Increasing tolerance of hospital Enterococcus faecium to handwash alcohols

被引：163

作者：

Pidot, Sacha J. ^{[1
]}

Gao, Wei ^{[1
]}

Buultjens, Andrew H. ^{[1
]}

Monk, Ian R. ^{[1
]}

Guerillot, Romain ^{[1
]}

Carter, Glen P. ^{[1
]}

Lee, Jean Y. H. ^{[1
]}

Lam, Margaret M. C. ^{[1
]}

Grayson, M. Lindsay ^{[2
,3
,4
]}

Ballard, Susan A. ^{[5
]}

Mahony, Andrew A. ^{[2
]}

Grabsch, Elizabeth A. ^{[2
]}

Kotsanas, Despina ^{[6
]}

Korman, Tony M. ^{[6
]}

Coombs, Geoffrey W. ^{[7
,8
]}

Robinson, J. Owen ^{[7
,8
]}

da Silva, Anders Goncalves ^{[5
]}

Seemann, Torsten ^{[9
]}

Howden, Benjamin P. ^{[1
,2
,3
,5
]}

Johnson, Paul D. R. ^{[1
,2
,3
]}

Stinear, Timothy P. ^{[1
]}

机构：

[1] Univ Melbourne, Peter Doherty Inst Infect & Immun, Dept Microbiol & Immunol, Melbourne, Vic 3010, Australia

[2] Austin Hlth, Infect Dis Dept, Heidelberg, Vic 3084, Australia

[3] Univ Melbourne, Dept Med, Heidelberg, Vic 3084, Australia

[4] Monash Univ, Dept Epidemiol & Prevent Med, Clayton, Vic 3800, Australia

[5] Univ Melbourne, Peter Doherty Inst Infect & Immun, Dept Microbiol & Immunol, Microbiol Diagnost Unit Publ Hlth Lab, Melbourne, Vic 3010, Australia

[6] Monash Hlth, Monash Infect Dis, Clayton, Vic 3168, Australia

[7] Murdoch Univ, Sch Vet & Life Sci, Antimicrobial Resistance & Infect Dis Res Lab, Murdoch, WA 6150, Australia

[8] Fiona Stanley Hosp, Dept Microbiol, PathWest Lab Med WA, Murdoch, WA 6150, Australia

[9] Univ Melbourne, Melbourne Bioinformat, Carlton, Vic 3053, Australia

来源：

SCIENCE TRANSLATIONAL MEDICINE | 2018年 / 10卷 / 452期

基金：

英国医学研究理事会;

关键词：

RESISTANT STAPHYLOCOCCUS-AUREUS; VANCOMYCIN-RESISTANT; BACTEREMIA; EFFICACY; PROGRAM; ETHANOL; COLONIZATION; EPIDEMIOLOGY; ADAPTATION; EMERGENCE;

D O I：

10.1126/scitranslmed.aar6115

中图分类号：

Q2 [细胞生物学];

学科分类号：

071009 ; 090102 ;

摘要：

Alcohol-based disinfectants and particularly hand rubs are a key way to control hospital infections worldwide. Such disinfectants restrict transmission of pathogens, such as multidrug-resistant Staphylococcus aureus and Enterococcus faecium. Despite this success, health care infections caused by E. faecium are increasing. We tested alcohol tolerance of 139 hospital isolates of E. faecium obtained between 1997 and 2015 and found that E. faecium isolates after 2010 were 10-fold more tolerant to killing by alcohol than were older isolates. Using a mouse gut colonization model of E. faecium transmission, we showed that alcohol-tolerant E. faecium resisted standard 70% isopropanol surface disinfection, resulting in greater mouse gut colonization compared to alcohol-sensitive E. faecium. We next looked for bacterial genomic signatures of adaptation. Alcohol-tolerant E. faecium accumulated mutations in genes involved in carbohydrate uptake and metabolism. Mutagenesis confirmed the roles of these genes in the tolerance of E. faecium to isopropanol. These findings suggest that bacterial adaptation is complicating infection control recommendations, necessitating additional procedures to prevent E. faecium from spreading in hospital settings.

引用

页数：10

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