RISE Research Institutes of Sweden, Agriculture and Food, Borås, Sweden.
Essity Hygiene and Health AB, Gothenburg, Sweden.
PLoS One. 2023 Jul 7;18(7):e0287855. doi: 10.1371/journal.pone.0287855. eCollection 2023.
The hospital environment represents an important mediator for the transmission of healthcare-associated infections through direct and indirect hand contact with hard surfaces and textiles. In this study, bacteria on high-touch sites, including textiles and hard surfaces in two care wards in Sweden, were identified using microbiological culture methods and 16S rDNA sequencing. During a cross-sectional study, 176 high-touch hard surfaces and textiles were identified and further analysed using microbiological culture for quantification of total aerobic bacteria, Staphylococcus aureus, Clostridium difficile and Enterobacteriacae. The bacterial population structures were further analysed in 26 samples using 16S rDNA sequencing. The study showed a higher frequency of unique direct hand-textile contacts (36 per hour), compared to hard surfaces (2.2 per hour). Hard surfaces met the recommended standard of ≤ 5 CFU/cm2 for aerobic bacteria and ≤ 1 CFU/cm2 for S. aureus (53% and 35%, respectively) to a higher extent compared to textiles (19% and 30%, respectively) (P = 0.0488). The number of bacterial genera was higher on textiles than on the hard surfaces. Staphylococcus (30.4%) and Corynebacterium (10.9%) were the most representative genera for textiles and Streptococcus (13.3%) for hard surfaces. The fact that a big percentage of the textiles did not fulfil the criteria for cleanliness, combined with the higher bacterial diversity, compared to hard surfaces, are indicators that textiles were bacterial reservoirs and potential risk vectors for bacterial transmission. However, since most of the bacteria found in the study belonged to the normal flora, it was not possible to draw conclusions of textiles and hard surfaces as sources of healthcare associated infections.
医院环境是通过直接和间接的手部接触硬表面和纺织品传播医源性感染的重要媒介。在这项研究中，使用微生物培养方法和 16S rDNA 测序对瑞典两个护理病房的高接触点（包括纺织品和硬表面）上的细菌进行了鉴定。在一项横断面研究中，确定了 176 个高接触硬表面和纺织品，并使用微生物培养进一步分析了总需氧菌、金黄色葡萄球菌、艰难梭菌和肠杆菌的定量。使用 16S rDNA 测序进一步分析了 26 个样本的细菌种群结构。研究表明，与硬表面（每小时 2.2 次）相比，直接手-纺织品接触的频率更高（每小时 36 次）。硬表面的需氧菌数量符合推荐标准（≤ 5 CFU/cm2），金黄色葡萄球菌（≤ 1 CFU/cm2）（分别为 53%和 35%），而纺织品的符合程度较低（分别为 19%和 30%）（P = 0.0488）。纺织品上的细菌属数量高于硬表面。葡萄球菌（30.4%）和棒状杆菌（10.9%）是纺织品最具代表性的属，而链球菌（13.3%）是硬表面最具代表性的属。由于很大一部分纺织品不符合清洁标准，而且与硬表面相比，细菌多样性更高，这表明纺织品是细菌的储存库，也是细菌传播的潜在风险载体。然而，由于研究中发现的大多数细菌都属于正常菌群，因此无法得出纺织品和硬表面是医源性感染来源的结论。
