Highlights
- •A strong link was found between occupancy and the level of environmental bacteria.
- •A rise in human microbiota-associated taxa was observed with occupancy.
- •Microbiota characteristics were similar between hospitals at equal occupancy.
- •Similar detection rate of Methicillin-resistant Staphylococcus aureus at both sites.
Summary
Background
Infection control is critical to safe hospital care. However, how bacteria within
nosocomial environments relate to space utilisation and occupancy remains poorly understood.
Our aim was to characterise the hospital microbiome in the context of the closure
of a tertiary hospital and the opening of a new facility.
Methods
Environmental swabs were collected from common and inpatient areas in the old and
new hospitals during a 12-month transition period. Microbiota characteristics were
determined by 16S rRNA gene sequencing and quantitative (q)PCR. Targeted assays were
used to detect Methicillin-resistant Staphylococcus aureus (MRSA) and vanB-positive Vancomycin-Resistant Enterococci (VRE).
Results
The transition to full occupancy in the new facility was associated with an increase
in bacterial load (inpatient areas, 3 months p = 0.001; common areas, 6 months p = 0.039) and a change in microbiota composition (baseline-12 months, PERMANOVA p = 0.002). These changes were characterised by an increase in human microbiota-associated
taxa, including Acinetobacter and Veillonella. Closure of the existing facility was associated with a decrease in bacterial load
(p = 0.040). Detection of MRSA did not differ significantly between sites.
Conclusions
Occupancy is a major determinant of bacterial dispersion within hospital environments.
Steady-state bacterial levels and microbiota composition provide a basis for assessment
of infection control measures.
Keywords
Abbreviations:
MRSA (Methicillin-resistant Staphylococcus aureus), VRE (vanB-positive vancomycin-Resistant Enterococci), oRAH (old Royal Adelaide Hospital), nRAH (new Royal Adelaide Hospital), MRO (Multi-resistant organisms), NMDS (Nonmetric multidimensional scaling), PERMANOVA (permutational multivariate analysis of variance), PERMDISP (homogeneity of multivariate dispersions), IQR (interquartile range), qPCR (quantitative PCR)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of InfectionAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Humans differ in their personal microbial cloud.PeerJ. 2015; 3: e1258
- Longitudinal analysis of microbial interaction between humans and the indoor environment.Science. 2014; 345: 1048-1052
- Human occupancy as a source of indoor airborne bacteria.PLoS ONE. 2012; 7: e34867
- Interconnected microbiomes and resistomes in low-income human habitats.Nature. 2016; 533: 212-216
- Bacterial contamination of inanimate surfaces and equipment in the intensive care unit.J Intensive Care. 2015; 3: 54
- Temporal variations in bacterial community diversity and composition throughout intensive care unit renovations.Microbiome. 2020; 8 (Jun): 86
- Exploring the hospital microbiome by high-resolution 16S rRNA profiling.Int J Mol Sci. 2019 Jun 25; 20: 3099
- Bacterial colonization and succession in a newly opened hospital.Sci Transl Med. 2017; 9: eaah6500
- Cartography of opportunistic pathogens and antibiotic resistance genes in a tertiary hospital environment.Nat. Med. 2020; 26: 941-951
- Hospital microbiome variations as analyzed by high-throughput sequencing.Omics. 2019; 23: 426-438
- Hospital-associated microbiota and implications for nosocomial infections.Trends Mol Med. 2015; 21 (Jul): 427-432
Hospitalstays. New royal adelaide hospital: how NRAH differs from old RAH, with new models of care, advanced technology 2019. Available from: https://www.hospitalstays.com.au/accommodation/General/new-royal-adelaide-hospital-how-nrah-differs-from-old-rah-with-new-models-of-care-advanced-technology.Accessed November 2020.
- Impact of long-term erythromycin therapy on the oropharyngeal microbiome and resistance gene reservoir in non-cystic fibrosis.Bronchiectasis. 2018; 3 (mSphere): e00103-e00118
- Sample storage conditions significantly influence faecal microbiome profiles.Sci Rep. 2015; 5: 16350
- Reproducible, interactive, scalable and extensible microbiome data science using QIIME 2.Nat. Biotechnol. 2019; 37: 852-857
- DADA2: high-resolution sample inference from Illumina amplicon data.Nat. Methods. 2016; 13: 581-583
- Determination of bacterial load by real-time PCR using a broad-range (universal) probe and primers set.Microbiol (Read). 2002; 148: 257-266
- Development of a real-time staphylococcus aureus and MRSA (SAM-) PCR for routine blood culture.J Microbiol Methods. 2007; 68: 296-302
- New real-time PCR assay for rapid detection of methicillin-resistant Staphylococcus aureus directly from specimens containing a mixture of staphylococci.J Clin Microbiol. 2004; 42: 1875-1884
- Where is the strength of evidence? A review of infection prevention and control guidelines.J Hosp Infect. 2020; 105: 242-251
- Bacterial diversity among four healthcare-associated institutes in Taiwan.Sci Rep. 2017; 7: 8230
- Introduction of NGS in environmental surveillance for healthcare-associated infection control.Microorganisms. 2019; 7: 708
- Molecular epidemiology of enterococcal bacteremia in Australia.J Clin Microbiol. 2014; 52: 897-905
Australian Commission on Safety and Quality in Health Care (ACSQHC). AURA 2019: third Australian report on antimicrobial use and resistance in human health. Available from: https://www.safetyandquality.gov.au/publications-and-resources/resource-library/aura-2019-third-australian-report-antimicrobial-use-and-resistance-human-health. Accessed November 2020.
- Environmental contamination makes an important contribution to hospital infection.J Hosp Infect. 2007; 65: 50-54
- Controlling methicillin-resistant Staphylococcus aureus (MRSA) in a hospital and the role of hydrogen peroxide decontamination: an interrupted time series analysis.BMJ Open. 2014; 4e004522
- Time-series analysis of health care–associated infections in a new hospital with all private rooms.JAMA Intern Med. 2019; 179: 1501-1506
Article info
Publication history
Published online: October 01, 2021
Accepted:
September 7,
2021
Identification
Copyright
© 2021 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
