Cruz-López Flora, Villarreal-Treviño Licet, Morfin-Otero Rayo, Martínez-Meléndez Adrián, Camacho-Ortiz Adrián, Rodríguez-Noriega Eduardo, Garza-González Elvira
Universidad Autónoma de Nuevo León, Facultad de Ciencias Biológicas, Departamento de Microbiología e Inmunología, Pedro de Alba S/N, Ciudad Universitaria, San Nicolás de los Garza, Nuevo León, Mexico.
Hospital Civil de Guadalajara 'Fray Antonio Alcalde', e Instituto de Patología Infecciosa y Experimental, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico.
Am J Infect Control. 2020 Nov;48(11):1329-1335. doi: 10.1016/j.ajic.2020.04.016. Epub 2020 Apr 28.
Patient colonization has been suggested as a risk factor in hospital-associated infections (HAI) development, which are of the most frequent complications in hospitals.
To examine the colonization process and possible transmission routes of HAI-causative agents in step-down care unit (SDCU) patients.
Patients admitted to SDCU within 48 hours of admission that had no evidence of infection present, nurse health care workers (HCWs), and relatives of infected patients were included. Participants were sampled and cultured at different times in different body surfaces. Environmental surfaces and medical devices were also sampled. Antimicrobial susceptibility and clonal relatedness were determined in selected HAI-causative agents, environmental, nurse HCWs, and patient isolates.
A total of 2,735 isolates corresponding to 126 species were identified. Of the 11 patients included, 8 developed 1-3 HAIs (14 isolates recovered as HAI-causative agents). Acinetobacter baumannii (36% of infections) was distributed in clone A (n = 1), B (n = 3), and F (n = 1); Klebsiella pneumoniae (29%) in clones A (n = 2) and B (n = 1) and Enterobacter cloacae (7%) in one clone A. Causative agents were progressively recovered from environmental surfaces and medical devices before and after HAI onset.
Highly related strains were recovered from environmental surfaces, patients, and nurse HCWs before and after HAI outcome. This is a first step to examine colonization process in SDCU settings and provides a base for further studies to understand colonization dynamics and the role of patients' relatives and nurse HCWs in organism transmission in the SDCU.
患者定植被认为是医院感染（HAI）发生的一个危险因素，医院感染是医院中最常见的并发症。
研究在逐步降低护理级别病房（SDCU）患者中HAI病原体的定植过程及可能的传播途径。
纳入入院48小时内入住SDCU且无感染证据的患者、护士医护人员（HCW）以及感染患者的亲属。在不同时间对参与者不同身体表面进行采样和培养。还对环境表面和医疗设备进行采样。对选定的HAI病原体、环境、护士HCW和患者分离株进行药敏试验和克隆相关性测定。
共鉴定出2735株分离株，对应126个菌种。纳入的11例患者中，8例发生了1 - 3次HAI（作为HAI病原体分离出14株）。鲍曼不动杆菌（占感染的36%）分布于克隆A（n = 1）、B（n = 3）和F（n = 1）；肺炎克雷伯菌（29%）分布于克隆A（n = 2）和B（n = 1），阴沟肠杆菌（7%）分布于一个克隆A。在HAI发病前后，病原体逐渐从环境表面和医疗设备中分离出来。
在HAI发生前后，从环境表面、患者和护士HCW中分离出高度相关的菌株。这是研究SDCU环境中定植过程的第一步，为进一步研究了解定植动态以及患者亲属和护士HCW在SDCU中病原体传播中的作用提供了基础。
