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Boutin S, Scherrer M, Späth I, Kocer K, Heeg K, Nurjadi D. Cross-contamination of carbapenem-resistant Gram-negative bacteria between patients and the hospital environment in the first year of a newly built surgical ward. J Hosp Infect 2024; 144:118-127. [PMID: 38081456 DOI: 10.1016/j.jhin.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/06/2023] [Accepted: 11/20/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Transmission and outbreaks of carbapenem-resistant Gram-negative bacteria (CRGN) in hospitals are often associated with contamination of the wastewater environment. We performed a prospective observational study to investigate the colonization of the hospital wastewater environment during the first year of occupancy of the surgical intermediate and intensive care units of a newly constructed building at the University Hospital of Heidelberg, Germany. METHODS We performed monthly screening of the wastewater system (toilets and sinks) for 12 months, starting 1 month before opening (1st October 2020 to 30th October 2021). Admission and weekly rectal screening of patients for CRGN were also performed in parallel. Bacterial isolates were characterized by whole-genome sequencing. RESULTS Twenty-seven of 1978 (1.4%) admitted patients were colonized/infected with CRGN. A total of 29 CRGN isolates from 24 patients and 52 isolates were available for sequencing. Within the first month of occupancy, we identified seven patients colonized/infected with CRGN, while none were found in the environmental reservoirs. The first detection of CRGN isolates in the sewage system started five months after the first occupancy. Two previously non-colonized patients were colonized/infected with Pseudomonas aeruginosa strains colonizing the sewage system. The significant identity of plasmids carrying the carbapenemase gene suggests that long-term colonization of the sewage system facilitates the emergence of new carbapenem-resistant clones. CONCLUSION Cross-contamination between patients and the hospital environment is bidirectional. Our study demonstrated that contamination of the hospital wastewater environment may lead to persistent colonization and may serve as a reservoir for nosocomial acquisition of CRGN.
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Affiliation(s)
- S Boutin
- University of Lübeck and University Medical Center Schleswig-Holstein, Department of Infectious Diseases and Microbiology, Lübeck, Germany; Heidelberg University Hospital, Department of Medical Microbiology and Hygiene, Heidelberg, Germany
| | - M Scherrer
- Heidelberg University Hospital, Department of Medical Microbiology and Hygiene, Heidelberg, Germany
| | - I Späth
- Heidelberg University Hospital, Department of Medical Microbiology and Hygiene, Heidelberg, Germany
| | - K Kocer
- Heidelberg University Hospital, Department of Medical Microbiology and Hygiene, Heidelberg, Germany
| | - K Heeg
- Heidelberg University Hospital, Department of Medical Microbiology and Hygiene, Heidelberg, Germany
| | - D Nurjadi
- University of Lübeck and University Medical Center Schleswig-Holstein, Department of Infectious Diseases and Microbiology, Lübeck, Germany; Heidelberg University Hospital, Department of Medical Microbiology and Hygiene, Heidelberg, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Germany.
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2
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Cullom A, Spencer MS, Williams MD, Falkinham JO, Brown C, Edwards MA, Pruden A. Premise Plumbing Pipe Materials and In-Building Disinfectants Shape the Potential for Proliferation of Pathogens and Antibiotic Resistance Genes. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:21382-21394. [PMID: 38071676 DOI: 10.1021/acs.est.3c05905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
In-building disinfectants are commonly applied to control the growth of pathogens in plumbing, particularly in facilities such as hospitals that house vulnerable populations. However, their application has not been well optimized, especially with respect to interactive effects with pipe materials and potential unintended effects, such as enrichment of antibiotic resistance genes (ARGs) across the microbial community. Here, we used triplicate convectively mixed pipe reactors consisting of three pipe materials (PVC, copper, and iron) for replicated simulation of the distal reaches of premise plumbing and evaluated the effects of incrementally increased doses of chlorine, chloramine, chlorine dioxide, and copper-silver disinfectants. We used shotgun metagenomic sequencing to characterize the resulting succession of the corresponding microbiomes over the course of 37 weeks. We found that both disinfectants and pipe material affected ARG and microbial community taxonomic composition both independently and interactively. Water quality and total bacterial numbers were not found to be predictive of pathogenic species markers. One result of particular concern was the tendency of disinfectants, especially monochloramine, to enrich ARGs. Metagenome assembly indicated that many ARGs were enriched specifically among the pathogenic species. Functional gene analysis was indicative of a response of the microbes to oxidative stress, which is known to co/cross-select for antibiotic resistance. These findings emphasize the need for a holistic evaluation of pathogen control strategies for plumbing.
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Affiliation(s)
- Abraham Cullom
- Civil and Environmental Engineering, Virginia Tech, 1145 Perry St., 418 Durham Hall, Blacksburg, Virginia 24061, United States
| | - Matheu Storme Spencer
- Civil and Environmental Engineering, Virginia Tech, 1145 Perry St., 418 Durham Hall, Blacksburg, Virginia 24061, United States
| | - Myra D Williams
- Department of Biological Sciences, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Joseph O Falkinham
- Department of Biological Sciences, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Connor Brown
- Department of Genetics, Bioinformatics, and Computational Biology, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Marc A Edwards
- Civil and Environmental Engineering, Virginia Tech, 1145 Perry St., 418 Durham Hall, Blacksburg, Virginia 24061, United States
| | - Amy Pruden
- Civil and Environmental Engineering, Virginia Tech, 1145 Perry St., 418 Durham Hall, Blacksburg, Virginia 24061, United States
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Omar H, Hambidge M, Firmanes B, Shabandri AM, Wilsher S. Bacteria isolated from equine uteri in The United Arab Emirates: A retrospective study. J Equine Vet Sci 2022; 115:104029. [PMID: 35659620 DOI: 10.1016/j.jevs.2022.104029] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/25/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022]
Abstract
The United Arab Emirates (UAE) presents a unique environment in which to breed horses with a non-physiological breeding season coupled with high temperatures and humidity for much of the year. This study aimed to describe bacterial isolates from the uteri of mares in the UAE and compare them to those reported elsewhere in the world. Bacterial antibiotic resistance was also analysed to give a starting point for future monitoring. A total of 2022 swabs taken over 5 breeding seasons from the endometrium (n = 1350) or from uterine lavages (n = 672) were submitted for microbiological culture and antibiotic sensitivity testing. At 48h post inoculation 616/2022 (30.5%) of cultures showed microbial growth from which 690 isolates were identified. Most positive plates (548/616; 89%) grew one isolate; 68 cultures had two (62/616; 10.1%) or three (6/616; 1%) isolates. The most frequently isolated bacteria were β-haemolytic Streptococcus (36.5%; 252/690), E. coli (10.6%; 73/690), P. aeruginosa (10.1%; 70/690), K. pneumoniae (8.8%; 61/690) and Aeromonas hydrophila (4.1%; 28/690). The lowest level of antibiotic susceptibility for all isolates was shown by trimethoprim-sulphonamide (36.4%; 198/544), with amikacin showing the highest (76.1%; 271/356). A significant decrease in susceptibility to doxycycline, enrofloxacin and erythromycin, but a significant increase for amoxicillin with clavulanic acid, was seen for β-haemolytic Streptococcus. Decreasing susceptibility of trimethoprim-sulphonamide between two time periods was seen for E. coli. Compared to other studies UAE-based mares had a high incidence of P. aeruginosa and K. pneumoniae isolates, whereas E. coli was represented far less frequently as an isolate.
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Affiliation(s)
- Hussein Omar
- Sharjah Equine Hospital, Al Dhaid Road, Bridge No.6, Al Atain Area, Sharjah, UAE
| | - Margaret Hambidge
- Sharjah Equine Hospital, Al Dhaid Road, Bridge No.6, Al Atain Area, Sharjah, UAE
| | - Bernadette Firmanes
- Sharjah Equine Hospital, Al Dhaid Road, Bridge No.6, Al Atain Area, Sharjah, UAE
| | - Abdul M Shabandri
- Sharjah Equine Hospital, Al Dhaid Road, Bridge No.6, Al Atain Area, Sharjah, UAE
| | - Sandra Wilsher
- Sharjah Equine Hospital, Al Dhaid Road, Bridge No.6, Al Atain Area, Sharjah, UAE.
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4
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Sukhum KV, Newcomer EP, Cass C, Wallace MA, Johnson C, Fine J, Sax S, Barlet MH, Burnham CAD, Dantas G, Kwon JH. Antibiotic-resistant organisms establish reservoirs in new hospital built environments and are related to patient blood infection isolates. COMMUNICATIONS MEDICINE 2022; 2:62. [PMID: 35664456 PMCID: PMC9160058 DOI: 10.1038/s43856-022-00124-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 05/06/2022] [Indexed: 02/03/2023] Open
Abstract
Background Healthcare-associated infections due to antibiotic-resistant organisms pose an acute and rising threat to critically ill and immunocompromised patients. To evaluate reservoirs of antibiotic-resistant organisms as a source of transmission to patients, we interrogated isolates from environmental surfaces, patient feces, and patient blood infections from an established and a newly built intensive care unit. Methods We used selective culture to recover 829 antibiotic-resistant organisms from 1594 environmental and 72 patient fecal samples, in addition to 81 isolates from blood cultures. We conducted antibiotic susceptibility testing and short- and long-read whole genome sequencing on recovered isolates. Results Antibiotic-resistant organism burden is highest in sink drains compared to other surfaces. Pseudomonas aeruginosa is the most frequently cultured organism from surfaces in both intensive care units. From whole genome sequencing, different lineages of P. aeruginosa dominate in each unit; one P. aeruginosa lineage of ST1894 is found in multiple sink drains in the new intensive care unit and 3.7% of blood isolates analyzed, suggesting movement of this clone between the environment and patients. Conclusions These results highlight antibiotic-resistant organism reservoirs in hospital built environments as an important target for infection prevention in hospitalized patients.
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Affiliation(s)
- Kimberley V. Sukhum
- The Edison Family Center for Genome Sciences and Systems Biology, Washington University School of Medicine in St Louis, St Louis, MO USA
- Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Erin P. Newcomer
- The Edison Family Center for Genome Sciences and Systems Biology, Washington University School of Medicine in St Louis, St Louis, MO USA
- Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, MO USA
- Department of Biomedical Engineering, Washington University in St Louis, St Louis, MO USA
| | - Candice Cass
- Department of Medicine, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Meghan A. Wallace
- Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Caitlin Johnson
- Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Jeremy Fine
- Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Steven Sax
- Department of Medicine, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Margaret H. Barlet
- Department of Medicine, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Carey-Ann D. Burnham
- Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, MO USA
- Department of Medicine, Washington University School of Medicine in St Louis, St Louis, MO USA
- Department of Molecular Microbiology, Washington University School of Medicine in St Louis, St Louis, MO USA
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Gautam Dantas
- The Edison Family Center for Genome Sciences and Systems Biology, Washington University School of Medicine in St Louis, St Louis, MO USA
- Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, MO USA
- Department of Biomedical Engineering, Washington University in St Louis, St Louis, MO USA
- Department of Molecular Microbiology, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Jennie H. Kwon
- Department of Medicine, Washington University School of Medicine in St Louis, St Louis, MO USA
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Guo L, Wan K, Zhu J, Ye C, Chabi K, Yu X. Detection and distribution of vbnc/viable pathogenic bacteria in full-scale drinking water treatment plants. JOURNAL OF HAZARDOUS MATERIALS 2021; 406:124335. [PMID: 33160785 DOI: 10.1016/j.jhazmat.2020.124335] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 05/22/2023]
Abstract
Viable but non-culturable (VBNC) bacteria have attracted widespread attention since they are inherently undetected by traditional culture-dependent methods. Importantly, VBNC bacteria could resuscitate under favorable conditions leading to significant public health concerns. Although the total number of viable bacteria has been theorized to be far greater than those that can be cultured, there have been no reports quantifying VBNC pathogenic bacteria in full-scale drinking water treatment plants (DWTPs). In this work, we used both culture-dependent and quantitative PCR combination with propidium monoazide (PMA) dye approaches to characterize cellular viability. Further, we established a method to quantify viable pathogens by relating specific gene copies to viable cell numbers. Ratios of culturable bacteria to viable 16S rRNA gene copies in water and biological activated carbon (BAC) biofilms were 0-4.75% and 0.04-56.24%, respectively. The VBNC E. coli, E. faecalis, P. aeruginosa, Salmonella sp., and Shigella sp. were detected at levels of 0-103 cells/100 mL in source water, 0-102 cells/100 mL in chlorinated water, and 0-103 cells/g in BAC biofilms. In addition, differences between the total and viable community structures after ozonation and chlorination were investigated. The relative abundance of opportunistic pathogens such as Mycobacterium, Sphingomonas, etc. increased in final water, likely due to their chlorine resistance. In summary, we detected significant quantities of viable/VBNC opportunistic pathogens in full-scale DWTPs, confirming that traditional, culture-dependent methods are inadequate for detecting VBNC bacteria. These findings suggest a need to develop and implement rapid, accurate methods for the detection of VBNC pathogenic bacteria in DWTPs to ensure the safety of drinking water.
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Affiliation(s)
- Lizheng Guo
- Key Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Kun Wan
- Key Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | | | - Chengsong Ye
- College of Environment & Ecology, Xiamen University, Xiamen 361102, China
| | - Kassim Chabi
- Key Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xin Yu
- Key Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; College of Environment & Ecology, Xiamen University, Xiamen 361102, China.
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Moyne O, Castelli F, Bicout DJ, Boccard J, Camara B, Cournoyer B, Faudry E, Terrier S, Hannani D, Huot-Marchand S, Léger C, Maurin M, Ngo TD, Plazy C, Quinn RA, Attree I, Fenaille F, Toussaint B, Le Gouëllec A. Metabotypes of Pseudomonas aeruginosa Correlate with Antibiotic Resistance, Virulence and Clinical Outcome in Cystic Fibrosis Chronic Infections. Metabolites 2021; 11:metabo11020063. [PMID: 33494144 PMCID: PMC7909822 DOI: 10.3390/metabo11020063] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 02/07/2023] Open
Abstract
Pseudomonas aeruginosa (P.a) is one of the most critical antibiotic resistant bacteria in the world and is the most prevalent pathogen in cystic fibrosis (CF), causing chronic lung infections that are considered one of the major causes of mortality in CF patients. Although several studies have contributed to understanding P.a within-host adaptive evolution at a genomic level, it is still difficult to establish direct relationships between the observed mutations, expression of clinically relevant phenotypes, and clinical outcomes. Here, we performed a comparative untargeted LC/HRMS-based metabolomics analysis of sequential isolates from chronically infected CF patients to obtain a functional view of P.a adaptation. Metabolic profiles were integrated with expression of bacterial phenotypes and clinical measurements following multiscale analysis methods. Our results highlighted significant associations between P.a “metabotypes”, expression of antibiotic resistance and virulence phenotypes, and frequency of clinical exacerbations, thus identifying promising biomarkers and therapeutic targets for difficult-to-treat P.a infections
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Affiliation(s)
- Oriane Moyne
- Département de Biochimie, Faculté de médecine de Grenoble, CNRS, CHU Grenoble Alpes, University Grenoble Alpes, Grenoble INP*, TIMC-IMAG, 38000 Grenoble, France; (O.M.); (D.J.B.); (D.H.); (S.H.-M.); (C.L.); (M.M.); (C.P.); (B.T.)
| | - Florence Castelli
- Département Médicaments et Technologies pour la Santé (DMTS), University Paris-Saclay, CEA, INRAE, MetaboHUB, 91191 Gif sur Yvette, France; (F.C.); (S.T.); (F.F.)
| | - Dominique J. Bicout
- Département de Biochimie, Faculté de médecine de Grenoble, CNRS, CHU Grenoble Alpes, University Grenoble Alpes, Grenoble INP*, TIMC-IMAG, 38000 Grenoble, France; (O.M.); (D.J.B.); (D.H.); (S.H.-M.); (C.L.); (M.M.); (C.P.); (B.T.)
- Biomathematics and Epidemiology EPSP-TIMC, Veterinary Campus of Lyon, VetAgro Sup, 69280 Marcy l’Etoile, France
- Laue-Langevin Institute, Theory Group, 71 Avenue des Martyrs, 38042 Grenoble, France
| | - Julien Boccard
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, 1211 Geneva, Switzerland;
| | - Boubou Camara
- CHU Grenoble Alpes, Service Hospitalier Universitaire de Pneumologie, Centre de Compétence de la Mucoviscidose, 38000 Grenoble, France;
| | - Benoit Cournoyer
- Department of Veterinary and biological sciences, Université Claude Bernard Lyon 1, University Lyon 1, VetAgro Sup, UMR Ecologie Microbienne, CNRS 5557, INRA 1418, 69280 Marcy L’Etoile, France;
| | - Eric Faudry
- CEA, INSERM, CNRS, Bacterial Pathogenesis and Cellular Responses, University Grenoble Alpes, UMR 1036/ERL 5261, 17 avenue des Martyrs, 38054 Grenoble, France; (E.F.); (T.-D.N.); (I.A.)
| | - Samuel Terrier
- Département Médicaments et Technologies pour la Santé (DMTS), University Paris-Saclay, CEA, INRAE, MetaboHUB, 91191 Gif sur Yvette, France; (F.C.); (S.T.); (F.F.)
| | - Dalil Hannani
- Département de Biochimie, Faculté de médecine de Grenoble, CNRS, CHU Grenoble Alpes, University Grenoble Alpes, Grenoble INP*, TIMC-IMAG, 38000 Grenoble, France; (O.M.); (D.J.B.); (D.H.); (S.H.-M.); (C.L.); (M.M.); (C.P.); (B.T.)
| | - Sarah Huot-Marchand
- Département de Biochimie, Faculté de médecine de Grenoble, CNRS, CHU Grenoble Alpes, University Grenoble Alpes, Grenoble INP*, TIMC-IMAG, 38000 Grenoble, France; (O.M.); (D.J.B.); (D.H.); (S.H.-M.); (C.L.); (M.M.); (C.P.); (B.T.)
| | - Claire Léger
- Département de Biochimie, Faculté de médecine de Grenoble, CNRS, CHU Grenoble Alpes, University Grenoble Alpes, Grenoble INP*, TIMC-IMAG, 38000 Grenoble, France; (O.M.); (D.J.B.); (D.H.); (S.H.-M.); (C.L.); (M.M.); (C.P.); (B.T.)
| | - Max Maurin
- Département de Biochimie, Faculté de médecine de Grenoble, CNRS, CHU Grenoble Alpes, University Grenoble Alpes, Grenoble INP*, TIMC-IMAG, 38000 Grenoble, France; (O.M.); (D.J.B.); (D.H.); (S.H.-M.); (C.L.); (M.M.); (C.P.); (B.T.)
| | - Tuan-Dung Ngo
- CEA, INSERM, CNRS, Bacterial Pathogenesis and Cellular Responses, University Grenoble Alpes, UMR 1036/ERL 5261, 17 avenue des Martyrs, 38054 Grenoble, France; (E.F.); (T.-D.N.); (I.A.)
| | - Caroline Plazy
- Département de Biochimie, Faculté de médecine de Grenoble, CNRS, CHU Grenoble Alpes, University Grenoble Alpes, Grenoble INP*, TIMC-IMAG, 38000 Grenoble, France; (O.M.); (D.J.B.); (D.H.); (S.H.-M.); (C.L.); (M.M.); (C.P.); (B.T.)
| | - Robert A. Quinn
- Department of Biochemistry and Molecular Biology, Michigan State University, East Lansing, MI 48824, USA;
| | - Ina Attree
- CEA, INSERM, CNRS, Bacterial Pathogenesis and Cellular Responses, University Grenoble Alpes, UMR 1036/ERL 5261, 17 avenue des Martyrs, 38054 Grenoble, France; (E.F.); (T.-D.N.); (I.A.)
| | - François Fenaille
- Département Médicaments et Technologies pour la Santé (DMTS), University Paris-Saclay, CEA, INRAE, MetaboHUB, 91191 Gif sur Yvette, France; (F.C.); (S.T.); (F.F.)
| | - Bertrand Toussaint
- Département de Biochimie, Faculté de médecine de Grenoble, CNRS, CHU Grenoble Alpes, University Grenoble Alpes, Grenoble INP*, TIMC-IMAG, 38000 Grenoble, France; (O.M.); (D.J.B.); (D.H.); (S.H.-M.); (C.L.); (M.M.); (C.P.); (B.T.)
| | - Audrey Le Gouëllec
- Département de Biochimie, Faculté de médecine de Grenoble, CNRS, CHU Grenoble Alpes, University Grenoble Alpes, Grenoble INP*, TIMC-IMAG, 38000 Grenoble, France; (O.M.); (D.J.B.); (D.H.); (S.H.-M.); (C.L.); (M.M.); (C.P.); (B.T.)
- Correspondence:
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Bellés A, Bueno J, Rojo-Bezares B, Torres C, Javier Castillo F, Sáenz Y, Seral C. Characterisation of VIM-2-producing Pseudomonas aeruginosa isolates from lower tract respiratory infections in a Spanish hospital. Eur J Clin Microbiol Infect Dis 2018; 37:1847-1856. [DOI: 10.1007/s10096-018-3318-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 06/27/2018] [Indexed: 10/28/2022]
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8
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Tran-Dinh A, Neulier C, Amara M, Nebot N, Troché G, Breton N, Zuber B, Cavelot S, Pangon B, Bedos JP, Merrer J, Grimaldi D. Impact of intensive care unit relocation and role of tap water on an outbreak of Pseudomonas aeruginosa expressing OprD-mediated resistance to imipenem. J Hosp Infect 2018; 100:e105-e114. [PMID: 29857026 DOI: 10.1016/j.jhin.2018.05.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 05/23/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND To assess the impact of the incidental relocation of an intensive care unit (ICU) on the risk of colonizations/infections with Pseudomonas aeruginosa exhibiting OprD-mediated resistance to imipenem (PA-OprD). AIM The primary aim was to compare the proportion of PA-OprD among P. aeruginosa samples before and after an incidental relocation of the ICU. The role of tap water as a route of contamination for colonization/infection of patients with PA-OprD was assessed as a secondary aim. METHODS A single-centre, observational, before/after comparison study was conducted from October 2013 to October 2015. The ICU was relocated at the end of October 2014. All P. aeruginosa-positive samples isolated from patients hospitalized ≥48 h in the ICU were included. Tap water specimens were collected every three months in the ICU. PA-OprD strains isolated from patients and tap water were genotyped using pulse-field gel electrophoresis. FINDINGS A total of 139 clinical specimens of P. aeruginosa and 19 tap water samples were analysed. The proportion of PA-OprD strains decreased significantly from 31% to 7.7% after the relocation of the ICU (P = 0.004). All PA-OprD clinical specimens had a distinct genotype. Surprisingly, tap water was colonized with a single PA-OprD strain during both periods, but this single clone has never been isolated from clinical specimens. CONCLUSION Relocation of the ICU was associated with a marked decrease in P. aeruginosa strains resistant to imipenem. The polyclonal character of PA-OprD strains isolated from patients and the absence of tap-water-to-patient contamination highlight the complexity of the environmental impact on the endogenous colonization/infection with P. aeruginosa.
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Affiliation(s)
- A Tran-Dinh
- Service de réanimation, 78150, Centre Hospitalier De Versailles, Le Chesnay, France; Département d'anesthésie et de réanimation chirurgicale, 75018, Centre Hospitalier de Bichat, Paris, France.
| | - C Neulier
- Service de Prévention du Risque Infectieux, Centre Hospitalier de Versailles, Le Chesnay, France
| | - M Amara
- Service de Biologie, Unité de microbiologie, 78157, Centre Hospitalier De Versailles, Le Chesnay, France
| | - N Nebot
- Service de pharmacie, 78150, Centre Hospitalier De Versailles, Le Chesnay, France
| | - G Troché
- Service de réanimation, 78150, Centre Hospitalier De Versailles, Le Chesnay, France
| | - N Breton
- Service de Prévention du Risque Infectieux, Centre Hospitalier de Versailles, Le Chesnay, France
| | - B Zuber
- Service de réanimation, 78150, Centre Hospitalier De Versailles, Le Chesnay, France
| | - S Cavelot
- Service de réanimation, 78150, Centre Hospitalier De Versailles, Le Chesnay, France
| | - B Pangon
- Service de Biologie, Unité de microbiologie, 78157, Centre Hospitalier De Versailles, Le Chesnay, France
| | - J P Bedos
- Service de réanimation, 78150, Centre Hospitalier De Versailles, Le Chesnay, France
| | - J Merrer
- Service de Prévention du Risque Infectieux, Centre Hospitalier de Versailles, Le Chesnay, France
| | - D Grimaldi
- Département de réanimation, CUB-Erasme, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
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Barbosa LN, Ferreira RS, Luiza Mello P, Garcia Garces H, Luana Chechi J, Frachin T, De Barros LC, De Moraes Guimenes Bosco S, Bagagli E, Fernandes Júnior A, Barraviera B, Delazari Dos Santos L. Molecular identification and phylogenetic analysis of Bothrops insularis bacterial and fungal microbiota. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2018; 81:142-153. [PMID: 29319420 DOI: 10.1080/15287394.2017.1395581] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Bothrops insularis, known as the golden lancehead snake, has its natural habitat restricted to Queimada Grande Island on the southern coast of Brazil. This culture-dependent study aimed to identify microorganisms obtained from the mouth, eyes, and cloaca of this species. Swabs from 20 snakes were collected for fungal and bacterial isolation. DNA was extracted from all samples, and identification was performed by amplifying the ITS1-5.8S-ITS2 regions and the 16S rDNA gene, respectively. All strains were identified and deposited in the GenBank nucleotide database. MEGA v6.0 software was utilized to construct phylogenetic trees. In total, 100 strains were isolated and characterized, from which 42 fungi were distributed into 23 species and 58 bacteria into 13 species. The genus Fusarium was predominant since 11 strains and probably a new species was isolated from this fungus. Pseudomonas aeruginosa and Enterococcus faecalis were the predominant groups of aerobic bacteria isolated. Phylogenetic analyses between bacterial and fungal sequences suggest a similarity between the microorganisms found on the island and on the continent. These findings may be attributed to anthropic actions resulting from both expeditions to the island and actions of migratory birds, which are the main sources of food for snakes.
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Affiliation(s)
- Lidiane Nunes Barbosa
- a Center for the Study of Venoms and Venomous Animals (CEVAP) , Sao Paulo State University (UNESP) , Botucatu , Sao Paulo , Brazil
| | - Rui Seabra Ferreira
- a Center for the Study of Venoms and Venomous Animals (CEVAP) , Sao Paulo State University (UNESP) , Botucatu , Sao Paulo , Brazil
- c Graduate Program in Tropical Diseases, Botucatu Medical School , Sao Paulo State University (UNESP) , Botucatu , Sao Paulo , Brazil
| | - Priscila Luiza Mello
- b Department of Microbiology and Immunology, Institute of Biosciences of Botucatu , Sao Paulo State University (UNESP) , Botucatu , Sao Paulo , Brazil
| | - Hans Garcia Garces
- b Department of Microbiology and Immunology, Institute of Biosciences of Botucatu , Sao Paulo State University (UNESP) , Botucatu , Sao Paulo , Brazil
| | - Jéssica Luana Chechi
- b Department of Microbiology and Immunology, Institute of Biosciences of Botucatu , Sao Paulo State University (UNESP) , Botucatu , Sao Paulo , Brazil
| | - Tarsila Frachin
- b Department of Microbiology and Immunology, Institute of Biosciences of Botucatu , Sao Paulo State University (UNESP) , Botucatu , Sao Paulo , Brazil
| | - Luciana Curtolo De Barros
- a Center for the Study of Venoms and Venomous Animals (CEVAP) , Sao Paulo State University (UNESP) , Botucatu , Sao Paulo , Brazil
| | - Sandra De Moraes Guimenes Bosco
- b Department of Microbiology and Immunology, Institute of Biosciences of Botucatu , Sao Paulo State University (UNESP) , Botucatu , Sao Paulo , Brazil
| | - Eduardo Bagagli
- b Department of Microbiology and Immunology, Institute of Biosciences of Botucatu , Sao Paulo State University (UNESP) , Botucatu , Sao Paulo , Brazil
| | - Ary Fernandes Júnior
- b Department of Microbiology and Immunology, Institute of Biosciences of Botucatu , Sao Paulo State University (UNESP) , Botucatu , Sao Paulo , Brazil
| | - Benedito Barraviera
- a Center for the Study of Venoms and Venomous Animals (CEVAP) , Sao Paulo State University (UNESP) , Botucatu , Sao Paulo , Brazil
- c Graduate Program in Tropical Diseases, Botucatu Medical School , Sao Paulo State University (UNESP) , Botucatu , Sao Paulo , Brazil
| | - Lucilene Delazari Dos Santos
- a Center for the Study of Venoms and Venomous Animals (CEVAP) , Sao Paulo State University (UNESP) , Botucatu , Sao Paulo , Brazil
- c Graduate Program in Tropical Diseases, Botucatu Medical School , Sao Paulo State University (UNESP) , Botucatu , Sao Paulo , Brazil
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10
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Lalancette C, Charron D, Laferrière C, Dolcé P, Déziel E, Prévost M, Bédard E. Hospital Drains as Reservoirs of Pseudomonas aeruginosa: Multiple-Locus Variable-Number of Tandem Repeats Analysis Genotypes Recovered from Faucets, Sink Surfaces and Patients. Pathogens 2017; 6:pathogens6030036. [PMID: 28792484 PMCID: PMC5617993 DOI: 10.3390/pathogens6030036] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 08/03/2017] [Accepted: 08/04/2017] [Indexed: 12/16/2022] Open
Abstract
Identifying environmental sources of Pseudomonas aeruginosa (Pa) related to hospital-acquired infections represents a key challenge for public health. Biofilms in water systems offer protection and favorable growth conditions, and are prime reservoirs of microorganisms. A comparative genotyping survey assessing the relationship between Pa strains recovered in hospital sink biofilm and isolated in clinical specimens was conducted. Environmental strains from drain, faucet and sink-surface biofilm were recovered by a culture method after an incubation time ranging from 48 to 240 h. The genotyping of 38 environmental and 32 clinical isolates was performed using a multiple-locus variable-number of tandem repeats analysis (MLVA). More than one-third of Pa isolates were only cultivable following ≥48 h of incubation, and were predominantly from faucet and sink-surface biofilms. In total, 41/70 strains were grouped within eight genotypes (A to H). Genotype B grouped a clinical and an environmental strain isolated in the same ward, 5 months apart, suggesting this genotype could thrive in both contexts. Genotype E grouped environmental isolates that were highly prevalent throughout the hospital and that required a longer incubation time. The results from the multi-hospital follow-up study support the drain as an important reservoir of Pa dissemination to faucets, sink surfaces and patients. Optimizing the recovery of environmental strains will strengthen epidemiological investigations, facilitate pathway identification, and assist in identifying and controlling the reservoirs potentially associated to hospital-acquired infections.
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Affiliation(s)
| | - Dominique Charron
- Department of Civil Engineering, Polytechnique Montréal, Montréal, QC H3T 1J4, Canada.
| | - Céline Laferrière
- Department of microbiology, infectious diseases and immunology, Université de Montréal, Montréal, QC H3T 1J4, Canada.
| | - Patrick Dolcé
- Department of Medical Microbiology and Infectious Diseases, Centre Hospitalier Régional de Rimouski, Rimouski, QC G5L 5T1, Canada.
| | - Eric Déziel
- INRS-Institut Armand-Frappier, Laval, QC H7V 1B7, Canada.
| | - Michèle Prévost
- Department of Civil Engineering, Polytechnique Montréal, Montréal, QC H3T 1J4, Canada.
| | - Emilie Bédard
- INRS-Institut Armand-Frappier, Laval, QC H7V 1B7, Canada.
- Department of Civil Engineering, Polytechnique Montréal, Montréal, QC H3T 1J4, Canada.
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11
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Wang H, Bédard E, Prévost M, Camper AK, Hill VR, Pruden A. Methodological approaches for monitoring opportunistic pathogens in premise plumbing: A review. WATER RESEARCH 2017; 117:68-86. [PMID: 28390237 PMCID: PMC5693313 DOI: 10.1016/j.watres.2017.03.046] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/19/2017] [Accepted: 03/22/2017] [Indexed: 05/06/2023]
Abstract
Opportunistic premise (i.e., building) plumbing pathogens (OPPPs, e.g., Legionella pneumophila, Mycobacterium avium complex, Pseudomonas aeruginosa, Acanthamoeba, and Naegleria fowleri) are a significant and growing source of disease. Because OPPPs establish and grow as part of the native drinking water microbiota, they do not correspond to fecal indicators, presenting a major challenge to standard drinking water monitoring practices. Further, different OPPPs present distinct requirements for sampling, preservation, and analysis, creating an impediment to their parallel detection. The aim of this critical review is to evaluate the state of the science of monitoring OPPPs and identify a path forward for their parallel detection and quantification in a manner commensurate with the need for reliable data that is informative to risk assessment and mitigation. Water and biofilm sampling procedures, as well as factors influencing sample representativeness and detection sensitivity, are critically evaluated with respect to the five representative bacterial and amoebal OPPPs noted above. Available culturing and molecular approaches are discussed in terms of their advantages, limitations, and applicability. Knowledge gaps and research needs towards standardized approaches are identified.
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Affiliation(s)
- Hong Wang
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai 200092, China.
| | - Emilie Bédard
- Department of Civil Engineering, Polytechnique Montreal, Montreal, QC, Canada
| | - Michèle Prévost
- Department of Civil Engineering, Polytechnique Montreal, Montreal, QC, Canada
| | - Anne K Camper
- Center for Biofilm Engineering and Department of Civil Engineering, Montana State University, Bozeman, MT 59717, USA
| | - Vincent R Hill
- Waterborne Disease Prevention Branch, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329, USA
| | - Amy Pruden
- Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA 24061, USA
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12
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Molecular epidemiology and spatiotemporal analysis of hospital-acquired Acinetobacter baumannii infection in a tertiary care hospital in southern Thailand. J Hosp Infect 2017; 95:53-58. [DOI: 10.1016/j.jhin.2016.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 10/03/2016] [Indexed: 12/28/2022]
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13
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Bédard E, Prévost M, Déziel E. Pseudomonas aeruginosa in premise plumbing of large buildings. Microbiologyopen 2016; 5:937-956. [PMID: 27353357 PMCID: PMC5221438 DOI: 10.1002/mbo3.391] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 06/01/2016] [Accepted: 06/06/2016] [Indexed: 12/27/2022] Open
Abstract
Pseudomonas aeruginosa is an opportunistic bacterial pathogen that is widely occurring in the environment and is recognized for its capacity to form or join biofilms. The present review consolidates current knowledge on P. aeruginosa ecology and its implication in healthcare facilities premise plumbing. The adaptability of P. aeruginosa and its capacity to integrate the biofilm from the faucet and the drain highlight the role premise plumbing devices can play in promoting growth and persistence. A meta‐analysis of P. aeruginosa prevalence in faucets (manual and electronic) and drains reveals the large variation in device positivity reported and suggest the high variability in the sampling approach and context as the main reason for this variation. The effects of the operating conditions that prevail within water distribution systems (disinfection, temperature, and hydraulic regime) on the persistence of P. aeruginosa are summarized. As a result from the review, recommendations for proactive control measures of water contamination by P. aeruginosa are presented. A better understanding of the ecology of P. aeruginosa and key influencing factors in premise plumbing are essential to identify culprit areas and implement effective control measures.
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Affiliation(s)
- Emilie Bédard
- Department of Civil Engineering, Polytechnique Montréal, Montréal, QC, Canada.,INRS-Institut Armand-Frappier, Laval, QC, Canada
| | - Michèle Prévost
- Department of Civil Engineering, Polytechnique Montréal, Montréal, QC, Canada
| | - Eric Déziel
- INRS-Institut Armand-Frappier, Laval, QC, Canada
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14
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Lefebvre A, Quantin C, Vanhems P, Lucet JC, Bertrand X, Astruc K, Chavanet P, Aho-Glélé LS. Impact of new water systems on healthcare-associated colonization or infection with Pseudomonas aeruginosa. GMS HYGIENE AND INFECTION CONTROL 2016; 11:Doc12. [PMID: 27274443 PMCID: PMC4886352 DOI: 10.3205/dgkh000272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM We aimed to study the impact of new water systems, which were less contaminated with P. aeruginosa, on the incidence of healthcare-associated P. aeruginosa cases (colonizations or infections) in care units that moved to a different building between 2005 and 2014. METHODS Generalized Estimated Equations were used to compare the incidence of P. aeruginosa healthcare-associated cases according to the building. RESULTS Twenty-nine units moved during the study period and 2,759 cases occurred in these units. No difference was observed when the new building was compared with older buildings overall. CONCLUSION Our results did not support our hypothesis of a positive association between water system contamination and the incidence of healthcare-associated P. aeruginosa cases. These results must be confirmed by linking results of water samples and patients' data.
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Affiliation(s)
- Annick Lefebvre
- Service d’épidémiologie et hygiène hospitalières, CHU Dijon, France
- Laboratoire Microbiologie Environnementale et Risques Sanitaires, Dijon, France
- Equipe opérationnelle d’hygiène, CHU Reims, Hôpital Maison Blanche, Reims, France
| | - Catherine Quantin
- Service de Biostatistiques et Information Médicale, CHU Dijon, France
- Département d’épidémiologie – EA 4184, Université de Bourgogne, Dijon, France
- Inserm UMR 1181 «Biostatistique, Biomathématique, PharmacoEpidémiologie et Maladies Infectieuses», Université de Bourgogne Franche-Comté, Dijon, France
| | - Philippe Vanhems
- Service d’Hygiène Hospitalière, Epidémiologie et Prévention, groupe hospitalier Edouard Herriot, Lyon, France
- Equipe d’épidémiologie et santé publique, Université Claude Bernard, Lyon, France
| | - Jean-Christophe Lucet
- UHLIN, groupe hospitalier Bichat – Claude Bernard, HUPNVS, AP-HP, Paris, France
- Université Paris Diderot, Paris, France
| | - Xavier Bertrand
- Service d’hygiène, CHU Besançon, France
- Laboratoire Chrono-environnement, UMR CNRS 6249, Université de Franche-Comté, Besançon, France
| | - Karine Astruc
- Service d’épidémiologie et hygiène hospitalières, CHU Dijon, France
| | - Pascal Chavanet
- Laboratoire Microbiologie Environnementale et Risques Sanitaires, Dijon, France
- Département de maladies infectieuses, CHU Dijon, France
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15
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Deredjian A, Colinon C, Hien E, Brothier E, Youenou B, Cournoyer B, Dequiedt S, Hartmann A, Jolivet C, Houot S, Ranjard L, Saby NPA, Nazaret S. Low occurrence of Pseudomonas aeruginosa in agricultural soils with and without organic amendment. Front Cell Infect Microbiol 2014; 4:53. [PMID: 24809025 PMCID: PMC4010769 DOI: 10.3389/fcimb.2014.00053] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 04/09/2014] [Indexed: 01/05/2023] Open
Abstract
The occurrence of Pseudomonas aeruginosa was monitored at a broad spatial scale in French agricultural soils, from various soil types and under various land uses to evaluate the ability of soil to be a natural habitat for that species. To appreciate the impact of agricultural practices on the potential dispersion of P. aeruginosa, we further investigated the impact of organic amendment at experimental sites in France and Burkina Faso. A real-time quantitative PCR (qPCR) approach was used to analyze a set of 380 samples selected within the French RMQS (“Réseau de Mesures de la Qualité des Sols”) soil library. In parallel, a culture-dependent approach was tested on a subset of samples. The results showed that P. aeruginosa was very rarely detected suggesting a sporadic presence of this bacterium in soils from France and Burkina Faso, whatever the structural and physico-chemical characteristics or climate. When we analyzed the impact of organic amendment on the prevalence of P. aeruginosa, we found that even if it was detectable in various manures (at levels from 103 to 105 CFU or DNA targets (g drywt)−1 of sample), it was hardly ever detected in the corresponding soils, which raises questions about its survival. The only case reports were from a vineyard soil amended with a compost of mushroom manure in Burgundy, and a few samples from two fields amended with raw urban wastes in the sub-urban area of Ouagadougou, Burkina Faso. In these soils the levels of culturable cells were below 10 CFU (g drywt)−1.
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Affiliation(s)
- Amélie Deredjian
- CNRS, Ecole Nationale Vétérinaire de Lyon, and Université Lyon 1, UMR 5557 Ecologie Microbienne, Université de Lyon Villeurbanne, France
| | - Céline Colinon
- CNRS, Ecole Nationale Vétérinaire de Lyon, and Université Lyon 1, UMR 5557 Ecologie Microbienne, Université de Lyon Villeurbanne, France
| | - Edmond Hien
- UMR Ecosol, IRD-Université de Ouagadougou, UFR/SVT Ouagadougou, Burkina Faso
| | - Elisabeth Brothier
- CNRS, Ecole Nationale Vétérinaire de Lyon, and Université Lyon 1, UMR 5557 Ecologie Microbienne, Université de Lyon Villeurbanne, France
| | - Benjamin Youenou
- CNRS, Ecole Nationale Vétérinaire de Lyon, and Université Lyon 1, UMR 5557 Ecologie Microbienne, Université de Lyon Villeurbanne, France
| | - Benoit Cournoyer
- CNRS, Ecole Nationale Vétérinaire de Lyon, and Université Lyon 1, UMR 5557 Ecologie Microbienne, Université de Lyon Villeurbanne, France
| | - Samuel Dequiedt
- Plateforme GenoSol, INRA-Université Bourgogne, AgroSup, UMR1347 Agroécologie Dijon, France
| | - Alain Hartmann
- INRA-Université Bourgogne, AgroSup, UMR1347 Agroécologie Dijon, France
| | | | - Sabine Houot
- INRA, UMR 1091 Environnement et Grandes Cultures Thiverval-Grignon, France
| | - Lionel Ranjard
- Plateforme GenoSol, INRA-Université Bourgogne, AgroSup, UMR1347 Agroécologie Dijon, France
| | | | - Sylvie Nazaret
- CNRS, Ecole Nationale Vétérinaire de Lyon, and Université Lyon 1, UMR 5557 Ecologie Microbienne, Université de Lyon Villeurbanne, France
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16
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Loveday HP, Wilson JA, Kerr K, Pitchers R, Walker JT, Browne J. Association between healthcare water systems and Pseudomonas aeruginosa infections: a rapid systematic review. J Hosp Infect 2013; 86:7-15. [PMID: 24289866 DOI: 10.1016/j.jhin.2013.09.010] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 09/18/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Pseudomonas aeruginosa is an opportunistic pathogen with a particular propensity to cause disease in the immunocompromised. Water systems have been reported to contribute to P. aeruginosa transmission in healthcare settings. AIM To systematically assess the evidence that healthcare water systems are associated with P. aeruginosa infection; to review aspects of design that can increase their potential to act as a reservoir; and to compare the efficacy of strategies for eradicating contamination and preventing infection. METHODS A rapid review methodology with a three-step search strategy was used to identify published studies. Scientific advisors were used to identify unpublished studies. FINDINGS Twenty-five relevant studies were included. There was plausible evidence of transmission of P. aeruginosa from water systems to patients and vice versa, although no direct evidence to explain the exact mode of transfer. Two studies provided plausible evidence for effective interventions: point-of-use filters and increasing chlorine disinfection. Non-touch taps and aspects of water system design were identified as probable risk factors for P. aeruginosa biofilm formation and subsequent transmission to patients. Poor hand hygiene or compliance with contact precautions were identified as potential contributory factors; plausible evidence to confirm this was not available. CONCLUSIONS Water systems can act as a source of P. aeruginosa infection in healthcare settings, although the route of transmission is unclear. Contamination appears to be confined to the distal ends of a water system and can persist for prolonged periods. Further studies are required to establish effective methods of preventing transmission and eradicating P. aeruginosa from plumbing systems.
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Affiliation(s)
- H P Loveday
- Richard Wells Research Centre, University of West London, London, UK
| | - J A Wilson
- Institute of Practice, Interdisciplinary Research & Enterprise, University of West London, London, UK.
| | - K Kerr
- Department of Medical Microbiology, Harrogate and District NHS Foundation Trust, Hull York Medical School, York, UK
| | | | - J T Walker
- Biosafety Unit, Health Protection Agency, Porton Down, UK
| | - J Browne
- Richard Wells Research Centre, University of West London, London, UK
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17
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Petit SMC, Lavenir R, Colinon-Dupuich C, Boukerb AM, Cholley P, Bertrand X, Freney J, Doléans-Jordheim A, Nazaret S, Laurent F, Cournoyer B. Lagooning of wastewaters favors dissemination of clinically relevant Pseudomonas aeruginosa. Res Microbiol 2013; 164:856-66. [PMID: 23792168 DOI: 10.1016/j.resmic.2013.06.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 06/02/2013] [Indexed: 12/01/2022]
Abstract
The significance of wastewater treatment lagoons (WWTLs) as point sources of clinically relevant Pseudomonas aeruginosa that can disseminate through rural and peri-urban catchments was investigated. A panel of P. aeruginosa strains collected over three years from WWTLs and community-acquired infections was compared by pulsed field gel electrophoresis (PFGE) DNA fingerprinting and multilocus sequence typing (MLST). Forty-four distantly related PFGE profiles and four clonal complexes were found among the WWTL strains analyzed. Some genotypes were repeatedly detected from different parts of WWTLs, including the influent, suggesting an ability to migrate and persist over time. MLST showed all investigated lineages to match sequence types described in other countries and strains from major clinical clones such as PA14 of ST253 and "C" of ST17 were observed. Some of these genotypes matched isolates from community-acquired infections recorded in the WWTL geographic area. Most WWTL strains harbored the main P. aeruginosa virulence genes; 13% harbored exoU-encoded cytoxins, but on at least six different genomic islands, with some of these showing signs of genomic instability. P. aeruginosa appeared to be highly successful opportunistic colonizers of WWTLs. Lagooning of wastewaters was found to favor dissemination of clinically relevant P. aeruginosa among peri-urban watersheds.
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Affiliation(s)
- Stéphanie M-C Petit
- Université de Lyon, Lyon, France; Research Group on Bacterial Opportunistic Pathogens and Environment, UMR5557 Ecologie Microbienne, Doua Campus, Université Lyon 1, CNRS, VetAgro Sup, 69622 Villeurbanne, France
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18
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Colinon C, Deredjian A, Hien E, Brothier E, Bouziri L, Cournoyer B, Hartman A, Henry S, Jolivet C, Ranjard L, Nazaret S. Detection and enumeration of Pseudomonas aeruginosa
in soil and manure assessed by an ecfX
qPCR assay. J Appl Microbiol 2013; 114:1734-49. [DOI: 10.1111/jam.12189] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 02/27/2013] [Accepted: 02/27/2013] [Indexed: 11/29/2022]
Affiliation(s)
- C. Colinon
- Université de Lyon, CNRS, Ecole Nationale Vétérinaire de Lyon Université Lyon 1, UMR 5557 Ecologie Microbienne; Villeurbanne Cedex France
| | - A. Deredjian
- Université de Lyon, CNRS, Ecole Nationale Vétérinaire de Lyon Université Lyon 1, UMR 5557 Ecologie Microbienne; Villeurbanne Cedex France
| | - E. Hien
- IRD UMR Eco-Sols; Université de Ouagadougou; UFR/SVT 03 BP 7021; Ouagadougou Burkina Faso
| | - E. Brothier
- Université de Lyon, CNRS, Ecole Nationale Vétérinaire de Lyon Université Lyon 1, UMR 5557 Ecologie Microbienne; Villeurbanne Cedex France
| | - L. Bouziri
- Centre de Recherches et de Technologies des Eaux; Laboratoire Traitement et Recyclage des Eaux; Hammam-Lif Tunisia
| | - B. Cournoyer
- Université de Lyon, CNRS, Ecole Nationale Vétérinaire de Lyon Université Lyon 1, UMR 5557 Ecologie Microbienne; Villeurbanne Cedex France
| | - A. Hartman
- INRA - Université Bourgogne; UMR 1229 Microbiologie du Sol et de l'Environnement; Dijon Cedex France
| | - S. Henry
- INRA - Université Bourgogne; UMR 1229 Microbiologie du Sol et de l'Environnement; Dijon Cedex France
| | | | - L. Ranjard
- INRA - Université Bourgogne; UMR 1229 Microbiologie du Sol et de l'Environnement; Dijon Cedex France
- INRA - Université Bourgogne; Plateforme Genosol; Dijon Cedex France
| | - S. Nazaret
- Université de Lyon, CNRS, Ecole Nationale Vétérinaire de Lyon Université Lyon 1, UMR 5557 Ecologie Microbienne; Villeurbanne Cedex France
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19
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Antibiotic and metal resistance among hospital and outdoor strains of Pseudomonas aeruginosa. Res Microbiol 2011; 162:689-700. [DOI: 10.1016/j.resmic.2011.06.007] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2010] [Accepted: 05/10/2011] [Indexed: 11/24/2022]
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20
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Pinot C, Deredjian A, Nazaret S, Brothier E, Cournoyer B, Segonds C, Favre-Bonté S. Identification of Stenotrophomonas maltophilia strains isolated from environmental and clinical samples: a rapid and efficient procedure. J Appl Microbiol 2011; 111:1185-93. [DOI: 10.1111/j.1365-2672.2011.05120.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Colinon C, Jocktane D, Brothier E, Rossolini GM, Cournoyer B, Nazaret S. Genetic analyses ofPseudomonas aeruginosaisolated from healthy captive snakes: evidence of high inter- and intrasite dissemination and occurrence of antibiotic resistance genes. Environ Microbiol 2010; 12:716-29. [DOI: 10.1111/j.1462-2920.2009.02115.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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Doléans-Jordheim A, Cournoyer B, Bergeron E, Croizé J, Salord H, André J, Mazoyer MA, Renaud FNR, Freney J. Reliability of Pseudomonas aeruginosa semi-automated rep-PCR genotyping in various epidemiological situations. Eur J Clin Microbiol Infect Dis 2009; 28:1105-11. [PMID: 19449044 DOI: 10.1007/s10096-009-0755-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Accepted: 05/01/2009] [Indexed: 11/27/2022]
Abstract
The purpose of this study was to evaluate the possibility of using a semi-automated repetitive DNA sequences-based polymerase chain reaction (rep-PCR) for typing Pseudomonas aeruginosa isolates. rep-PCR profiles obtained by the DiversiLab system of 84 P. aeruginosa isolates from distinct epidemiological situations were obtained. rep-PCR groupings were in good agreement with the origin of these isolates. Linked rep-PCR profiles were observed for isolates recovered from a same family of cystic fibrosis (CF) patients, for the etiological agents of clustered cases of nosocomial infections, and for some isolates recovered from a same hospital room. rep-PCR and pulsed-field gel electrophoresis SpeI restricted genomic DNA (PFGE-SpeI) profiles were compared. In a few instances, rep-PCR revealed genetic divergences among isolates of a same group of PFGE-SpeI profiles. These divergences could reflect genetic drifts among closely related isolates, as illustrated by those observed between clinical and environmental isolates of a same group of PFGE-SpeI profiles. The interpretation of such differences will require further studies, but the rep-PCR analysis of P. aeruginosa diversity appeared to be an appropriate method to investigate infra-specific genetic relatedness.
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