Pérez Jiménez Jesús Antonio, Penelo Hidalgo Silvia, Baquero Artigao María-Rosario, Ortiz-Díez Gustavo, Ayllón Santiago Tania
Facultad de Ciencias de la Salud, Universidad Alfonso X el Sabio, Madrid, Spain.
Servicio de Urgencias, Hospitalización y UCI, Hospital Clínico Veterinario Complutense, Universidad Complutense de Madrid, Madrid, Spain.
Environ Microbiol Rep. 2024 Dec;16(6):e70055. doi: 10.1111/1758-2229.70055.
Managing infections caused by multidrug-resistant Gram-negative bacilli is a major public health concern, particularly in hospitals where surfaces can act as reservoirs for resistant microorganisms. Identifying these bacteria in hospital environments is crucial for improving healthcare safety. This study aimed to analyse environmental samples from a veterinary hospital to identify prevalent microorganisms and detect antimicrobial resistance patterns. A total of 183 surface samples were collected from 26 areas at the Veterinary Clinical Hospital of Alfonso X el Sabio University in Madrid. The isolated strains were identified, and susceptibility profiles were determined via the disk diffusion method. Clonality analysis was performed using pulsed-field gel electrophoresis. In total, 109 strains were isolated: 76.15% from the Enterobacteriaceae family and 23.85% non-fermenting Gram-negative bacilli. The isolates included Klebsiella, Enterobacter, Escherichia and Pseudomonas species, which could include high-risk clones, given their ability to carry several antimicrobial resistance genes. The equine area had the highest number of isolates (n = 71), accounting for 65% of the total. High resistance indices were observed against at least five of the 16 antibiotics tested, indicating significant multidrug resistance. Clonality analysis suggested potential cross-transmission within the facility. This study sampled hospital surfaces but not personnel or animals, making contamination sources unclear. Without resampling, the effectiveness of cleaning protocols remains uncertain. Results suggest that hospital staff play a key role in bacterial transmission. The lack of specialised preventive measures in veterinary hospitals highlights a need for further research and improvement.
应对耐多药革兰氏阴性杆菌引起的感染是一个重大的公共卫生问题，在医院尤其如此，因为医院环境表面可能成为耐药微生物的储存库。在医院环境中识别这些细菌对于提高医疗安全至关重要。本研究旨在分析一家兽医医院的环境样本，以识别流行的微生物并检测抗菌药物耐药模式。从马德里阿方索十世·智者大学兽医临床医院的26个区域共采集了183份表面样本。对分离出的菌株进行鉴定，并通过纸片扩散法确定药敏谱。使用脉冲场凝胶电泳进行克隆性分析。总共分离出109株菌株：76.15%来自肠杆菌科，23.85%为非发酵革兰氏阴性杆菌。分离株包括克雷伯菌属、肠杆菌属、大肠杆菌属和假单胞菌属，鉴于它们携带多种抗菌药物耐药基因的能力，可能包括高风险克隆。马区的分离株数量最多（n = 71），占总数的65%。在测试的16种抗生素中，至少对其中5种观察到高耐药指数，表明存在显著的多重耐药性。克隆性分析表明该设施内可能存在交叉传播。本研究对医院表面进行了采样，但未对人员或动物进行采样，因此污染源不明。在未重新采样的情况下，清洁方案的有效性仍不确定。结果表明医院工作人员在细菌传播中起关键作用。兽医医院缺乏专门的预防措施，凸显了进一步研究和改进的必要性。
