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
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 American Journal of Infection ControlAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The Hippocratic Oath and the Ethics of Medicine.Oxford University Press, 2004
- Guidelines for preventing infectious complications among hematopoietic cell transplantation recipients: a global perspective.Biol Blood Marrow Transplant. 2009; 15: 1143-1238
- Whole genome sequencing revealed new molecular characteristics in multidrug resistant staphylococci recovered from high frequency touched surfaces in London.Sci Rep. 2019; 9: 9637
- AmiGO: online access to ontology and annotation data.Bioinformatics. 2009; 25: 288-289
- The MetaCyc Database of metabolic pathways and enzymes and the BioCyc collection of Pathway/Genome Databases.Nucleic Acids Res. 2008; 36: D623-D631
- Species-level functional profiling of metagenomes and metatranscriptomes.Nat Methods. 2018; 15: 962-968
- UniProt: the universal protein knowledgebase.Nucleic Acids Res. 2016; 45: D158-D169
- UniProt: the universal protein knowledgebase.Nucleic Acids Res. 2017; 45: D158-D169
- Trichodysplasia spinulosa: a rare complication of immunosuppression.JAAD Case Rep. 2016; 2: 307-309
- Healthcare personnel attire and devices as fomites: a systematic review.Infect Control Hosp Epidemiol. 2016; 37: 1367-1373
- Efflux pump mediated antimicrobial resistance by staphylococci in health-related environments: challenges and the quest for inhibition.Antibiotics (Basel). 2021; 10: 1502
- Chapter 1 - Update on human polyomaviruses and cancer.in: Vande Woude GF Klein G Advances in Cancer Research. 106. Academic Press, 2010: 1-51
- Bacteriophages in natural and artificial environments.Pathogens. 2019; 8: 100
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.
