Spatiotemporal dynamics of multidrug resistant bacteria on intensive care unit surfaces

Alaric W. D’Souza, Robert F. Potter, Meghan Wallace, Angela Shupe, Sanket Patel, Xiaoqing Sun, Danish Gul, Jennie H. Kwon, Saadia Andleeb (), Carey-Ann D. Burnham () and Gautam Dantas ()
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Alaric W. D’Souza: Washington University School of Medicine
Robert F. Potter: Washington University School of Medicine
Meghan Wallace: Washington University School of Medicine
Angela Shupe: Washington University School of Medicine
Sanket Patel: Washington University School of Medicine
Xiaoqing Sun: Washington University School of Medicine
Danish Gul: National University of Sciences and Technology Islamabad
Jennie H. Kwon: Washington University School of Medicine
Saadia Andleeb: National University of Sciences and Technology Islamabad
Carey-Ann D. Burnham: Washington University School of Medicine
Gautam Dantas: Washington University School of Medicine

Nature Communications, 2019, vol. 10, issue 1, 1-19

Abstract: Abstract Bacterial pathogens that infect patients also contaminate hospital surfaces. These contaminants impact hospital infection control and epidemiology, prompting quantitative examination of their transmission dynamics. Here we investigate spatiotemporal and phylogenetic relationships of multidrug resistant (MDR) bacteria on intensive care unit surfaces from two hospitals in the United States (US) and Pakistan collected over one year. MDR bacteria isolated from 3.3% and 86.7% of US and Pakistani surfaces, respectively, include common nosocomial pathogens, rare opportunistic pathogens, and novel taxa. Common nosocomial isolates are dominated by single lineages of different clones, are phenotypically MDR, and have high resistance gene burdens. Many resistance genes (e.g., blaNDM, blaOXA carbapenamases), are shared by multiple species and flanked by mobilization elements. We identify Acinetobacter baumannii and Enterococcus faecium co-association on multiple surfaces, and demonstrate these species establish synergistic biofilms in vitro. Our results highlight substantial MDR pathogen burdens in hospital built-environments, provide evidence for spatiotemporal-dependent transmission, and demonstrate potential mechanisms for multi-species surface persistence.

Date: 2019
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DOI: 10.1038/s41467-019-12563-1

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