Department of Infectious Diseases, Medical Microbiology and Hospital Hygiene, University Hospital Heidelberg, Heidelberg, Germany.
Department of Infectious Diseases, Medical Microbiology and Hospital Hygiene, University Hospital Heidelberg, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg University Hospital, Heidelberg, Germany.
Environ Res. 2022 Jan;203:111808. doi: 10.1016/j.envres.2021.111808. Epub 2021 Jul 31.
Carbapenemase-producing bacteria are a risk factor in clinical settings worldwide. The aim of the study was to accelerate the time to results during an outbreak situation with bla-positive Enterobacter cloacae by using a real-time multiplex quantitative PCR (qPCR) directly on rectal swab specimens and on wastewater samples to detect carbapenemase-producing bacteria. Thus, we analyzed 681 rectal swabs and 947 environmental samples during a five-month period by qPCR and compared the results to culture screening. The qPCR showed a sensitivity of 100% by testing directly from rectal swabs and was in ten cases more sensitive than the culture-based methods. Environmental screening for bla-carbapenemase genes by qPCR revealed reservoirs of different carbapenemase genes that are potential sources of transmission and might lead to new outbreaks. The rapid identification of patients colonized with those isolates and screening of the hospital environment is essential for earlier patient treatment and eliminating potential sources of nosocomial infections.
产碳青霉烯酶细菌是全球临床环境中的一个危险因素。本研究的目的是通过直接对直肠拭子标本和废水样本进行实时多重定量 PCR（qPCR）检测产碳青霉烯酶的阴沟肠杆菌 bla 阳性，从而在暴发情况下加速结果的产生。因此，我们在五个月的时间内通过 qPCR 分析了 681 份直肠拭子和 947 份环境样本，并将结果与培养筛选进行了比较。qPCR 直接从直肠拭子检测的灵敏度为 100%，在 10 个病例中比基于培养的方法更敏感。qPCR 对 bla-碳青霉烯酶基因的环境筛选显示了不同碳青霉烯酶基因的储库，这些基因可能是传播的潜在来源，并可能导致新的暴发。快速鉴定那些定植患者和筛选医院环境对于早期患者治疗和消除医院感染的潜在来源至关重要。
