医院水槽生物膜的细菌再定植。

IF 3.9 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection Pub Date : 2025-06-02 DOI:10.1016/j.jhin.2025.05.013

H.G. Healy , E. Pawluk , L. Dieter , S.C. Roberts , W. Tanner , T. Mathew , D. Peaper , R.A. Martinello , J. Peccia

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引用次数: 0

摘要

背景：众所周知，医院水槽排水沟是导致医疗保健相关感染（HAIs）的许多病原体的宿主。排水管细菌可以迁移到排水管盖上，然后在水槽使用过程中通过液滴扩散传播到周围表面和患者。因此，清洁水槽表面是限制排水管和患者之间传播的关键干预策略。在这项研究中，我们的目的是：(i)表征微生物群落的分类和水槽成分的丰度；（ii）评估清洁后细菌重新定殖到水槽表面的动力学和来源。方法：对美国康涅狄格州纽黑文市医院水槽的排水管、排水管盖、水槽盆、饮用水和p-疏水阀液（251例）在干预表面清洁/消毒前后进行取样。通过培养计数、数字液滴PCR、MALDI-ToF和16S rRNA基因扩增子测序来评估细菌丰度和分类。结果：排水生物膜细菌丰度中位数分别为1.80 × 108个16S rRNA基因拷贝/cm2和2.06 × 106个CFU/cm2，与水槽表面细菌丰度相关。走廊水槽比病房水槽使用频率更高，细菌丰度更高。下水道微生物群落以Novosphingobium和Sphingobium为主，检出不动杆菌、假单胞菌、军团菌和窄养单胞菌。水槽表面有丰富的分枝杆菌、甲基细菌-甲基蓝菌和鞘菌，以及皮肤微生物群常见的属（如棒状杆菌、葡萄球菌、链球菌）。在清洁/消毒后，通常无法在排水盖上检测到可培养细菌；细菌基因拷贝数减少，但在24小时内反弹到清洁前水平的80%以上。7 d后，9.2%的再定殖细菌来自排水管，15.7%来自自来水。结论：本研究有助于了解医院水槽表面病原菌丰度的影响因素和常规清洁消毒的局限性。

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Bacterial recolonization of hospital sink biofilms

Background

Hospital sink drains are known reservoirs for many pathogens that cause healthcare-associated infections (HAIs). Drain bacteria can migrate up to the drain cover and then spread to surrounding surfaces and patients through droplet dispersal during sink use. Therefore, cleaning sink surfaces represents a key intervention strategy to limit transmission between drains and patients.

Aims

In this study, we aimed to: (1) characterize microbial community taxonomy and abundance in sink components and (2) evaluate the kinetics and sources of bacterial recolonization onto sink surfaces after cleaning.

Methods

Drainpipes, drain covers, sink basins, drinking water, and p-trap liquid from hospital sinks in New Haven, CT, USA were sampled before and after intervention surface cleaning/disinfection (N = 251). Bacterial abundance and taxonomy were assessed via culture counts, digital droplet PCR, MALDI-ToF, and 16S rRNA gene amplicon sequencing.

Findings

Drain biofilms had median bacterial abundance of 1.80 × 10⁸ 16S rRNA gene copies/cm² and 2.06 × 10⁶ cfu/cm², which correlated with bacterial abundance on sink surfaces. Hallway sinks, which were used more frequently than patient room sinks, had higher bacterial abundance. Drain microbial communities largely consisted of novosphingobium and sphingobium, with detection of acinetobacter, pseudomonas, legionella, and stenotrophomonas. Sink surfaces had abundant mycobacterium, methylobacterium–methylorubrum, and sphingobium, as well as genera common to skin microbiomes (e.g., corynebacterium, staphylococcus, streptococcus). Immediately after cleaning/disinfection, culturable bacteria were generally undetectable on drain covers; bacterial gene copies were reduced but rebounded to over 80% of pre-cleaning levels within 24 h. After seven days, 9.2% of recolonizing bacteria were derived from drains, and 15.7% were from tap water.

Conclusion

This study contributes to our understanding of factors that influence pathogen abundance on hospital sink surfaces and limitations of routine cleaning and disinfection.

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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.