Odoyo Erick, Kyanya Cecilia, Mutai Winnie, Musila Lillian
United States Army Medical Research Directorate - Africa, PO Box 606-00621, Nairobi, Kenya.
University of Nairobi, PO Box 30197-00200, Nairobi, Kenya.
Access Microbiol. 2020 Sep 18;2(12):acmi000171. doi: 10.1099/acmi.0.000171. eCollection 2020.
The contribution of (formerly ) to the burden of hospital-associated infections (HAIs) remains undetermined in many African countries.
This study aimed to identify a sensitive and readily adaptable detection assay and to evaluate the HAI risk in Kenya.
Sterile swabs in neutralizing buffer were used to sample equipment or surfaces that patients and clinical staff touched frequently. These swabs were either plated directly on chromogenic agar or cultured in an enrichment broth before plating. The swab suspensions, enrichment broth and plate cultures were screened by quantitative PCR (qPCR) to determine the most efficient detection method. The HAI risk was evaluated by testing the -positive samples by qPCR for the A, B and binary toxins.
was detected on 4/57 (7.0 %) equipment and surfaces by direct culture. The additional enrichment step increased the detection rate 10-fold to 43/57 (75.4 %). In total, 51/57 (89.5 %) environmental samples were positive for detected through either culture or qPCR. The genes encoding the primary toxins, and , were detected on six surfaces, while the genes encoding the binary toxins, and , were detected on 2/57 (3.5 %) and 3/57 (5.3 %) surfaces, respectively. Different toxin gene profiles were detected: the - gene profile on 4/10 (40 %) high-touch surfaces, + on 3/10 (30 %) surfaces, on 2/10 (20 %) surfaces and on one high-touch surface.
The widespread contamination of hospital environments by toxigenic gives a strong indication of the high risk of infections (CDIs). The two-step culture process described can easily be adapted for monitoring hospital environment contamination by .
在许多非洲国家，（以前称为 ）对医院感染（HAIs）负担的贡献仍未确定。
本研究旨在确定一种灵敏且易于应用的 检测方法，并评估肯尼亚的 医院感染风险。
使用置于中和缓冲液中的无菌拭子对患者和临床工作人员经常接触的设备或表面进行采样。这些拭子要么直接接种在显色琼脂上，要么在接种前在增菌肉汤中培养。通过定量PCR（qPCR）对拭子悬液、增菌肉汤和平板培养物进行筛查，以确定最有效的检测方法。通过对 - 阳性样本进行qPCR检测A、B和二元毒素来评估医院感染风险。
通过直接培养在4/57（7.0%）的设备和表面上检测到 。额外的增菌步骤使检测率提高了10倍，达到43/57（75.4%）。总共，51/57（89.5%）的环境样本通过培养或qPCR检测出 呈阳性。在六个表面上检测到编码主要毒素 和 的基因，而编码二元毒素 和 的基因分别在2/57（3.5%）和3/57（5.3%）的表面上检测到。检测到不同的 毒素基因谱：在4/10（40%）的高接触表面上为 - 基因谱，在3/10（30%）的表面上为 + ，在2/10（20%）的表面上为 ，在一个高接触表面上为 。
产毒 对医院环境的广泛污染有力地表明了 感染（CDIs）的高风险。所描述的两步培养过程可轻松适用于监测医院环境中 的污染情况。
