Zhang Xiang, Zhou Yu, Fu Lu, Zhou Lu, Cheng Xiangjun, Zhang Wei, Tan Zhongming
Department of Infection Management, The First Affiliated Hospital with Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu Province, People's Republic of China.
Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu Province, People's Republic of China.
Infect Drug Resist. 2024 Oct 3;17:4279-4289. doi: 10.2147/IDR.S473525. eCollection 2024.
is an opportunistic pathogen responsible for hospital-acquired infections (HAIs). The aim of this study was to describe an outbreak caused by infection in a neonatal intensive care unit (NICU) and provide investigation, prevention and control strategies for this outbreak.
We conducted an epidemiological investigation of the NICU outbreak, involving seven neonates, staff, and environmental screening, to identify the source of infection. WGS analyses were performed on isolates, including species identification, core genome single-nucleotide polymorphism (cgSNP) analysis, pan-genome analysis, and genetic characterization assessment of the prevalence of specific antibiotic resistance and virulence genes.
Eight strains were isolated from this outbreak, with seven from neonates and one from environment. Six clinical cases within three days in 2021 were linked to one strain isolated from environmental samples; isolates varied by 0-69 SNPs and were confirmed to be from an outbreak through WGS. Multiple infection prevention measures were implemented, including comprehensive environmental disinfection and stringent protocols, and all affected neonates were transferred to the isolation wards. Following these interventions, no further cases of infections were observed. Furthermore, pan-genome analysis results suggested that in human may exhibit host specificity.
The investigation has revealed that the outbreak was linked to the milk preparation workbench by the WGS. It is recommended that there be a stronger focus on environmental disinfection management in order to raise awareness, improve identification, and prevention of healthcare-associated infections that are associated with the hospital environment.
是一种导致医院获得性感染（HAIs）的机会致病菌。本研究的目的是描述新生儿重症监护病房（NICU）由感染引起的一次暴发，并为此次暴发提供调查、预防和控制策略。
我们对NICU的暴发进行了流行病学调查，涉及7名新生儿、工作人员以及环境筛查，以确定感染源。对分离株进行了全基因组测序（WGS）分析，包括菌种鉴定、核心基因组单核苷酸多态性（cgSNP）分析、泛基因组分析以及特定抗生素耐药性和毒力基因流行率的遗传特征评估。
从此次暴发中分离出8株菌株，7株来自新生儿，1株来自环境。2021年三天内的6例临床病例与从环境样本中分离出的1株菌株有关；分离株之间的单核苷酸多态性差异为0 - 69个，并通过WGS确认来自一次暴发。实施了多种感染预防措施，包括全面的环境消毒和严格的规程，所有受影响的新生儿都被转移到了隔离病房。采取这些干预措施后，未观察到进一步的感染病例。此外，泛基因组分析结果表明，在人类中可能表现出宿主特异性。
调查显示，此次暴发通过WGS与牛奶制备工作台有关。建议更加强化对环境消毒管理的关注，以提高认识，改进对与医院环境相关的医疗保健相关感染的识别和预防。
