Liu Ye, Wang Fang, Zhou Ziyuan, Liu Bowen, Wu Zhongwen, Pan Xiaxia
Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79, Qingchun Rd, Hangzhou, 310003, China.
Department of infectious diseases, Beilun District People's Hospital, Ningbo, 315800, Zhejiang, China.
Sci Rep. 2024 Dec 28;14(1):31301. doi: 10.1038/s41598-024-82659-2.
Hospital-acquired infection (HAI) and antimicrobial resistance (AMR) represent major challenges in healthcare system. Despite numerous studies have assessed environmental and patient samples, very few studies have explored the microbiome and resistome profiles of medical staff including nursing workers. This cross-sectional study was performed in a tertiary hospital in China and involved 25 nurses (NSs), 25 nursing workers (NWs), and 55 non-medical control (NC). Stool samples from all participants and hand samples (i.e., the microbiome sample from hand skin, which were collected by swabbing both hands with a sponge-swab soaked with neutralized buffer and centrifuging the liquid buffer) from NSs and NWs were collected for metagenomic analysis. Metagenomic analysis revealed that medical staff exhibited lower abundances of beneficial species such as Blautia, and Bifidobacterium in the gut microbiome. However, an important potential pathogen, Staphylococcus haemolyticus, was enriched in the hands of NWs, suggesting a considerable prevalence of pathogenesis and multi-drug resistance. Accordantly, ARG analysis revealed worse hand hygiene among NWs than among NSs, characterized by a higher diversity of ARGs and a higher abundance of ARGs conferring multi-drug resistance including mdtF, acrB, AcrF and evgS. This study provides a comprehensive overview of the microbial and ARG profiles in the gut and hands of NSs and NWs. The higher abundance of potential pathogens and diverse multi-drug resistant ARGs in NWs hands indicates insufficient hand hygiene and a higher risk of HAI in this subgroup. This study is the first to highlight the critical need to improve hand hygiene among NWs, thus mitigating the risks of AMR and HAI.
医院获得性感染(HAI)和抗菌药物耐药性(AMR)是医疗保健系统面临的重大挑战。尽管有许多研究评估了环境和患者样本,但很少有研究探索包括护理人员在内的医务人员的微生物组和耐药组概况。这项横断面研究在中国的一家三级医院进行,涉及25名护士(NSs)、25名护理工(NWs)和55名非医疗对照人员(NC)。收集了所有参与者的粪便样本以及NSs和NWs的手部样本(即手部皮肤的微生物组样本,通过用浸有中和缓冲液的海绵拭子擦拭双手并离心液体缓冲液来收集)用于宏基因组分析。宏基因组分析显示,医务人员肠道微生物组中有益菌如布劳特氏菌和双歧杆菌的丰度较低。然而,一种重要的潜在病原体——溶血葡萄球菌在NWs的手部富集,这表明发病机制和多重耐药性的患病率相当高。相应地,抗菌药物耐药基因(ARG)分析显示,NWs的手部卫生状况比NSs差,其特征是ARG多样性更高,以及赋予多重耐药性的ARG丰度更高,包括mdtF、acrB、AcrF和evgS。本研究全面概述了NSs和NWs肠道及手部的微生物和ARG概况。NWs手部潜在病原体丰度较高以及多种多重耐药性ARG表明该亚组手部卫生不足且HAI风险较高。本研究首次强调了改善NWs手部卫生的迫切需求,从而降低AMR和HAI的风险。