Li Xin-Peng, Wang Shi-Fu, Hou Pei-Bin, Liu Jing, Du Pengcheng, Bai Li, Fanning Séamus, Zhang Hua-Ning, Chen Yu-Zhen, Zhang Yun-Kui, Kang Dian-Min
Shandong Center for Disease Control and Prevention, Jinan 250014, China.
Academy of Preventive Medicine, Shandong University, Jinan 250014, China.
Ann Transl Med. 2020 May;8(9):603. doi: 10.21037/atm-19-2743.
To investigate the epidemiological and phenotypic characteristics and molecular relatedness of , which were cultured from the blood and cerebrospinal fluid (CSF) samples isolated from two neonates.
In the present case study, two infected neonates were interviewed and epidemiological investigation performed. The phenotypic characteristics and molecular relatedness of was characterized by serotyping, pulsed-field gel electrophoresis and whole-genome sequencing (WGS).
The field investigation found that the two neonates were born in the same hospital (Hospital B) and admitted to the neonatal department through different channels within half an hour by different nurses, where they were weighed and placed in different but adjacent incubators. Then they were cared for by the same group of nurses that evening. It is worth noting that there was no record of sanitation of the neonatal incubator of neonate-1. The serotype of the two isolated were 1/2b, with an indistinguishable pulsotypes and were sequence type (ST) 87. WGS showed that there were no core SNP differences identified. In order to explore the genomic traits associated with virulence genes, we identified the pathogenicity island 4 and found that the genome was devoid of any stress islands. There are no positive results from the environmental samples. Considering the genomic data together with epidemiological evidence and clinical symptoms, insufficient surface cleaning along with the nursing staff caring for these neonates was considered as cross-infection factors.
To our knowledge, this is the first report of a nosocomial cross-infection of ST87 between two neonates, which carries the recently identified gene cluster expressing the cellobiose-family phosphotransferase system (PTS-LIPI-4) between two neonates. The test results of environmental samples in the hospital indicate that strict sterilization and patient isolation measures cannot be emphasized enough in neonatal nursing.
研究从两名新生儿的血液和脑脊液（CSF）样本中培养出的[具体细菌名称未给出]的流行病学和表型特征以及分子相关性。
在本病例研究中，对两名受感染的新生儿进行了访谈并开展了流行病学调查。通过血清分型、脉冲场凝胶电泳和全基因组测序（WGS）对[具体细菌名称未给出]的表型特征和分子相关性进行了表征。
现场调查发现，这两名新生儿在同一家医院（B医院）出生，在半小时内由不同护士通过不同渠道入住新生儿科，在那里他们被称重并安置在不同但相邻的 incubator 中。当晚他们由同一组护士护理。值得注意的是，新生儿1的新生儿 incubator 没有卫生清洁记录。分离出的两种[具体细菌名称未给出]的血清型均为1/2b，脉冲型无法区分，序列类型（ST）为87。WGS显示未发现核心单核苷酸多态性差异。为了探索与[具体细菌名称未给出]毒力基因相关的基因组特征，我们鉴定了[具体细菌名称未给出]致病岛4，发现基因组中没有任何应激岛。环境样本没有阳性结果。综合基因组数据、流行病学证据和临床症状，表面清洁不足以及护理这些新生儿的医护人员被认为是交叉感染因素。
据我们所知，这是首次报道两名新生儿之间发生ST87型[具体细菌名称未给出]的医院内交叉感染，该菌株在两名新生儿之间携带最近鉴定出的表达纤维二糖家族磷酸转移酶系统（PTS-LIPI-4）的基因簇。医院环境样本的检测结果表明，在新生儿护理中，严格的消毒和患者隔离措施再怎么强调都不为过。
