调查澳大利亚一家囊性纤维化中心儿童之间脓肿分枝杆菌的传播情况。
Investigating transmission of Mycobacterium abscessus amongst children in an Australian cystic fibrosis centre.
作者信息
Yan Jennifer, Kevat Ajay, Martinez Elena, Teese Nicky, Johnson Kareena, Ranganathan Sarath, Harrison Jo, Massie John, Daley Andrew
机构信息
Department of Microbiology, Royal Children's Hospital, 50 Flemington Rd, Parkville, Victoria, Australia; Department of Infection Prevention and Control, Royal Children's Hospital, 50 Flemington Rd, Parkville, Victoria, Australia.
Department of Respiratory Medicine, Royal Children's Hospital, 50 Flemington Rd, Parkville, Victoria, Australia; Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, Victoria, Australia.
出版信息
J Cyst Fibros. 2020 Mar;19(2):219-224. doi: 10.1016/j.jcf.2019.02.011. Epub 2019 Mar 8.
BACKGROUND
Mycobacterium abscessus is an emerging pathogen in cystic fibrosis (CF) lung disease. Hospital transmission of M. abscessus has been described. This paper details the investigation into possible cross-transmission of M. abscessus locally at our paediatric hospital CF centre, and the subsequent infection control response.
METHODS
Whole genome sequencing (WGS) of M. abscessus respiratory isolates with epidemiological linkage analysis using hospital electronic medical records.
RESULTS
6.7% (22/328) of CF patients had M. abscessus isolated from respiratory specimens. WGS revealed a cluster of three patients with genomically related isolates that differed by <7 single nucleotide polymorphisms (SNPs), suggesting a shared recent ancestor and probable cross-transmission. Epidemiological investigation revealed multiple potential crossovers between patients with genomically similar M. abscessus isolates.
CONCLUSIONS
Cross-infection of NTM occurs in CF hospital patients. Hospital infection control practices should be upgraded to reflect this. Consensus is needed between centres.
背景
脓肿分枝杆菌是囊性纤维化（CF）肺部疾病中一种新出现的病原体。已有关于脓肿分枝杆菌医院内传播的报道。本文详细介绍了对我院儿科医院CF中心可能存在的脓肿分枝杆菌局部交叉传播的调查以及随后的感染控制应对措施。
方法
对脓肿分枝杆菌呼吸道分离株进行全基因组测序（WGS），并利用医院电子病历进行流行病学关联分析。
结果
6.7%（22/328）的CF患者呼吸道标本中分离出脓肿分枝杆菌。WGS显示有三名患者的分离株在基因组上相关，单核苷酸多态性（SNP）差异小于7个，这表明它们有共同的近期祖先且可能存在交叉传播。流行病学调查发现，基因组相似的脓肿分枝杆菌分离株的患者之间存在多个潜在的交叉感染情况。
结论
非结核分枝杆菌（NTM）在CF住院患者中发生交叉感染。医院感染控制措施应升级以反映这一情况。各中心之间需要达成共识。
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