학술논문
Cartography of opportunistic pathogens and antibiotic resistance genes in a tertiary hospital environment
Document Type
Author
Chng, Kern Rei; Li, Chenhao; Bertrand, Denis; Ng, Amanda Hui Qi; Kwah, Junmei Samantha; Low, Hwee Meng; Tong, Chengxuan; Natrajan, Maanasa; Zhang, Michael Hongjie; Xu, Licheng; Ko, Karrie Kwan Ki; Ho, Eliza Xin Pei; Av-Shalom, Tamar; Teo, Jeanette Woon Pei; Khor, Chiea Chuen; Chen, Swaine L.; Mason, Christopher E.; Ng, Oon Tek; Marimuthu, Kalisvar; Ang, Brenda; Nagarajan, Niranjan; Danko, David; Bezdan, Daniela; Afshinnekoo, Ebrahim; Ahsanuddin, Sofia; Bhattacharya, Chandrima; Butler, Daniel J.; De Filippis, Francesca; Hecht, Jochen; Kahles, Andre; Karasikov, Mikhail; Kyrpides, Nikos C.; Leung, Marcus H. Y.; Meleshko, Dmitry; Mustafa, Harun; Mutai, Beth; Neches, Russell Y.; Ng, Amanda; Nieto-Caballero, Marina; Nikolayeva, Olga; Nikolayeva, Tatyana; Png, Eileen; Sanchez, Jorge L.; Shaaban, Heba; Sierra, Maria A.; Tong, Xinzhao; Young, Ben; Alicea, Josue; Bhattacharyya, Malay; Blekhman, Ran; Castro-Nallar, Eduardo; Canas, Ana M.; Chatziefthimiou, Aspassia D.; Crawford, Robert W.; Deng, Youping; Desnues, Christelle; Dias-Neto, Emmanuel; Donnellan, Daisy; Dybwad, Marius; Elhaik, Eran; Ercolini, Danilo; Frolova, Alina; Graf, Alexandra B.; Green, David C.; Hajirasouliha, Iman; Hernandez, Mark; Iraola, Gregorio; Jang, Soojin; Jones, Angela; Kelly, Frank J.; Knights, Kaymisha; Labaj, Pawel P.; Lee, Patrick K. H.; Shawn, Levy; Ljungdahl, Per; Lyons, Abigail; Mason-Buck, Gabriella; McGrath, Ken; Mongodin, Emmanuel F.; Moraes, Milton Ozorio; Noushmehr, Houtan; Oliveira, Manuela; Ossowski, Stephan; Osuolale, Olayinka O.; Ozcan, Orhan; Paez-Espino, David; Rascovan, Nicolas; Richard, Hugues; Raetsch, Gunnar; Schriml, Lynn M.; Semmler, Torsten; Sezerman, Osman U.; Shi, Leming; Song, Le Huu; Suzuki, Haruo; Court, Denise Syndercombe; Thomas, Dominique; Tighe, Scott W.; Udekwu, Klas; Ugalde, Juan A.; Valentine, Brandon; Vassilev, Dimitar; Vayndorf, Elena; Velavan, Thirumalaisamy P.; Zambrano, Maria M.; Zhu, Jifeng; Zhu, Sibo
Source
Nature Medicine. 26:941-951
Subject
Language
English
ISSN
1078-8956
1546-170X
1546-170X
Abstract
Although disinfection is key to infection control, the colonization patterns and resistomes of hospital-environment microbes remain underexplored. We report the first extensive genomic characterization of microbiomes, pathogens and antibiotic resistance cassettes in a tertiary-care hospital, from repeated sampling (up to 1.5 years apart) of 179 sites associated with 45 beds. Deep shotgun metagenomics unveiled distinct ecological niches of microbes and antibiotic resistance genes characterized by biofilm-forming and human-microbiome-influenced environments with corresponding patterns of spatiotemporal divergence. Quasi-metagenomics with nanopore sequencing provided thousands of high-contiguity genomes, phage and plasmid sequences (>60% novel), enabling characterization of resistome and mobilome diversity and dynamic architectures in hospital environments. Phylogenetics identified multidrug-resistant strains as being widely distributed and stably colonizing across sites. Comparisons with clinical isolates indicated that such microbes can persist in hospitals for extended periods (>8 years), to opportunistically infect patients. These findings highlight the importance of characterizing antibiotic resistance reservoirs in hospitals and establish the feasibility of systematic surveys to target resources for preventing infections. Spatiotemporal characterization of microbial diversity and antibiotic resistance in a tertiary-care hospital reveals broad distribution and persistence of antibiotic-resistant organisms that could cause opportunistic infections in a healthcare setting.