Handwashing sinks as reservoirs of carbapenem-resistant Acinetobacter baumannii in the intensive care unit: a prospective multicenter study

重症监护病房洗手池作为耐碳青霉烯类鲍曼不动杆菌储存库:一项前瞻性多中心研究

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Abstract

INTRODUCTION: The extent to which sinks are contaminated by carbapenem-resistant Acinetobacter baumannii (CRAB) in intensive care units (ICUs) and the association between these contaminated sinks and hospital-acquired CRAB infections during the non-cluster period remains largely unknown. Here, we performed a prospective multicenter study in 16 ICUs at 11 tertiary hospitals in Chengdu, China. METHODS: We sampled sinks, collected CRAB clinical isolates, and conducted whole-genome sequencing and analysis. RESULTS: A total of 789 swabs were collected from 158 sinks, and 16 CRAB isolates were recovered from 16 sinks, resulting in a contamination rate of 10.16%. Twenty-seven clinical isolates were collected during the study period. The majority (97.67%, 42/43) of the CRAB isolates belonged to ST2, and 36 (83.72%) of them had both bla (OXA-23) and bla (OXA-66). The 43 strains belonged to 12 clones. One certain clone caused multiple contaminations of seven sinks in one GICU. Two clones of ST2 bla (OXA-23) and bla (OXA-66)-carrying sink strains were likely the sources of the two clusters in the two GICUs, respectively. Five ST2 bla (OXA-23)-carrying isolates were found to be common clones but were recovered from two hospitals. CONCLUSION: The contamination rate of CRAB in handwashing sinks is high in some local ICUs, and the contaminated sinks can serve as environmental reservoirs for CRAB clusters.

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