PDF(Pubmed)
Abstract：
Carbapenem-resistant Acinetobacter baumannii (CRAB) strains can cause severe and difficult-to-treat infections in patients with compromised general health. CRAB strains disseminate rapidly in nosocomial settings by patient-to-patient contact, through medical devices and inanimate reservoirs. The occurrence of CRAB in patients residing in the intensive care units (ICUs) of the Sahloul University hospital in Sousse, Tunisia is high. The objective of the current study was to determine whether the surfaces of items present in five ICU wards and the medical personnel there operating could serve as reservoirs for CRAB strains. Furthermore, CRAB isolates from patients residing in the ICUs during the sampling campaign were analyzed for genome comparison with isolates from the ICUs environment. Overall, 206 items were screened for CRAB presence and 27 (14%) were contaminated with a CRAB isolate. The items were located in several areas of three ICUs. Eight of the 54 (15%) screened people working in the wards were colonized by CRAB on the hands. Patients residing in the ICUs were infected with CRAB strains sharing extensive genomic similarity with strains recovered in the nosocomial environment. The strains belonged to three sub-clades of the internationally disseminated clone (ST2). A clone emerging in the Mediterranean basin (ST85) was detected as well. The strains were OXA-23 or NDM-1 producers and were also pan-aminoglycoside resistant due to the presence of the armA gene. Hygiene measures are urgent to be implemented in the Sahloul hospital to avoid further spread of difficult-to-treat CRAB strains and preserve health of patients and personnel operating in the ICU wards.
摘要：
耐碳青霉烯类鲍曼不动杆菌（CRAB）菌株可在整体健康受损的患者中引起严重且难以治疗的感染。CRAB菌株通过患者与患者的接触在医院环境中迅速传播，通过医疗设备和无生命的水库。居住在苏塞Sahloul大学医院重症监护病房（ICU）的患者中CRAB的发生，突尼斯很高。当前研究的目的是确定五个ICU病房中存在的物品表面以及在那里工作的医务人员是否可以作为CRAB菌株的储库。此外，分析了在采样活动期间居住在ICU中的患者的CRAB分离株，以与来自ICU环境的分离株进行基因组比较。总的来说,对206个项目进行了CRAB的筛选，其中27个（14％）被CRAB分离株污染。这些物品位于三个ICU的几个区域。在病房工作的54名接受筛查的人中有8名（15％）被手上的CRAB定居。居住在ICU中的患者感染了与在医院环境中恢复的菌株具有广泛的基因组相似性的CRAB菌株。这些菌株属于国际传播克隆（ST2）的三个子分支。还检测到在地中海盆地（ST85）出现的克隆。这些菌株是OXA-23或NDM-1生产者，并且由于armA基因的存在，也具有泛氨基糖苷抗性。Sahloul医院迫切需要采取卫生措施，以避免难以治疗的CRAB菌株进一步传播，并保护ICU病房中患者和工作人员的健康。
