分别为 79%（15/19）、32%（6/19）和 16%（3/19），而对照组分别为 13%（3/24）、4%（1/24）和 0%（0/24）。与对照组相比，喷雾灌溉器更有可能携带 CoNS（p<0.01）、抗生素耐药性 CoNS（p<0.01）和 MRCoNS（p=0.02）。即使考虑到时间变化（p=0.05），暴露于再生水中的 CoNS 携带率显著增加（p=0.04）。我们的数据强调需要进一步研究从再生水向环境和人类社区传播 CoNS 和抗生素耐药性 CoNS 的潜力，以及相关的公共卫生影响。
