Highlights
- •Whole genome DNA sequencing (WGS) was performed on bone marrow transplantation physician items.
- •WGS identified thousands of unique bacteria, DNA viruses, fungi, and bacteriophages.
- •Antimicrobial resistance elements were identified on all items tested.
- •Stethoscopes contained the greatest frequency of antibiotic resistance genes.
Abstract
Background
Hospital acquired infections pose a significant risk for patients undergoing hematopoietic
stem cell transplantation. Horizontal transfer of antimicrobial resistance genes contributes
to prevalence of multidrug-resistant infections in this patient population.
Methods
At an academic bone marrow transplantation center, we performed whole genome DNA sequencing
(WGS) on commonly used physician items, including badges, stethoscopes, soles of shoes,
and smart phones from 6 physicians. Data were analyzed to determine antimicrobial
resistance and virulence factor genes.
Results
A total of 1,126 unique bacterial species, 495 distinct bacteriophages, 91 unique
DNA viruses, and 175 fungal species were observed. Every item contained bacteria with
antibiotic and/or antiseptic resistance genes. Stethoscopes contained greatest frequency
of antibiotic resistance and more plasmid-carriage of antibiotic resistance.
Discussion and Conclusions
These data indicate that physician examination tools and personal items possess potentially
pathogenic microbes. Infection prevention policies must consider availability of resources
to clean physical examination tools as well as provider awareness when enacting hospital
policies. Additionally, the prevalence of antimicrobial resistance genes (eg, encoding
resistance to aminoglycosides, β-lactams, and quinolones) reinforces need for antimicrobial
stewardship, including for immunocompromised patients. Further research is needed
to assess whether minute quantities of microbes on physician objects detectable by
WGS represents clinically significant inoculums for immunocompromised patients.
Key Words
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Article info
Publication history
Published online: October 25, 2022
Publication stage
In Press Journal Pre-ProofFootnotes
These results have not been presented at any conferences. This manuscript is not under consideration for publication elsewhere.
Funding: Katz Foundation.
Conflicts of interest: None to report.
Identification
Copyright
© 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
