Volling Cheryl, Ahangari Narges, Bartoszko Jessica J, Coleman Brenda L, Garcia-Jeldes Felipe, Jamal Alainna J, Johnstone Jennie, Kandel Christopher, Kohler Philipp, Maltezou Helena C, Maze Dit Mieusement Lorraine, McKenzie Nneka, Mertz Dominik, Monod Adam, Saeed Salman, Shea Barbara, Stuart Rhonda L, Thomas Sera, Uleryk Elizabeth, McGeer Allison
Sinai Health System, Toronto, Ontario, Canada.
McMaster University, Hamilton, Ontario, Canada.
Open Forum Infect Dis. 2020 Dec 8;8(2):ofaa590. doi: 10.1093/ofid/ofaa590. eCollection 2021 Feb.
Increasing rates of antimicrobial-resistant organisms have focused attention on sink drainage systems as reservoirs for hospital-acquired Gammaproteobacteria colonization and infection. We aimed to assess the quality of evidence for transmission from this reservoir. We searched 8 databases and identified 52 studies implicating sink drainage systems in acute care hospitals as a reservoir for Gammaproteobacterial colonization/infection. We used a causality tool to summarize the quality of evidence. Included studies provided evidence of co-occurrence of contaminated sink drainage systems and colonization/infection, temporal sequencing compatible with sink drainage reservoirs, some steps in potential causal pathways, and relatedness between bacteria from sink drainage systems and patients. Some studies provided convincing evidence of reduced risk of organism acquisition following interventions. No single study provided convincing evidence across all causality domains, and the attributable fraction of infections related to sink drainage systems remains unknown. These results may help to guide conduct and reporting in future studies.
抗菌耐药生物的发生率不断上升，这使得人们将注意力集中在水槽排水系统上，因为它是医院获得性γ-变形菌定植和感染的储存库。我们旨在评估来自该储存库的传播证据的质量。我们检索了8个数据库，确定了52项研究，这些研究表明，急症医院的水槽排水系统是γ-变形菌定植/感染的储存库。我们使用一种因果关系工具来总结证据的质量。纳入的研究提供了受污染的水槽排水系统与定植/感染同时出现的证据、与水槽排水储存库相符的时间顺序、潜在因果途径中的一些步骤，以及来自水槽排水系统的细菌与患者之间的相关性。一些研究提供了令人信服的证据，表明干预后生物体获得风险降低。没有一项研究在所有因果关系领域都提供了令人信服的证据，与水槽排水系统相关的感染归因比例仍然未知。这些结果可能有助于指导未来研究的开展和报告。
