一家兽医医院的医院获得性细菌和人畜共患病细菌及其相关的抗菌药物敏感性概况：一项系统综述。
Hospital-acquired and zoonotic bacteria from a veterinary hospital and their associated antimicrobial-susceptibility profiles: A systematic review.
作者信息
Sebola Dikeledi C, Oguttu James W, Kock Marleen M, Qekwana Daniel N
机构信息
Section Veterinary Public Health, Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa.
Department of Agriculture and Animal Health, College of Agriculture and Environmental Sciences, University of South Africa, Johannesburg, South Africa.
出版信息
Front Vet Sci. 2023 Jan 9;9:1087052. doi: 10.3389/fvets.2022.1087052. eCollection 2022.
BACKGROUND
Hospital-acquired infections (HAIs) are associated with increased mortality, morbidity, and an economic burden due to costs associated with extended hospital stays. Furthermore, most pathogens associated with HAIs in veterinary medicine are zoonotic. This study used published data to identify organisms associated with HAIs and zoonosis in veterinary medicine. Furthermore, the study also investigated the antimicrobial-susceptibility profile of these bacterial organisms.
METHODS
A systematic literature review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Search terms and five electronic databases were used to identify studies published over 20 years (2000-2020). The risk of bias was assessed using the "Strengthening the Reporting of Observational Studies in Epidemiology-Vet" (STROBE-Vet) checklist.
RESULTS
Out of the identified 628 papers, 27 met the inclusion criteria for this study. Most studies (63%, 17/27) included were either from small animal or companion animal clinics/hospitals, while 5% (4/27) were from large animal clinics/hospitals inclusive of bovine and equine hospitals. Hospital-acquired bacteria were reported from environmental surfaces (33%, 9/27), animal clinical cases (29.6%, 8/27), and fomites such as cell phones, clippers, stethoscopes, and computers (14.8%, 4/27). spp. was the most (63%; 17/27) reported organism, followed by (19%; 5/27), spp. (15%, 4/27), spp. (15%; 4/27), (15%, 4/27), (4%, 1/27), and (4%; 1/27). Multidrug-resistant (MDR) organisms were reported in 71% (12/17) of studies linked to Methicillin-resistant (MRSA), Methicillin-resistant (MRSP), spp., Typhimurium, and . The A gene was identified in both MRSA and MRSP, the CMY-2 gene in and spp., and the A gene in isolate. Six studies reported organisms from animals with similar clonal lineage to those reported in human isolates.
CONCLUSION
Organisms associated with hospital-acquired infections and zoonosis have been reported from clinical cases, environmental surfaces, and items used during patient treatment and care. species is the most reported organism in cases of HAIs and some isolates shared similar clonal lineage to those reported in humans. Some organisms associated with HAIs exhibit a high level of resistance and contain genes associated with antibiotic resistance.
背景
医院获得性感染（HAIs）与死亡率和发病率的增加以及因延长住院时间产生的成本所带来的经济负担相关。此外，兽医学中与医院获得性感染相关的大多数病原体都是人畜共患病原体。本研究利用已发表的数据来确定兽医学中与医院获得性感染和人畜共患病相关的微生物。此外，该研究还调查了这些细菌微生物的抗菌药敏谱。
方法
根据系统评价和荟萃分析的首选报告项目（PRISMA）指南进行了系统的文献综述。使用检索词和五个电子数据库来识别20多年（2000 - 2020年）间发表的研究。使用“加强流行病学观察性研究报告 - 兽医版”（STROBE - Vet）清单评估偏倚风险。
结果
在识别出的628篇论文中，27篇符合本研究的纳入标准。纳入的大多数研究（63%，17/27）来自小动物或伴侣动物诊所/医院，而5%（4/27）来自包括牛和马医院在内的大动物诊所/医院。医院获得性细菌报告于环境表面（33%，9/27）、动物临床病例（29.6%，8/27）以及手机、剪刀、听诊器和电脑等污染物（14.8%，4/27）。 属是报告最多的微生物（63%；17/27），其次是 （19%；5/27）、 属（15%，4/27）、 属（15%；4/27）、 （15%，4/27）、 （4%，1/27）和 （4%；1/27）。在与耐甲氧西林金黄色葡萄球菌（MRSA）、耐甲氧西林凝固酶阴性葡萄球菌（MRSP）、 属、鼠伤寒沙门氏菌和 相关的研究中，71%（12/17）报告了多重耐药（MDR）微生物。在MRSA和MRSP中均鉴定出A基因，在 和 属中鉴定出CMY - 2基因，在 分离株中鉴定出A基因。六项研究报告了来自动物的微生物，其克隆谱系与人类分离株中报告的相似。
结论
已从临床病例、环境表面以及患者治疗和护理期间使用的物品中报告了与医院获得性感染和人畜共患病相关的微生物。在医院获得性感染病例中， 属是报告最多的微生物，一些分离株与人类中报告的具有相似的克隆谱系。一些与医院获得性感染相关的微生物表现出高度耐药性，并含有与抗生素耐药性相关的基因。
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