已发表论文

使用 mNGS 进行中国老年重症监护病房的微生物群落特征和分子耐药性监测

 

Authors Yang J, Li L, Zhu X, He C, Li T, Qin J, Wang Y 

Received 3 June 2023

Accepted for publication 29 July 2023

Published 8 August 2023 Volume 2023:16 Pages 5121—5134

DOI https://doi.org/10.2147/IDR.S421702

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Prof. Dr. Héctor M Mora-Montes

Background: Surface pathogens in the ICU pose a global public health threat, especially to elderly patients who are immunocompromised. To detect these pathogens, unbiased methods such as metagenomic next-generation sequencing (mNGS) are increasingly utilized for environmental microbiological surveillance.
Methods: In a six-month study from January to July 2022, we investigated microbial communities in Chinese geriatric ICUs by regularly monitoring multiple surfaces at three-month intervals. Using mNGS sequencing, we analyzed microorganisms present at eight specific locations within the ICU. Additionally, we compared pathogen profiles and drug resistance genes between patient cultures and environmental samples collected during the same period.
Results: The microbial composition remained relatively stable over time, but significant differences in alpha diversities were observed among various surfaces such as floors, hands, pumps, trolleys, and ventilator inlets/outlets. Surfaces with high contact frequency for healthcare workers, including workstations, ventilator panels, trolleys, pumps, and beds, harbored pathogenic microorganisms such as Acinetobacter baumannii Cutibacterium acnes Staphylococcus haemolyticus Pseudomonas aeruginosa , and Enterococcus faecium Acinetobacter baumannii , particularly the carbapenem-resistant strain (CRAB), was the most frequently identified pathogen in geriatric ICU patients regardless of testing method used. The mNGS approach enabled detection of viruses, fungi, and parasites that are challenging to culture. Additionally, an abundance of drug resistance genes was found in almost all environmental samples.
Conclusion: The microbial composition and abundance in the ICU remained relatively constant over time. The floor exhibited the highest microbial diversity and abundance in the ICU environment. Drug-resistant genes in the ICU environment may migrate between patients. Overall, mNGS is an emerging and powerful tool for microbiological monitoring of the hospital environment.
Keywords: geriatric intensive care unit, environmental microorganisms, mNGS, infection and prevention and control, hospital-acquired infections