INRS-Centre Armand-Frappier Santé Biotechnologie, Laval, Quebec, Canada.
CHU Sainte-Justine Research Center, Montréal, Quebec, Canada.
Appl Environ Microbiol. 2023 May 31;89(5):e0010523. doi: 10.1128/aem.00105-23. Epub 2023 Apr 17.
Compelling evidence suggests a contribution of the sink environment to the transmission of opportunistic pathogens from the hospital environment to patients in neonatal intensive care units (NICU). In this study, the distribution of the opportunistic pathogen Serratia marcescens in the sink environment and newborns in a NICU was investigated. More than 500 sink drain and faucet samples were collected over the course of five sampling campaigns undertaken over 3 years. Distribution and diversity of S. marcescens were examined with a modified MacConkey medium and a high-throughput short-sequence typing (HiSST) method. Sink drains were an important reservoir of S. marcescens, with an average of 44% positive samples, whereas no faucet sample was positive. The genotypic diversity of S. marcescens was moderate, with an average of two genotypes per drain, while the spatial distribution of S. marcescens was heterogeneous. The genotypic profiles of 52 clinical isolates were highly heterogeneous, with 27 unique genotypes, of which 71% of isolates were found in more than one patient. S. marcescens acquisition during the first outbreaks was mainly caused by horizontal transmissions. HiSST analyses revealed 10 potential cases of patient-to-patient transmission of S. marcescens, five cases of patient-to-sink transmission, and one bidirectional transfer between sink and patient. Environmental and clinical isolates were found in sink drains up to 1 year after the first detection, supporting persisting drain colonization. This extensive survey suggests multiple reservoirs of S. marcescens within the NICU, including patients and sink drains, but other external sources should also be considered. The bacterium Serratia marcescens is an important opportunistic human pathogen that thrives in many environments, can become multidrug resistant, and is often involved in nosocomial outbreaks in neonatal intensive care units (NICU). We evaluated the role of sinks during five suspected S. marcescens outbreaks in a NICU. An innovative approach combining molecular and culture methods was used to maximize the detection and typing of S. marcescens in the sink environment. Our results indicate multiple reservoirs of S. marcescens within the NICU, including patients, sink drains, and external sources. These results highlight the importance of sinks as a major reservoir of S. marcescens and potential sources of future outbreaks.
有充分的证据表明，从医院环境到新生儿重症监护病房（NICU）的患者，水槽环境对机会性病原体的传播有一定贡献。在这项研究中，研究了机会性病原体粘质沙雷氏菌在水槽环境和 NICU 新生儿中的分布。在 3 年的 5 次采样活动中，收集了超过 500 个水槽排水管和水龙头样本。使用改良的 MacConkey 培养基和高通量短序列分型（HiSST）方法检查了沙雷氏菌的分布和多样性。水槽排水管是沙雷氏菌的重要储库，平均有 44%的阳性样本，而没有水龙头样本呈阳性。沙雷氏菌的基因型多样性中等，每个排水管平均有两种基因型，而沙雷氏菌的空间分布不均匀。52 株临床分离株的基因型谱高度异质，有 27 种独特的基因型，其中 71%的分离株存在于不止一个患者中。首次爆发期间沙雷氏菌的获得主要是由水平传播引起的。HiSST 分析显示，有 10 例潜在的沙雷氏菌患者间传播病例，5 例患者-水槽传播病例，以及 1 例水槽-患者双向传播病例。首次检测后 1 年内，仍可在水槽排水管中检测到环境和临床分离株，支持持续的排水管定植。这项广泛的调查表明，NICU 中存在多个沙雷氏菌储库，包括患者和水槽排水管，但也应考虑其他外部来源。粘质沙雷氏菌是一种重要的机会性病原体，在许多环境中都能茁壮成长，可变得对多种药物具有耐药性，并且经常参与新生儿重症监护病房（NICU）的医院感染爆发。我们评估了水槽在 NICU 中五次疑似粘质沙雷氏菌爆发期间的作用。采用分子和培养方法相结合的创新方法，最大限度地提高了水槽环境中粘质沙雷氏菌的检测和分型。我们的结果表明，NICU 中有多个粘质沙雷氏菌储库，包括患者、水槽排水管和外部来源。这些结果突出了水槽作为粘质沙雷氏菌主要储库和未来爆发潜在来源的重要性。
