College of Animal Science and Veterinary Medicine, Shandong Agricultural University; Key Laboratory of Animal Bioengineering and Animal Disease of Shandong Province; Sino-German Cooperative Research Centre for Zoonosis of Animal Origin, Shandong Province; 61 Daizong Road, Tai'an 271000, Shandong Province, China.
Tai'an Central Hospital, Tai'an, China.
Environ Int. 2020 Apr;137:105479. doi: 10.1016/j.envint.2020.105479. Epub 2020 Feb 18.
Antibiotic-resistant bacteria (ARB) present a global public health problem. Microorganisms are the main cause of hospital-acquired infections, and the biological contamination of hospital environments can cause the outbreak of a series of infectious diseases. Therefore, it is very important to understand the spread of antibiotic-resistant bacteria in hospital environments. This study examines the concentrations of aerobic bacteria and E. coli in ward environments and the airborne transmission of bacterial drug resistance. The results show that the three wards examined have an average aerobic bacterial concentration of 132 CFU∙m and an average inhalable aerobic bacterial concentration of 73 CFU∙m, with no significant difference (P > 0.05) among the three wards. All isolated E. coli showed multi-drug resistance to not only third-generation cephalosporin antibiotics, but also quinolones, aminoglycosides, and sulfonamides. Furthermore, 51 airborne E. coli strains isolated from the air in the three wards and the corridor were screened for ESBLs, and 12 (23.53%) were ESBL-positive. The drug-resistance gene of the 12 ESBL-positive strains was mainly TEM gene, and the detection rate was 66.67% (8/12). According to a homology analysis with PFGE, 100% homologous E. coli from the ward at 5 m and 10 m outside the ward in the corridor shared the same drug-resistance spectrum, which further proves that airborne E. coli carrying a drug-resistance gene spreads out of the ward through gas exchange. This leads to biological pollution inside, outside, and around the ward, which poses a direct threat to the health of patients, healthcare workers, and surrounding residents. It is also the main reason for the antibiotic resistance in the hospital environment. More attention should be paid to comprehensive hygiene management in the surrounding environment of hospitals.
耐抗生素细菌（ARB）是一个全球性的公共卫生问题。微生物是医院获得性感染的主要原因，医院环境的生物污染可导致一系列传染病的爆发。因此，了解医院环境中耐抗生素细菌的传播非常重要。本研究检查了病房环境中需氧菌和大肠杆菌的浓度以及细菌耐药性的空气传播。结果表明，检查的三间病房的平均需氧菌浓度为 132 CFU·m，平均可吸入需氧菌浓度为 73 CFU·m，三间病房之间没有显著差异（P > 0.05）。所有分离的大肠杆菌不仅对第三代头孢菌素抗生素，而且对喹诺酮类、氨基糖苷类和磺胺类药物均表现出多药耐药性。此外，从三间病房和走廊空气中分离的 51 株空气中大肠杆菌被筛选出 ESBLs，其中 12 株（23.53%）为 ESBL 阳性。12 株 ESBL 阳性株的耐药基因主要为 TEM 基因，检出率为 66.67%（8/12）。根据 PFGE 的同源性分析，来自病房的 5 m 和 10 m 走廊外的大肠杆菌 100%同源，具有相同的耐药谱，这进一步证明了携带耐药基因的空气传播大肠杆菌通过气体交换从病房中扩散出来。这导致病房内、外和周围的生物污染，直接威胁到患者、医护人员和周围居民的健康，也是医院环境中抗生素耐药性的主要原因。应更加关注医院周围环境的综合卫生管理。
