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在不同医院环境中使用宏转录组学评估一种新型连续清洁设备。

Assessment of a novel continuous cleaning device using metatranscriptomics in diverse hospital environments.

作者信息

Wright Justin R, Ly Truc T, Cromwell Karen B, Brislawn Colin J, Chen See Jeremy R, Anderson Samantha Lc, Pellegrino Jordan, Peachey Logan, Walls Christine Y, Lloyd Charise M, Jones Olcay Y, Lawrence Matthew W, Bess Jessica A, Wall Arthur C, Shope Alexander J, Lamendella Regina

机构信息

Contamination Source Identification, LLC., Huntingdon, PA, United States.

Walter Reed National Military Medical Center, Bethesda, MD, United States.

出版信息

Front Med Technol. 2023 Mar 3;5:1015507. doi: 10.3389/fmedt.2023.1015507. eCollection 2023.

Abstract

INTRODUCTION

Despite routine implementation of cleaning and disinfection practices in clinical healthcare settings, high-touch environmental surfaces and contaminated equipment often serve as reservoirs for the transmission of pathogens associated with healthcare-associated infections (HAIs).

METHODS

The current study involved the analysis of high-touch surface swabs using a metatranscriptomic sequencing workflow (CSI-Dx™) to assess the efficacy of cleanSURFACES® technology in decreasing microbial burden by limiting re-contamination. This is a non-human single center study conducted in the Emergency Department (ED) and on an inpatient Oncology Ward of Walter Reed National Military Medical Center that have followed hygienic practices during the COVID-19 pandemic environment.

RESULTS

Although there was no difference in observed microbial richness (two-tailed Wilcoxon test with Holm correction, P > 0.05), beta diversity findings identified shifts in microbial community structure between surfaces from baseline and post-intervention timepoints (Day 1, Day 7, Day 14, and Day 28). Biomarker and regression analyses identified significant reductions in annotated transcripts for various clinically relevant microorganisms' post-intervention, coagulase-negative staphylococci and , at ED and Oncology ward, respectively. Additionally, post-intervention samples predominantly consisted of Proteobacteria and to a lesser extent skin commensals and endogenous environmental microorganisms in both departments.

DISCUSSION

Findings support the value of cleanSURFACES®, when coupled with routine disinfection practices, to effectively impact on the composition of active microbial communities found on high-touch surfaces in two different patient care areas of the hospital (one outpatient and one inpatient) with unique demands and patient-centered practices.

摘要

引言

尽管临床医疗环境中常规实施了清洁和消毒措施,但高接触环境表面和受污染的设备往往是与医疗相关感染(HAIs)相关病原体传播的储存库。

方法

本研究采用宏转录组测序工作流程(CSI-Dx™)对高接触表面拭子进行分析,以评估cleanSURFACES®技术通过限制再污染来降低微生物负荷的效果。这是一项在沃尔特·里德国家军事医疗中心急诊科和住院肿瘤科病房进行的非人体单中心研究,这些科室在新冠疫情期间遵循了卫生规范。

结果

尽管观察到的微生物丰富度没有差异(采用霍尔姆校正的双尾威尔科克森检验,P>0.05),但β多样性分析结果表明,从基线到干预后时间点(第1天、第7天、第14天和第28天),不同表面的微生物群落结构发生了变化。生物标志物和回归分析确定,干预后,急诊科和肿瘤科病房中各种临床相关微生物的注释转录本显著减少,分别为凝固酶阴性葡萄球菌和 。此外,干预后的样本在两个科室中主要由变形菌组成,皮肤共生菌和内源性环境微生物的比例较小。

讨论

研究结果支持cleanSURFACES®与常规消毒措施相结合,对医院两个不同患者护理区域(一个门诊区域和一个住院区域)高接触表面上活跃微生物群落的组成产生有效影响,这两个区域有独特的需求和以患者为中心的做法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5434/10020724/0f8ca7d82581/fmedt-05-1015507-g001.jpg

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