Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia, USA.
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Appl Environ Microbiol. 2019 Jan 9;85(2). doi: 10.1128/AEM.01997-18. Print 2019 Jan 15.
An alarming rise in hospital outbreaks implicating hand-washing sinks has led to widespread acknowledgment that sinks are a major reservoir of antibiotic-resistant pathogens in patient care areas. An earlier study using green fluorescent protein (GFP)-expressing (GFP-) as a model organism demonstrated dispersal from drain biofilms in contaminated sinks. The present study further characterizes the dispersal of microorganisms from contaminated sinks. Replicate hand-washing sinks were inoculated with GFP-, and dispersion was measured using qualitative (settle plates) and quantitative (air sampling) methods. Dispersal caused by faucet water was captured with settle plates and air sampling methods when bacteria were present on the drain. In contrast, no dispersal was captured without or in between faucet events, amending an earlier theory that bacteria aerosolize from the P-trap and disperse. Numbers of dispersed GFP- cells diminished substantially within 30 minutes after faucet usage, suggesting that the organisms were associated with larger droplet-sized particles that are not suspended in the air for long periods. Among the possible environmental reservoirs in a patient care environment, sink drains are increasingly recognized as a potential reservoir to hospitalized patients of multidrug-resistant health care-associated pathogens. With increasing antimicrobial resistance limiting therapeutic options for patients, a better understanding of how pathogens disseminate from sink drains is urgently needed. Once this knowledge gap has decreased, interventions can be engineered to decrease or eliminate transmission from hospital sink drains to patients. The current study further defines the mechanisms of transmission for bacteria that colonize sink drains.
洗手池相关医院感染的惊人增长，使得人们普遍认识到，在病患护理区域，洗手池是抗生素耐药病原体的主要储存库。此前的一项研究使用表达绿色荧光蛋白 (GFP)的模型生物证明了，污染洗手池的排水生物膜中存在 GFP 的扩散。本研究进一步描述了污染洗手池中微生物的扩散情况。使用 GFP 对重复的洗手池进行接种，并使用定性（沉降平板）和定量（空气采样）方法来测量分散度。当排水中有细菌时，使用沉降平板和空气采样方法捕获由水龙头水引起的扩散。相比之下，在没有水龙头事件或两次水龙头事件之间，没有捕获到扩散，修正了细菌从 P 型存水弯气溶胶化并扩散的早期理论。在水龙头使用后 30 分钟内，分散的 GFP-细胞数量大大减少，这表明这些生物与较大的液滴大小的颗粒有关，这些颗粒不会在空气中长时间悬浮。在病患护理环境中的可能环境储库中，水槽排水系统越来越被认为是医院环境中多重耐药性卫生保健相关病原体感染住院患者的潜在储库。随着抗生素耐药性的增加，限制了患者的治疗选择，迫切需要更好地了解病原体如何从水槽排水系统传播。一旦缩小了这一知识差距，就可以设计干预措施来减少或消除医院水槽排水系统向患者的传播。目前的研究进一步定义了定植在水槽排水系统中的细菌的传播机制。
