Birlutiu Victoria, Birlutiu Rares-Mircea, Ene Razvan, Rusu Dana
Faculty of Medicine, Lucian Blaga University of Sibiu, Str. Lucian Blaga, Nr. 2A, 550169 Sibiu, Romania.
Infectious Diseases Department, County Clinical Emergency Hospital, Bvd Corneliu Coposu, Nr. 2-4, 550245 Sibiu, Romania.
Microorganisms. 2025 Mar 28;13(4):775. doi: 10.3390/microorganisms13040775.
Skin microbiota plays a crucial role in host defense. Disruptions in this balance can lead to systemic infections. Colonization by pathogenic microorganisms significantly increases the risk of symptomatic infections, prolongs hospital stays and increases healthcare costs. In Romania, the widespread misuse of antibiotics in the community further complicates the management of bacterial resistance, emphasizing the need for proactive measures. Our institution implemented a comprehensive multi-body-site colonization screening protocol starting from January 2024 until June 2024. The screening targeted high-risk patients, including those in ICUs, Oncology, and Hematology Clinics, and individuals with prior hospitalizations, antibiotic use, or medical devices. This study aimed to investigate the prevalence of colonization by multidrug-resistant organisms upon hospital admission and assess the changes in colonization rates during hospitalization. Samples from nasal, axillary, inguinal, and rectal swabs were processed on specialized chromogenic media to detect multidrug-resistant organisms such as methicillin-resistant (MRSA), ESBL-producing , and carbapenemase-producing bacteria. During the first two trimesters of the year 2024, 1522 patients aged 14 to 99 years underwent multi-body-site colonization screening at the County Clinical Emergency Hospital Sibiu, Romania. A total of 18,993 samples were analyzed, yielding a diverse range of bacterial isolates. The most common results were -ESBL-negative (3584 cases, 18.9%) and the KESC bacteria group ( spp., spp., spp., and spp.)-MDR-negative (3435 cases, 18.1%). Conversely, positive results were less frequent, with -MDR-positive results in 62 cases (0.3%), -ESBL-positive results in 342 cases (1.8%), and KESC group-MDR-positive results in 491 cases (2.6%). Other notable findings included -VRE-positive (157 cases, 0.8%) and MRSA-positive nasal swabs (141 cases, 0.7%). Rare isolates included -VRE-positive (4 cases, 0.0%) and Proteeae group-MDR-positive (33 cases, 0.2%). Negative screening for MRSA was prevalent across nasal (1850 cases, 9.7%), inguinal (742 cases, 3.9%), and axillary swabs (1124 cases, 5.9%), with substantially lower positive rates. The diversity of swab types and their distribution across various clinics and departments underscores the broad diagnostic approaches and patient-care strategies adopted during the study. These findings highlight the need for tailored infection prevention strategies and continuous surveillance to mitigate the spread of multidrug-resistant organisms and enhance patient safety across diverse clinical environments.
皮肤微生物群在宿主防御中起着至关重要的作用。这种平衡的破坏会导致全身感染。病原微生物的定植会显著增加出现症状性感染的风险，延长住院时间并增加医疗成本。在罗马尼亚，社区中抗生素的广泛滥用使细菌耐药性的管理更加复杂，这凸显了采取积极措施的必要性。我们机构从2024年1月至2024年6月实施了一项全面的多部位定植筛查方案。筛查针对高危患者，包括重症监护病房、肿瘤科和血液科诊所的患者，以及有过住院史、使用过抗生素或使用过医疗设备的个体。本研究旨在调查入院时多重耐药菌的定植率，并评估住院期间定植率的变化。采集鼻、腋窝、腹股沟和直肠拭子样本，在专门的显色培养基上进行处理，以检测多重耐药菌，如耐甲氧西林金黄色葡萄球菌（MRSA）、产超广谱β-内酰胺酶（ESBL）菌和产碳青霉烯酶细菌。在2024年的前两个季度，罗马尼亚锡比乌县临床急救医院对1522名年龄在14至99岁的患者进行了多部位定植筛查。共分析了18993个样本，分离出了多种细菌。最常见的结果是ESBL阴性（3584例，18.9%）和KESC菌群（肺炎克雷伯菌属、大肠埃希菌属、奇异变形杆菌属和阴沟肠杆菌属）多重耐药阴性（3435例，18.1%）。相反，阳性结果较少，MRSA多重耐药阳性结果62例（0.3%），ESBL阳性结果342例（1.8%），KESC菌群多重耐药阳性结果491例（2.6%）。其他显著发现包括耐万古霉素肠球菌（VRE）阳性（157例，0.8%）和鼻拭子MRSA阳性（141例，0.7%）。罕见分离株包括VRE阳性（4例，0.0%）和变形杆菌属多重耐药阳性（33例，0.2%）。鼻拭子（1850例，9.7%）、腹股沟拭子（742例，3.9%）和腋窝拭子（1124例，5.9%）中MRSA阴性筛查普遍，阳性率低得多。拭子类型的多样性及其在不同诊所和科室的分布强调了研究期间采用的广泛诊断方法和患者护理策略。这些发现凸显了需要制定针对性的感染预防策略并持续监测以减轻多重耐药菌的传播，并在不同临床环境中提高患者安全性。
