Passenger Pathogens on Physicians

Source avec lien : American Journal of Infection Control, (Prépublication). 10.1016/j.ajic.2022.10.007

Dans un centre universitaire de transplantation de moelle osseuse, nous avons réalisé un séquençage de l’ADN du génome entier (WGS) sur des objets couramment utilisés par les médecins, notamment des badges, des stéthoscopes, des semelles de chaussures et des smartphones de 6 médecins. Les données ont été analysées pour déterminer les gènes de résistance aux antimicrobiens et de facteurs de virulence.

Background Hospital acquired infections pose a significant risk for patients undergoing hematopoietic stem cell transplantation. Horizontal transfer of antimicrobial resistance genes contributes to prevalence of multidrug-resistant infections in this patient population. Methods At an academic bone marrow transplantation center, we performed whole genome DNA sequencing (WGS) on commonly used physician items, including badges, stethoscopes, soles of shoes, and smart phones from 6 physicians. Data were analyzed to determine antimicrobial resistance and virulence factor genes. Results A total of 1,126 unique bacterial species, 495 distinct bacteriophages, 91 unique DNA viruses, and 175 fungal species were observed. Every item contained bacteria with antibiotic and/or antiseptic resistance genes. Stethoscopes contained greatest frequency of antibiotic resistance and more plasmid-carriage of antibiotic resistance. Discussion and Conclusions These data indicate that physician examination tools and personal items possess potentially pathogenic microbes. Infection prevention policies must consider availability of resources to clean physical examination tools as well as provider awareness when enacting hospital policies. Additionally, the prevalence of antimicrobial resistance genes (eg, encoding resistance to aminoglycosides, β-lactams, and quinolones) reinforces need for antimicrobial stewardship, including for immunocompromised patients. Further research is needed to assess whether minute quantities of microbes on physician objects detectable by WGS represents clinically significant inoculums for immunocompromised patients.

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