Mathys Dimitria A, Mollenkopf Dixie F, Van Balen Joany C, Wittum Thomas E
Veterinary Preventive Medicine, The Ohio State University , Columbus, Ohio.
Vector Borne Zoonotic Dis. 2018 Nov;18(11):620-623. doi: 10.1089/vbz.2018.2320. Epub 2018 Jul 13.
The dissemination of Enterobacteriaceae expressing resistance to clinically important antibiotics such as extended-spectrum cephalosporins (ESC), carbapenems, and fluoroquinolones is of critical concern to both human and veterinary medicine. In healthcare facilities, the movement of patients, personnel, and equipment provides an opportunity for Enterobacteriaceae carrying antibiotic resistance genes to disseminate in the hospital environment where they pose a threat to patients, staff, and hospital visitors. We collected environmental samples using electrostatic cloths to estimate the frequency of resistant Enterobacteriaceae contamination on human and veterinary hospital surfaces. Samples were enriched in nutrient broth modified with antibiotics to provide specific selection pressure to select for bacteria expressing AmpC β-lactamase (bla), extended-spectrum β-lactamase (ESBL, bla), carbapenemase, quinolone, and fluoroquinolone-resistant phenotypes. A total of 31 contact surfaces were sampled at each of five visits to two human hospitals. In addition, 34 surfaces were sampled at each of three visits to a veterinary hospital serving both farm animal and companion animal patients. Isolates expressing the bla phenotype were recovered from 0.6%, 100%, and 18.2% of human hospitals, veterinary farm animal, and veterinary companion animal hospital surfaces, respectively. Isolates expressing the bla phenotype were recovered from 0.6%, 55%, and 16.7% of human hospitals, farm animal, and companion animal veterinary hospital surfaces, respectively. Carbapenemase-producing Enterobacteriaceae (CPE) were detected from 1.3% of human hospital surfaces, but none were recovered from the veterinary hospital. Fluoroquinolone resistance was detected in 0.6%, 5.0%, and 37.9% of human hospitals, farm animal, and companion animal veterinary hospital surfaces, respectively. Our results indicate that ESC and fluoroquinolone-resistant Enterobacteriaceae can contaminate surfaces in both human and veterinary medical settings, with higher prevalence observed in veterinary hospitals, although the recovery of CPE from human hospital environments is concerning. Hospital medical trolleys or carts may serve as fomites for the dissemination of clinically relevant resistant bacteria.
表达对临床上重要抗生素（如超广谱头孢菌素（ESC）、碳青霉烯类和氟喹诺酮类）耐药的肠杆菌科细菌的传播，是人类医学和兽医学都极为关注的问题。在医疗机构中，患者、医护人员和设备的流动为携带抗生素耐药基因的肠杆菌科细菌在医院环境中传播提供了机会，它们对患者、工作人员和医院访客构成威胁。我们使用静电布收集环境样本，以估计人类医院和兽医院表面耐药肠杆菌科细菌的污染频率。样本在添加了抗生素的营养肉汤中富集，以提供特定的选择压力，筛选出表达AmpC β-内酰胺酶（bla）、超广谱β-内酰胺酶（ESBL，bla）、碳青霉烯酶、喹诺酮和氟喹诺酮耐药表型的细菌。在对两家人类医院的五次访问中，每次对31个接触表面进行采样。此外，在对一家同时服务农场动物和伴侣动物患者的兽医院的三次访问中，每次对34个表面进行采样。分别从人类医院、兽医农场动物医院和兽医伴侣动物医院表面的0.6%、100%和18.2%中分离出表达bla表型的菌株。分别从人类医院、农场动物医院和伴侣动物兽医医院表面的0.6%、55%和16.7%中分离出表达bla表型的菌株。在1.3%的人类医院表面检测到产碳青霉烯酶肠杆菌科细菌（CPE），但在兽医院未分离到。在人类医院、农场动物医院和伴侣动物兽医医院表面分别有0.6%、5.0%和37.9%检测到氟喹诺酮耐药。我们的结果表明，ESC和氟喹诺酮耐药的肠杆菌科细菌可污染人类和兽医学环境中的表面，兽医院中的患病率更高，尽管从人类医院环境中分离出CPE令人担忧。医院的医疗推车或手推车可能成为传播临床相关耐药细菌的媒介物。
