Журнал микробиологии, эпидемиологии и иммунобиологии. 2021; 98: 266-275
Дополнительный резервуар госпитальных микроорганизмов в медицинских организациях
https://doi.org/10.36233/0372-9311-120Аннотация
Введение. Подавляющее большинство инфекций, связанных с оказанием медицинской помощи (ИСМП), развиваются в результате колонизации локусов пациентов госпитальными штаммами возбудителей.
Цель исследования — изучение дополнительного резервуара микроорганизмов в медицинских организациях.
Материалы и методы. Исследовано 28 образцов больничной пыли методами сканирующей электронной микроскопии и динамического рассеяния света, энергодисперсионной рентгеновской спектроскопии и высокотемпературного каталитического окисления, 97 проб — полимеразной цепной реакцией и на бактериологическом анализаторе «VITEK®2 Compact» с целью исследования микробного разнообразия. Проведены индикация биологических плёнок (n = 29) с помощью каталазного индикатора, определение общего количества микроорганизмов в 1 м3 воздуха.
Результаты. Пыль вентиляционных решеток контаминирована в 71,13% случаев, доля резистентных к антибиотикам штаммов бактерий — в 69,44%, бактерий, образующих биопленки, — в 48%. Биоразнообразие представлено 21 родом микроорганизмов, сохранявшимся в течение 6 мес. Во всех образцах присутствовала наноразмерная фракция. Органический субстрат представлен углеродом (16,26–50,69%), азотом (1,59–25,03%), водородом (2,03–6,67%), серой (0,15–2,38%) и кислородом (20,02–37,50%). Общее микробное число до и после открывания дверей и окон — 276 и 462 КОЕ/м3 соответственно (p = 0,046). Минеральный компонент содержал натрий (0,07–1,86%), магний (0,11–1,40%), алюминий (0,36–1,78%), кремний (0,21–4,64%), фосфор (0,04–0,81%), хлор (0,05–2,83%), калий (0,04–0,85%), кальций (0,19–7,49%), железо (0,08–1,61%).
Обсуждение. Широкий спектр микроорганизмов, наличие органического субстрата и микроэлементов свидетельствуют о возможности сохранения, накопления и возврата в больничную среду возбудителей ИСМП.
Заключение. На решетках вытяжных вентиляционных систем и прилежащих частей воздуховодов в условиях медицинских организаций может формироваться дополнительный резервуар микроорганизмов — возбудителей ИСМП, играющий значимую роль в поддержании эпидемического процесса ИСМП.
Список литературы
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Journal of microbiology, epidemiology and immunobiology. 2021; 98: 266-275
A novel source of hospital microorganisms in healthcare settings
https://doi.org/10.36233/0372-9311-120Abstract
Background. Most healthcare-associated infections (HAI) develop due to a colonization of patients and healthcare workers by hospital strains of pathogens. The aim to study was to assess whether the dust within the health facilities can harbor microorganisms acting as a reservoir of HAIs.
Materials and methods. Dust samples collected in the air ducts and ventilation grilles of health facilities underwent a detailed physicochemical analysis by means of scanning electron microscopy, dynamic light scattering, energy-dispersive X-ray spectroscopy, and high-temperature catalytic oxidation. Bacterial and viral diversity was investigated using an automated biochemical analyzer and polymerase chain reaction, respectively. Investigation of the microenvironment included detection of biofilms using a catalase indicator and quantification of viable microorganisms per 1 m3 air.
Results. Dust from the hospital ventilation grilles and air ducts was contaminated with microorganisms in 71.13% of cases. Strikingly, multidrug-resistant and biofilm-forming strains have been found in 69.4% and 48.0% of samples, respectively. The total viable count before and after opening doors and windows was 276 and 462 colony-forming units/m3 respectively (p = 0.046). Biodiversity was represented by 21 genera of microorganisms which were consistently detected upon 6 months of follow-up. All samples contained a nanosized particulate matter. Chemical elements comprising dust were carbon (16.26–50.69%), oxygen (20.02–37.50%), nitrogen (1.59–25.03%), hydrogen (2.03–6.67%), sulfur (0.15–2.38%), calcium (0.19–7.49%), silicon (0.21–4.64%), chlorine (0.05–2.83%), sodium (0.07–1.86%), aluminum (0.36–1.78%), iron (0.08–1.61%), magnesium (0.11–1.40%), potassium (0.04–0.85%), and phosphorus (0.04–0.81%).
Discussion. A wide range of multidrug-resistant strains of bacteria, detected in a hospital particulate matter with a diverse chemical composition, indicates the persistence of HAI-causing pathogens in the hospital environment.
Conclusion. Dust from the ventilation grilles and adjacent air ducts should be considered as an additional reservoir of multidrug-resistant strains of bacteria in the healthcare settings.
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