AMR Laboratory, Department of Biosciences, Sri Sathya Sai Institute of Higher Learning, Puttaparthi, India.
Infection Control, Sri Sathya Sai Institute of Higher Medical Sciences, Prasanthigram, India.
J Med Microbiol. 2022 Mar;71(3). doi: 10.1099/jmm.0.001500.
. is now considered as a major bacterial pathogen associated with hospital infections. Frequently, multidrug-resistant (MDR) and extensively drug-resistant (XDR) are being encountered. Unusual increase in the infections led to the suspicion of outbreaks in the urology ward and cardiothoracic and vascular surgery intensive care unit (CTVS-ICU). We hypothesize that the localized outbreaks may have originated from environmental sources within the hospital premises. An alternative possibility is the transmission from a previously infected patient or hospital attendant. Understanding the drug-resistance profile and genome characteristics of these clinical samples would determine the likely source of infection and spread. To perform epidemiological and molecular investigations on the suspected outbreaks of in the study centre and identify potential sources of infection. Fourteen drug-resistant isolated from patients of the urology ward, CTVS-ICU and tap waters collected during the suspected outbreaks were subjected to microbiological and genomic analysis. Comparative genome (CG) analysis of these 14 study genomes with 284 complete genomes was performed. Multilocus sequence typing analysis revealed that the isolates belonged to five different sequence types (ST235, ST357, ST639, ST654 and ST1203) and clustered into three distinct groups while two CTVS-ICU isolates remained as singletons. Genome analysis distinguished that the outbreaks in the urology ward and CTVS-ICU are independent, epidemiologically unrelated to each other and with the tap-water isolates. This study highlights the presence of distinct, clonally unrelated, drug-resistant within a hospital setting. The genome analysis of the two localized outbreaks revealed their distinct genetic background and phylogenetically unrelated origin. Vigilant screening and effective implementation of infection control measures led to the successful containment of potential environmental reservoirs of within the premises.
. 现在被认为是与医院感染相关的主要细菌病原体。经常遇到多药耐药（MDR）和广泛耐药（XDR） 。 感染的异常增加导致怀疑在泌尿科病房和心胸血管外科重症监护病房（CTVS-ICU）发生了暴发。我们假设局部暴发可能源自医院内的环境来源。另一种可能性是来自先前感染的患者或医院工作人员的传播。了解这些临床样本的耐药谱和基因组特征将确定感染和传播的可能来源。对研究中心疑似 暴发进行流行病学和分子调查，并确定潜在感染源。对来自泌尿科病房、CTVS-ICU 患者和疑似暴发期间采集的自来水的 14 株耐药 进行微生物学和基因组分析。对这 14 株研究基因组与 284 株完整 基因组进行比较基因组（CG）分析。对这些分离株进行多位点序列分型分析，结果显示，分离株属于五个不同的序列型（ST235、ST357、ST639、ST654 和 ST1203），分为三个不同的组，而两个 CTVS-ICU 分离株则为单独的一组。基因组分析表明，泌尿科病房和 CTVS-ICU 的暴发是独立的，彼此之间在流行病学上没有关联，与自来水分离株也没有关联。本研究强调了在医院环境中存在独特的、克隆无关的耐药 。对两个局部暴发的基因组分析显示了它们不同的遗传背景和系统发育上无关的起源。通过警惕性筛查和有效实施感染控制措施，成功控制了医院内潜在的 环境储源。
