Yang Jilin, Li Lingyi, Zhu Xiaolin, He Chen, Li Ting, Qin Jiahong, Wang Yijie
Department of Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China.
Department of Medical, Hangzhou Matridx Biotechnology Company, Hangzhou, People's Republic of China.
Infect Drug Resist. 2023 Aug 8;16:5121-5134. doi: 10.2147/IDR.S421702. eCollection 2023.
Surface pathogens in the ICU pose a global public health threat, especially to elderly patients who are immunocompromised. To detect these pathogens, unbiased methods such as metagenomic next-generation sequencing (mNGS) are increasingly utilized for environmental microbiological surveillance.
In a six-month study from January to July 2022, we investigated microbial communities in Chinese geriatric ICUs by regularly monitoring multiple surfaces at three-month intervals. Using mNGS sequencing, we analyzed microorganisms present at eight specific locations within the ICU. Additionally, we compared pathogen profiles and drug resistance genes between patient cultures and environmental samples collected during the same period.
The microbial composition remained relatively stable over time, but significant differences in alpha diversities were observed among various surfaces such as floors, hands, pumps, trolleys, and ventilator inlets/outlets. Surfaces with high contact frequency for healthcare workers, including workstations, ventilator panels, trolleys, pumps, and beds, harbored pathogenic microorganisms such as , , , , and . , particularly the carbapenem-resistant strain (CRAB), was the most frequently identified pathogen in geriatric ICU patients regardless of testing method used. The mNGS approach enabled detection of viruses, fungi, and parasites that are challenging to culture. Additionally, an abundance of drug resistance genes was found in almost all environmental samples.
The microbial composition and abundance in the ICU remained relatively constant over time. The floor exhibited the highest microbial diversity and abundance in the ICU environment. Drug-resistant genes in the ICU environment may migrate between patients. Overall, mNGS is an emerging and powerful tool for microbiological monitoring of the hospital environment.
重症监护病房（ICU）中的表面病原体构成全球公共卫生威胁，对免疫功能低下的老年患者尤其如此。为了检测这些病原体，诸如宏基因组下一代测序（mNGS）等无偏差方法越来越多地用于环境微生物监测。
在2022年1月至7月为期六个月的研究中，我们通过每三个月定期监测多个表面，对中国老年ICU中的微生物群落进行了调查。使用mNGS测序，我们分析了ICU内八个特定位置存在的微生物。此外，我们比较了同期患者培养物和环境样本之间的病原体谱和耐药基因。
微生物组成随时间保持相对稳定，但在地板、手部、泵、推车和呼吸机进出口等不同表面之间观察到α多样性存在显著差异。医护人员接触频率高的表面，包括工作站、呼吸机面板、推车、泵和病床，携带了诸如 、 、 、 和 等致病微生物。 ，尤其是耐碳青霉烯菌株（CRAB），无论使用何种检测方法，都是老年ICU患者中最常鉴定出的病原体。mNGS方法能够检测难以培养的病毒、真菌和寄生虫。此外，在几乎所有环境样本中都发现了大量耐药基因。
ICU中的微生物组成和丰度随时间保持相对恒定。地板在ICU环境中表现出最高的微生物多样性和丰度。ICU环境中的耐药基因可能在患者之间迁移。总体而言，mNGS是医院环境微生物监测的一种新兴且强大的工具。
