Gentile Dominic, Allbaugh Rachel A, Adiguzel Mehmet C, Kenne Danielle E, Sahin Orhan, Sebbag Lionel
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States.
Department of Veterinary Microbiology and Preventive Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA, United States.
Front Vet Sci. 2020 Dec 23;7:571503. doi: 10.3389/fvets.2020.571503. eCollection 2020.
The present study describes the prevalence of bacterial cross-contamination in a veterinary ophthalmology setting, a serious issue that can result in healthcare-associated (or nosocomial) infections among patients and staff. Retrospective ( = 5 patients) and prospective ( = 23 patients) studies evaluated bacterial isolates in companion animals presenting with ulcerative keratitis, sampling the patients' cornea and surrounding examination room, including the environment (exam table, countertop, floor) and ophthalmic equipment (slit lamp, transilluminator, direct ophthalmoscope, indirect headset, tonometer). Results of bacterial culture and antibiotic susceptibility testing were recorded, and degree of genetic relatedness was evaluated in six pairs of isolates (cornea + environment or equipment) using pulse-field gel electrophoresis (PFGE). Overall contamination rate of ophthalmic equipment, environment, and examination rooms (equipment + environment) was 42.9% (15/35 samples), 23.7% (9/38 samples) and 32.9% (24/73 samples), respectively. Methicillin-resistant (MRSP), a multi-drug resistant (MDR) pathogen with zoonotic potential, was isolated in 8.2% (6/73) of samples. The patient's cornea was likely the source of cross-contamination in 50% (3/6) of MRSP pairs as evaluated by PFGE; notably, two of the three similar bacterial strains did not have an exact match of their antibiotic susceptibility profiles, highlighting the importance of advanced diagnostics such as PFGE to assess cross-contamination in healthcare facilities. Future work could examine the contamination prevalence of specific equipment or the efficacy of cleaning protocols to mitigate cross-contamination in veterinary practice.
本研究描述了兽医眼科环境中细菌交叉污染的发生率，这是一个严重问题，可能导致患者和工作人员发生医疗保健相关（或医院内）感染。回顾性研究（n = 5例患者）和前瞻性研究（n = 23例患者）评估了患有溃疡性角膜炎的伴侣动物的细菌分离株，对患者的角膜以及周围检查室进行采样，包括环境（检查台、台面、地面）和眼科设备（裂隙灯、透照器、直接检眼镜、间接头戴式检眼镜、眼压计）。记录细菌培养和抗生素敏感性测试的结果，并使用脉冲场凝胶电泳（PFGE）对六对分离株（角膜+环境或设备）的遗传相关性程度进行评估。眼科设备、环境和检查室（设备+环境）的总体污染率分别为42.9%（15/35个样本）、23.7%（9/38个样本）和32.9%（24/73个样本）。耐甲氧西林金黄色葡萄球菌（MRSP）是一种具有人畜共患病潜力的多重耐药（MDR）病原体，在8.2%（6/73）的样本中被分离出来。通过PFGE评估，在50%（3/6）的MRSP配对中，患者的角膜可能是交叉污染的来源；值得注意的是，三株相似细菌菌株中的两株其抗生素敏感性谱并不完全匹配，这突出了PFGE等先进诊断方法在评估医疗机构交叉污染方面的重要性。未来的工作可以研究特定设备的污染发生率或清洁方案在减轻兽医实践中交叉污染方面的效果。
