葡萄牙长期和急性医疗保健机构室内空气的多药耐药性评估。

IF 3.9 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection Pub Date : 2025-02-19 DOI:10.1016/j.jhin.2025.02.005

C. Santos-Marques , C. Teixeira , R. Pinheiro , W.M. Brück , S. Gonçalves Pereira

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引用次数: 0

摘要

背景：除医院外，卫生保健单位对空气作为病原体池和多药耐药（MDR）的了解很少。目的：目前的研究旨在描绘这些特点在葡萄牙长期医疗保健单位（LTHU）和中心医院（CH）。方法：采集空气样品，测定其微生物负荷（细菌和真菌）。随机选择分离的细菌进行进一步的鉴定，特别是通过基质辅助激光解吸/电离飞行时间（MALDI-TOF）质谱，抗菌药敏试验和pcr筛选扩展谱β -内酰胺酶，碳青霉烯酶基因和mecA基因进行鉴定，并对后者的阳性结果进行RAPD分析。结果：共收集192份样本(LTHU: n=86；CH: n = 106)。LTHU的细菌载量有统计学意义。住院区CH细菌和真菌负荷显著低于门诊区和非住院区。共分离出164株细菌(MALDI-TOF: n=78；推测：n=86)，大多数属于葡萄球菌属(LTHU: n=42；CH: n = 57)。两种情况下，对红霉素的耐药率最高，对万古霉素的耐药率最低。18株（11%）为MDR (LTHU: n=9；CH: n=9)， MDR葡萄球菌分离株7株(LTHU: n=4；CH: n=3)表示mecA。值得注意的是，9株非耐多药葡萄球菌(LTHU: n=5；CH: n=4)也出现了mecA。结论：卫生单位室内空气可能是耐多药病原菌和耐药基因的重要来源。此外，LTHU的空气质量似乎比医院差，支持性地区的空气质量也比治疗护理地区差。这可能表明需要探索可能的未知感染途径。

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Multidrug resistance assessment of indoor air in Portuguese long-term and acute healthcare settings

Background

Knowledge about air as a pool of pathogens and multidrug resistance (MDR) in healthcare units apart from hospitals is scarce.

Aim

To investigate these features in a Portuguese long-term healthcare unit (LTHU) and a central hospital (CH).

Methods

Air samples were collected and their microbial load (bacteria and fungi) determined. Bacterial isolates were randomly selected for further characterization, particularly identification by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry, antimicrobial susceptibility testing, and polymerase chain reaction screening of extended-spectrum β-lactamases, carbapenemase genes and mecA gene, with RAPD profile assessment of positive results of the latter.

Findings

A total of 192 samples were collected (LTHU: 86; CH: 106). LTHU showed a statistically significantly higher bacterial load. CH bacteria and fungi loads in inpatient sites were statistically significantly lower than in outpatients or non-patient sites. A total of 164 bacterial isolates were identified (MALDI-TOF: 78; presumptively: 86), the majority belonging to Staphylococcus genus (LTHU: 42; CH: 57). The highest antimicrobial resistance rate was to erythromycin and vancomycin the least, in both settings. Eighteen isolates (11%) were classified as MDR (LTHU: 9; CH: 9), with 7 MDR Staphylococcus isolates (LTHU: 4; CH: 3) presenting mecA. Nine non-MDR Staphylococcus (LTHU: 5; CH: 4) also presented mecA.

Conclusion

The current study highlights that healthcare unit indoor air can be an important pool of MDR pathogens and antimicrobial resistance genes. Also, LTHUs appear to have poorer air quality than hospitals, as well as supportive areas compared to curative care areas. This may suggest possible yet unknown routes of infection that need to be explored.

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来源期刊

Journal of Hospital Infection 医学-传染病学

CiteScore

12.70

自引率

5.80%

发文量

271

审稿时长

19 days

期刊介绍： The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience. The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that: provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings; provide new insight into cleaning, disinfection and decontamination; provide new insight into the design of healthcare premises; describe novel aspects of outbreaks of infection; throw light on techniques for effective antimicrobial stewardship; describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control; improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change; improve understanding of the use of IT systems in infection surveillance and prevention and control.