Department of Anesthesia, University of Iowa, Iowa City, IA, USA.
Department of Anesthesia, University of Iowa, Iowa City, IA, USA.
J Hosp Infect. 2018 Nov;100(3):299-308. doi: 10.1016/j.jhin.2018.06.020. Epub 2018 Jun 30.
Desiccation tolerance increases Staphylococcus aureus survival and risk of transmission. A better understanding of factors driving intraoperative transmission of S. aureus pathogens may lead to innovative improvements in intraoperative infection control.
To determine whether desiccation tolerance is associated with intraoperative S. aureus transmission, and to examine typical transmission dynamics for desiccation-tolerant isolates in the operating room in order to provide the impetus for development of improved intraoperative infection control strategies.
S. aureus isolates (N=173) were collected from anaesthesia work area reservoirs in 274 operating room environments. Desiccation tolerance was assessed and the potential association with sequence type (ST) and clonal transmission was evaluated. Whole cell genome analysis and pulsed-field gel electrophoresis analysis were used to compare desiccation-tolerant isolates with causative organisms of infection.
S. aureus ST 5 isolates had greater desiccation tolerance than all other intraoperative STs [ST 5, N=34, median Day 2 colony-forming unit (cfu) survival 0.027% ± 0.029%; other STs, N=139, median Day 2 cfu survival 0.0091% ± 1.41%; corrected P=0.0001]. ST 5 was associated with increased risk of clonal transmission (relative risk 1.82, 95% confidence interval 1.23-2.71, P=0.003). ST 5 transmission was linked by whole cell genome analysis to postoperative infection.
Increased desiccation tolerance is associated with intraoperative transmission of S. aureus ST 5 isolates that are linked to postoperative infection. Future work should determine whether attenuation of desiccation-tolerant, intraoperative ST 5 strains can impact the incidence of healthcare-associated infections.
干燥耐受性会增加金黄色葡萄球菌的存活和传播风险。更好地了解导致手术期间金黄色葡萄球菌病原体传播的因素，可能会促使手术期间感染控制的创新改进。
确定干燥耐受性是否与手术期间金黄色葡萄球菌的传播有关，并研究干燥耐受性分离株在手术室中的典型传播动力学，以便为开发改进的手术期间感染控制策略提供动力。
从 274 个手术室环境中的麻醉工作区储液器中收集金黄色葡萄球菌分离株（N=173）。评估干燥耐受性，并评估其与序列型（ST）和克隆传播的潜在关联。使用全细胞基因组分析和脉冲场凝胶电泳分析比较干燥耐受性分离株与感染的病原体。
金黄色葡萄球菌 ST5 分离株比所有其他手术期间的 ST 具有更高的干燥耐受性[ST5，N=34，第 2 天菌落形成单位（cfu）存活率中位数 0.027%±0.029%；其他 ST，N=139，第 2 天 cfu 存活率中位数 0.0091%±1.41%；校正 P=0.0001]。ST5 与克隆传播的风险增加相关（相对风险 1.82，95%置信区间 1.23-2.71，P=0.003）。通过全细胞基因组分析，ST5 的传播与术后感染有关。
干燥耐受性增加与手术期间金黄色葡萄球菌 ST5 分离株的传播有关，这些分离株与术后感染有关。未来的工作应该确定衰减干燥耐受性、手术期间 ST5 株是否会影响医疗保健相关感染的发生率。
