Department of Environmental Health Engineering, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran.
Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
J Infect Public Health. 2024 Jul;17(7):102469. doi: 10.1016/j.jiph.2024.102469. Epub 2024 May 31.
In recent years, the global spread of antimicrobial resistance has become a concerning issue, often referred to as a "silent pandemic". Healthcare-associated infections (HAIs) caused by antibiotic-resistant bacteria (ARB) are a recurring problem, with some originating from waterborne route. The study aimed to investigate the presence of clinically relevant opportunistic bacteria and antibiotic resistance genes (ARGs) in hospital water distribution systems (WDSs).
Water and biofilm samples (n = 192) were collected from nine hospitals in Isfahan and Kashan, located in central Iran, between May 2022 and June 2023. The samples were analyzed to determine the presence and quantities of opportunistic bacteria and ARGs using cultural and molecular methods.
Staphylococcus spp. were highly detected in WDS samples (90 isolates), with 33 % of them harboring mecA gene. However, the occurrences of E. coli (1 isolate), Acinetobacter baumannii (3 isolates), and Pseudomonas aeruginosa (14 isolates) were low. Moreover, several Gram-negative bacteria containing ARGs were identified in the samples, mainly belonging to Stenotrophomonas, Sphingomonas and Brevundimonas genera. Various ARGs, as well as intI1, were found in hospital WDSs (ranging from 14 % to 60 %), with higher occurrences in the biofilm samples.
Our results underscore the importance of biofilms in water taps as hotspots for the dissemination of opportunistic bacteria and ARG within hospital environments. The identification of multiple opportunistic bacteria and ARGs raises concerns about the potential exposure and acquisition of HAIs, emphasizing the need for proactive measures, particularly in controlling biofilms, to mitigate infection risks in healthcare settings.
近年来，抗菌药物耐药性在全球范围内的传播已成为一个令人关注的问题，通常被称为“无声的大流行”。由耐药菌（ARB）引起的与医疗保健相关的感染（HAI）是一个反复出现的问题，其中一些源自水源。本研究旨在调查医院供水系统（WDS）中临床相关机会性细菌和抗生素耐药基因（ARGs）的存在情况。
本研究于 2022 年 5 月至 2023 年 6 月期间在伊朗中部的伊斯法罕和卡尚的 9 家医院采集了 192 份水和生物膜样本。使用培养和分子方法分析样本，以确定机会性细菌和 ARGs 的存在和数量。
WDS 样本中高度检测到葡萄球菌属（Staphylococcus spp.）（90 株），其中 33%的菌株携带 mecA 基因。然而，仅检测到 1 株大肠埃希菌（E. coli）、3 株鲍曼不动杆菌（Acinetobacter baumannii）和 14 株铜绿假单胞菌（Pseudomonas aeruginosa）。此外，在样本中还鉴定出几种含有 ARGs 的革兰氏阴性菌，主要属于嗜麦芽窄食单胞菌属（Stenotrophomonas）、鞘氨醇单胞菌属（Sphingomonas）和短小芽孢杆菌属（Brevundimonas）。在医院 WDS 中发现了各种 ARGs，以及 intI1，其发生率在 14%至 60%之间，生物膜样本中的发生率更高。
本研究结果强调了生物膜在水嘴中作为医院环境中机会性细菌和 ARG 传播热点的重要性。鉴定出多种机会性细菌和 ARGs 引起了人们对潜在的 HAIs 暴露和获得的关注，强调需要采取积极措施，特别是在控制生物膜方面，以减轻医疗保健环境中的感染风险。
