Datasheet1_Assessment of a novel continuous cleaning device using metatranscriptomics in diverse hospital environments.docx

IntroductionDespite routine implementation of cleaning and disinfection practices in clinical healthcare settings, high-touch environmental surfaces and contaminated equipment often serve as reservoirs for the transmission of pathogens associated with healthcare-associated infections (HAIs).
MethodsThe current study involved the analysis of high-touch surface swabs using a metatranscriptomic sequencing workflow (CSI-Dx™) to assess the efficacy of cleanSURFACES® technology in decreasing microbial burden by limiting re-contamination. This is a non-human single center study conducted in the Emergency Department (ED) and on an inpatient Oncology Ward of Walter Reed National Military Medical Center that have followed hygienic practices during the COVID-19 pandemic environment.
ResultsAlthough there was no difference in observed microbial richness (two-tailed Wilcoxon test with Holm correction, P > 0.05), beta diversity findings identified shifts in microbial community structure between surfaces from baseline and post-intervention timepoints (Day 1, Day 7, Day 14, and Day 28). Biomarker and regression analyses identified significant reductions in annotated transcripts for various clinically relevant microorganisms' post-intervention, coagulase-negative staphylococci and Malassezia restricta, at ED and Oncology ward, respectively. Additionally, post-intervention samples predominantly consisted of Proteobacteria and to a lesser extent skin commensals and endogenous environmental microorganisms in both departments.
DiscussionFindings support the value of cleanSURFACES®, when coupled with routine disinfection practices, to effectively impact on the composition of active microbial communities found on high-touch surfaces in two different patient care areas of the hospital (one outpatient and one inpatient) with unique demands and patient-centered practices.

引言：尽管临床医疗环境中常规开展清洁与消毒操作，但高频接触环境表面及受污染的医疗器械常成为医疗保健相关感染（healthcare-associated infections, HAIs）相关病原体传播的储存库。

方法：本研究采用宏转录组测序（metatranscriptomic sequencing）流程（CSI-Dx™）对高频接触表面拭子进行分析，以评估cleanSURFACES®技术通过限制再污染降低微生物负荷的效果。本研究为非人单中心研究，开展于沃尔特·里德国家军事医疗中心的急诊科（Emergency Department, ED）及住院肿瘤病房，该场所在新冠疫情期间始终遵循卫生操作规范。

结果：尽管观测到的微生物丰富度无显著差异（采用Holm校正的双侧Wilcoxon秩和检验，P>0.05），但β多样性（beta diversity）分析结果显示，基线与干预后时间点（第1天、第7天、第14天及第28天）的表面微生物群落结构发生了显著变化。生物标志物（biomarker）与回归分析显示，干预后急诊科与肿瘤病房分别出现了多种临床相关微生物的注释转录本显著降低，其中急诊科为凝固酶阴性葡萄球菌（coagulase-negative staphylococci），肿瘤病房为限制性马拉色菌（Malassezia restricta）。此外，两个科室的干预后样本均以变形菌门（Proteobacteria）为主，其次为皮肤共生菌与内源性环境微生物。

讨论：本研究结果证实，将cleanSURFACES®技术与常规消毒操作相结合，可有效改变医院两个不同的患者诊疗区域（分别为门诊区域与住院区域）内高频接触表面的活性微生物群落组成，这两个区域具有独特的诊疗需求与以患者为中心的服务模式。