Ben-Amram Hila, Azrad Maya, Cohen-Assodi Jackie, Sharabi-Nov Adi, Edelstein Shimon, Agay-Shay Keren, Peretz Avi
Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
The Clinical Microbiology Laboratory, Ziv Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
J Epidemiol Glob Health. 2024 Jun;14(2):291-297. doi: 10.1007/s44197-024-00215-7. Epub 2024 Apr 2.
Hospital-acquired resistant infections (HARI) are infections, which develop 48 h or more after admission to a healthcare facility. HARI pose a considerably acute challenge, due to limited treatment options. These infections are associated bacterial biofilms, which act as a physical barrier to diverse external stresses, such as desiccation, antimicrobials and biocides. We assessed the influence of multiple factors on biofilm production by HARI -associated bacteria.
Bacteria were isolated from samples of patients with respiratory HARI who were hospitalized during 2020-2022 in north Israel. Following antibiotic susceptibility testing by disc diffusion or broth microdilution, biofilm formation capacities of resistant bacteria (methicillin-resistant staphylococcus aureus, extended spectrum beta-lactamase-producing Escherichia coli and Klebsiela pneumonia, and multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii) was assessed using the crystalline violet staining method. Data regarding season, time to infection, bacterial species, patient age and gender, year, and medical department were collected from the patient medical records.
Among the 226 study isolates, K. pneumonia was the most prevalent (35.4%) bacteria, followed by P. aeruginosa (23.5%), and methicillin-resistant staphylococcus aureus (MRSA) (21.7%). A significantly higher rate of HARI was documented in 2022 compared to 2020-2021. The majority of isolates (63.3%) were strong biofilm producers, with K. pneumonia (50.3%) being most dominant, followed by P. aeruginosa (29.4%). Biofilm production strength was significantly affected by seasonality and hospitalization length, with strong biofilm production in autumn and in cases where hospitalization length exceeded 30 days.
Biofilm production by HARI bacteria is influenced by bacterial species, season and hospitalization length.
医院获得性耐药感染（HARI）是指在入住医疗机构48小时或更长时间后发生的感染。由于治疗选择有限，HARI构成了相当严峻的挑战。这些感染与细菌生物膜有关，细菌生物膜对多种外部压力（如干燥、抗菌药物和杀菌剂）起到物理屏障的作用。我们评估了多种因素对HARI相关细菌生物膜形成的影响。
从2020年至2022年期间在以色列北部住院的呼吸道HARI患者的样本中分离细菌。通过纸片扩散法或肉汤微量稀释法进行抗生素敏感性测试后，使用结晶紫染色法评估耐药细菌（耐甲氧西林金黄色葡萄球菌、产超广谱β-内酰胺酶的大肠杆菌和肺炎克雷伯菌，以及多重耐药铜绿假单胞菌和鲍曼不动杆菌）的生物膜形成能力。从患者病历中收集有关季节、感染时间、细菌种类、患者年龄和性别、年份以及医疗科室的数据。
在226株研究分离株中，肺炎克雷伯菌是最常见的细菌（35.4%），其次是铜绿假单胞菌（23.5%）和耐甲氧西林金黄色葡萄球菌（MRSA）（21.7%）。与2020年至2021年相比，2022年记录的HARI发生率显著更高。大多数分离株（63.3%）是强生物膜产生菌，其中肺炎克雷伯菌（50.3%）最为占主导地位，其次是铜绿假单胞菌（29.4%）。生物膜产生强度受季节和住院时间的显著影响，秋季以及住院时间超过30天的情况下生物膜产生较强。
HARI细菌的生物膜形成受细菌种类、季节和住院时间的影响。
