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Sci Transl Med. 2017 May 24;9(391). pii: eaah6500. doi: 10.1126/scitranslmed.aah6500.

Bacterial colonization and succession in a newly opened hospital.

Author information

1
Department of Ecology and Evolution, University of Chicago, 1101 East 57th Street, Chicago, IL 60637, USA.
2
Division of Biosciences, Argonne National Laboratory, 9700 South Cass Avenue, Argonne, IL 60439, USA.
3
Microbiome Center, Department of Surgery, University of Chicago, A27 South Maryland Avenue, Chicago, IL 60637, USA.
4
Alkek Center for Metagenomics and Microbiome Research, Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, USA.
5
Department of Medicine, University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
6
Department of Civil Engineering, University of Toronto, 35 St. George Street, Toronto, Ontario M5S 1A4, Canada.
7
Dalla Lana School of Public Health, University of Toronto, 223 College Street, Toronto, Ontario M5T 1R4, Canada.
8
Department of Pediatrics, University of California, San Diego, San Diego, CA 92037, USA.
9
Department of Computer Science and Engineering, University of California, San Diego, San Diego, CA 92037, USA.
10
Department of Civil, Architectural and Environmental Engineering, Illinois Institute of Technology, 3201 South Dearborn Street, Chicago, IL 60616, USA.
11
Department of Ecology and Evolution, University of Chicago, 1101 East 57th Street, Chicago, IL 60637, USA. gilbertjack@gmail.com.

Abstract

The microorganisms that inhabit hospitals may influence patient recovery and outcome, although the complexity and diversity of these bacterial communities can confound our ability to focus on potential pathogens in isolation. To develop a community-level understanding of how microorganisms colonize and move through the hospital environment, we characterized the bacterial dynamics among hospital surfaces, patients, and staff over the course of 1 year as a new hospital became operational. The bacteria in patient rooms, particularly on bedrails, consistently resembled the skin microbiota of the patient occupying the room. Bacterial communities on patients and room surfaces became increasingly similar over the course of a patient's stay. Temporal correlations in community structure demonstrated that patients initially acquired room-associated taxa that predated their stay but that their own microbial signatures began to influence the room community structure over time. The α- and β-diversity of patient skin samples were only weakly or nonsignificantly associated with clinical factors such as chemotherapy, antibiotic usage, and surgical recovery, and no factor except for ambulatory status affected microbial similarity between the microbiotas of a patient and their room. Metagenomic analyses revealed that genes conferring antimicrobial resistance were consistently more abundant on room surfaces than on the skin of the patients inhabiting those rooms. In addition, persistent unique genotypes of Staphylococcus and Propionibacterium were identified. Dynamic Bayesian network analysis suggested that hospital staff were more likely to be a source of bacteria on the skin of patients than the reverse but that there were no universal patterns of transmission across patient rooms.

PMID:
28539477
PMCID:
PMC5706123
DOI:
10.1126/scitranslmed.aah6500
[Indexed for MEDLINE]
Free PMC Article

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