Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Dr Ricardo Jorge, Lisboa, Portugal.
Unidade de Investigação & Desenvolvimento, Departamento de Saúde Ambiental, INSA, Lisboa, Portugal.
J Hosp Infect. 2022 May;123:43-51. doi: 10.1016/j.jhin.2022.01.025. Epub 2022 Feb 18.
Central venous catheter-related bloodstream infection (CRBSI) is a huge public health concern with considerable impact on mortality and health costs.
A three-year observational study enrolling three tertiary hospitals located in Lisbon, Portugal, was designed to identify the major aetiological agents of CRBSI, their ability to colonize central venous catheters and their antimicrobial resistance profiles.
Aetiological agents of CRBSI were identified by Vitek 2. Whole-genome sequencing was used to confirm CRBSI by the most prevalent aetiological agents and characterize their resistome. Central venous catheter colonization (namely by biofilm assembly) was monitored by scanning electron microscopy.
Staphylococci were the most prevalent causative agent (36/58, 62.0%), with S. aureus and coagulase-negative S. epidermidis accounting for 24.1% and 36.2% of CRBSIs, respectively. Fifty-nine of 72 staphylococci isolates were meticillin resistant. Comparative genomic analysis of central venous catheters/haemoculture pairs of isolates revealed genomic matches for 35 of 36 pairs and a good correlation between antibiotic susceptibility phenotype and the presence of antimicrobial resistance genetic determinants. Biofilms were present on 48.6% of the central venous catheters; nevertheless, no statistically significant association was established between biofilm assembly and CRBSI, and the presence/absence of ica operon and agr groups did not correlate with biofilm phenotypes, highlighting the need for further studies to elucidate biofilms' role on this healthcare-associated infection.
Whole-genome sequencing was shown to be a valuable tool to confirm CRBSI. Although more than 42.3% of the central venous catheters were colonized by staphylococci, no statistically significant association was found between CRBSI and biofilms.
中心静脉导管相关性血流感染（CRBSI）是一个严重的公共卫生问题，对死亡率和医疗成本有重大影响。
设计了一项为期三年的观察性研究，纳入了葡萄牙里斯本的三家三级医院，旨在确定 CRBSI 的主要病原体、它们在中心静脉导管上定植的能力及其抗菌药物耐药谱。
通过 Vitek 2 鉴定 CRBSI 的病原体。使用全基因组测序来确认最常见的病原体引起的 CRBSI，并对其耐药组进行特征分析。通过扫描电子显微镜监测中心静脉导管的定植（即生物膜形成）。
葡萄球菌是最常见的病原体（36/58，62.0%），其中金黄色葡萄球菌和凝固酶阴性表皮葡萄球菌分别占 CRBSI 的 24.1%和 36.2%。72 株葡萄球菌中有 59 株对甲氧西林耐药。对中心静脉导管/血培养分离株的配对进行比较基因组分析，发现 36 对中的 35 对有基因组匹配，抗生素敏感性表型与抗菌药物耐药遗传决定因素的存在之间存在良好的相关性。48.6%的中心静脉导管上存在生物膜；然而，生物膜形成与 CRBSI 之间没有建立统计学上的显著关联，ica 操纵子和 agr 群的存在/缺失与生物膜表型也没有相关性，这突显了需要进一步研究来阐明生物膜在这种与医疗保健相关的感染中的作用。
全基因组测序被证明是一种确认 CRBSI 的有用工具。尽管超过 42.3%的中心静脉导管被葡萄球菌定植，但 CRBSI 与生物膜之间没有建立统计学上的显著关联。
