Biomedical Resource Unit, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal Durban, Durban, South Africa.
Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
Microb Drug Resist. 2021 Dec;27(12):1692-1704. doi: 10.1089/mdr.2020.0543. Epub 2021 Sep 20.
This study aimed to assess the molecular dissemination of species in public hospitals in South Africa. The study conducted over 3 months during 2017 involved representative samples obtained from three wards (general ward, intensive care unit, and pediatric unit) from four public hospitals denoted as A (Central), B (Tertiary), C (Regional), and D (District). Swabs collected from 11 distinct hospital surfaces were screened using selective media, biochemical testing, and molecular methods. Overall, 17% (135/777) isolates were identified with a prevalence of 24% (32/135) for central, 33% (45/135) for tertiary, 27% (36/135) for regional, and 16% (22/135) for district hospital. species were further confirmed to belong to (129/135; 96%) and (6/135; 4%). Prevalence was similar across the wards, averaging 33.3% (45/135). The highest prevalence of isolates was found on the drip stands (11.8%), sink (11.8%), ward phone (11.5%), and nurses' tables (10.3%). Minimum inhibitory concentration analyses revealed high resistance to β-lactams, fluoroquinolones, and tetracyclines. The most common resistance genes detected were (56%) and t (5%). Enterotoxin virulence genes (77%) and (88%) associated with the diarrheal syndrome were most detected; however, no genes (cereulide toxin) for emetic syndrome was found. The enterobacterial repetitive intergenic consensus PCR revealed considerable diversity at the different levels of health care, although the clonal spread of strains between the sites/wards within each specific hospital was revealed. The study highlighted the dissemination of drug-resistant spp. in public hospital environments and calls for the design of optimal strategies to curb their spread.
本研究旨在评估南非公立医院中 种的分子传播。该研究在 2017 年进行了 3 个月，涉及从四个公立医院的三个病房（普通病房、重症监护室和儿科病房）获得的代表性样本，这四个公立医院分别表示为 A（中央）、B（三级）、C（区域）和 D（地区）。从 11 个不同的医院表面采集的拭子使用选择性培养基、生化测试和分子方法进行筛选。总体而言，17%（135/777）的分离株被鉴定，其中中央医院的患病率为 24%（32/135），三级医院为 33%（45/135），区域医院为 27%（36/135），地区医院为 16%（22/135）。 种进一步确认为 （129/135；96%）和 （6/135；4%）。各病房的患病率相似，平均为 33.3%（45/135）。 分离株的最高患病率见于滴水架（11.8%）、水槽（11.8%）、病房电话（11.5%）和护士桌（10.3%）。最低抑菌浓度分析显示，对β-内酰胺类、氟喹诺酮类和四环素类药物的耐药性较高。检测到的最常见耐药基因是 （56%）和 t （5%）。与腹泻综合征相关的肠毒素毒力基因 （77%）和 （88%）最常被检测到；然而，没有发现呕吐综合征的 基因（呕吐毒素）。肠杆菌重复基因间共识 PCR 显示，在不同级别的医疗保健中存在相当大的多样性，尽管在每个特定医院的各站点/病房之间发现了菌株的克隆传播。该研究强调了耐药性 spp. 在公立医院环境中的传播，并呼吁制定最佳策略来遏制其传播。
