title: Presence, distribution and molecular epidemiology of multi-drug-resistant Gram-negative bacilli from medical personnel of intensive care units in Tianjin, China, 2007-2015.
abstract: BACKGROUND
  Multi-drug-resistant Gram-negative bacteria (MDRGNB) have become an important cause of nosocomial infection in intensive care units (ICUs).
  
  
  OBJECTIVE
  To investigate the molecular epidemiology of MDRGNB isolated from medical personnel (MP) and non-medical personnel (NMP) at 69 ICUs in Tianjin, China.
  
  
  METHODS
  From April 2007 to October 2015, 2636 nasal and hand swab samples from 1185 MP and 133 NMP were cultured for GNB (including MDRGNB), meticillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). The susceptibilities of GNB to 14 antimicrobial agents were determined, and 80 MDRGNB were characterized using pulsed-field gel electrophoresis (PFGE) and dendrogram analysis.
  
  
  RESULTS
  In total, 301 GNB were identified in 269 MP, including 109 MDRGNB isolates in 104 MP. Forty-two GNB were isolated from 39 NMP, which included 20 NMP with MDRGNB. Overall, 8.8% of MP were colonized with MDRGNB, which greatly exceeded colonization rates with MRSA (0.9%) and VRE (0.1%). Three pairs of Klebsiella pneumoniae and one pair of Enterobacter aerogenes were indistinguishable from each other, but the majority of isolate tests had distinct PFGE profiles.
  
  
  CONCLUSIONS
  The prevalence of MDRGNB was high among ICU MP in Tianjin, and greatly exceeded that of VRE and MRSA. There was no difference in the rates of nasal carriage of MDRGNB between MP and NMP, but NMP were significantly more likely to have hand colonization with MDRGNB. PFGE profiles showed that there was only limited sharing of strains of MDR E. aerogenes and K. pneumoniae between personnel.
authors.affiliation: Department of Infectious Disease, Tianjin Centres for Disease Control and Prevention, Tianjin, China. Electronic address: 563478498@qq.com.
authors.forename: H
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Infectious Disease, Tianjin Centres for Disease Control and Prevention, Tianjin, China.
authors.forename: C N
authors.initials: CN
authors.lastname: Fei
authors.affiliation: Department of Infectious Disease, Tianjin Centres for Disease Control and Prevention, Tianjin, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Infectious Disease, Tianjin Centres for Disease Control and Prevention, Tianjin, China.
authors.forename: G W
authors.initials: GW
authors.lastname: Liu
authors.affiliation: Department of Infectious Disease, Tianjin Centres for Disease Control and Prevention, Tianjin, China.
authors.forename: J
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Infectious Disease, Tianjin Centres for Disease Control and Prevention, Tianjin, China.
authors.forename: J
authors.initials: J
authors.lastname: Dong
mesh_terms: D000328:Adult; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D002681:China / Q000453:epidemiology; D016000:Cluster Analysis; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006090:Gram-Negative Bacteria / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D006225:Hand / Q000382:microbiology; D006282:Health Personnel; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D017720:Molecular Epidemiology; D009296:Nasal Cavity / Q000382:microbiology; D015995:Prevalence; D065507:Vancomycin-Resistant Enterococci / Q000302:isolation & purification; D055815:Young Adult
keywords: Gram-negative bacteria; Intensive care unit; Medical personnel; Multi-drug resistant; Non-medical personnel