Valzano Felice, Coda Anna Rita Daniela, Liso Arcangelo, Arena Fabio
Department of Clinical and Experimental Medicine, University of Foggia, Via Napoli 20, 71122 Foggia, Italy.
Department of Medical and Surgical Sciences, University of Foggia, Via Napoli 20, 71122 Foggia, Italy.
Microorganisms. 2024 Jan 10;12(1):136. doi: 10.3390/microorganisms12010136.
Antimicrobial resistance (AMR) poses several issues concerning the management of hospital-acquired infections, leading to increasing morbidity and mortality rates and higher costs of care. Multidrug-resistant (MDR) bacteria can spread in the healthcare setting by different ways. The most important are direct contact transmission occurring when an individual comes into physical contact with an infected or colonized patient (which can involve healthcare workers, patients, or visitors) and indirect contact transmission occurring when a person touches contaminated objects or surfaces in the hospital environment. Furthermore, in recent years, toilets in hospital settings have been increasingly recognised as a hidden source of MDR bacteria. Different sites in restrooms, from toilets and hoppers to drains and siphons, can become contaminated with MDR bacteria that can persist there for long time periods. Therefore, shared toilets may play an important role in the transmission of nosocomial infections since they could represent a reservoir for MDR bacteria. Such pathogens can be further disseminated by bioaerosol and/or droplets potentially produced during toilet use or flushing and be transmitted by inhalation and contact with contaminated fomites. In this review, we summarize available evidence regarding the molecular features of MDR bacteria contaminating toilets of healthcare environments, with a particular focus on plumbing components and sanitary installation. The presence of bacteria with specific molecular traits in different toilet sites should be considered when adopting effective managing and containing interventions against nosocomial infections potentially due to environmental contamination. Finally, here we provide an overview of traditional and new approaches to reduce the spreading of such infections.
抗菌药物耐药性（AMR）给医院获得性感染的管理带来了诸多问题，导致发病率和死亡率不断上升，医疗成本增加。多重耐药（MDR）细菌可通过不同途径在医疗环境中传播。其中最重要的是直接接触传播，即个体与感染或定植的患者发生身体接触时（可能涉及医护人员、患者或访客），以及间接接触传播，即人接触医院环境中被污染的物体或表面时。此外，近年来，医院环境中的厕所越来越被认为是MDR细菌的一个隐藏来源。卫生间的不同部位，从马桶、排水口到下水道和虹吸管，都可能被MDR细菌污染，这些细菌可在那里长期存活。因此，共用厕所可能在医院感染的传播中起重要作用，因为它们可能是MDR细菌的一个储存库。此类病原体可通过使用厕所或冲水过程中可能产生的生物气溶胶和/或飞沫进一步传播，并通过吸入和接触受污染的污染物而传播。在本综述中，我们总结了有关污染医疗环境厕所的MDR细菌分子特征的现有证据，特别关注管道部件和卫生设施。在采取针对可能因环境污染导致的医院感染的有效管理和控制干预措施时，应考虑不同厕所部位存在具有特定分子特征的细菌。最后，我们在此概述减少此类感染传播的传统方法和新方法。
