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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Public Health | doi: 10.3389/fpubh.2019.00240

Microbial community profiling in intensive care units expose limitations in current sanitary standards

  • 1Department of Biology, Faculty of Philosophy, Sciences and Languages ​​of Ribeirão Preto, University of São Paulo, Brazil
  • 2Department of Cellular and Molecular Biology and Pathogenic Bioagents, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
  • 3National Laboratory for Scientific Computing (LNCC), Brazil
  • 4Department of Biochemistry and Immunology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
  • 5Clinical Hospital, Faculty of Medicine, University of São Paulo, Brazil
  • 6University of São Paulo, Brazil

Hospital-associated infections (HAIs) are a leading cause of morbidity and mortality in intensive care units (ICUs) and neonatal intensive care units (NICUs). Organisms causing these infections are often present on surfaces around the patient. Given that microbiota may vary across different ICUs, the HAI-related microbial signatures within these units remain underexplored. In this study, we use deep-sequencing analyses to explore and compare the structure of bacterial communities at inanimate surfaces of the ICU and NICU wards of The Medical School Clinics Hospital (Brazil). The data revealed that NICU presents higher biodiversity than ICU and surfaces closest to the patient showed a peculiar microbiota, distinguishing one unit from the other. Several facultative anaerobes or obligate anaerobes HAI-related genera were classified as biomarkers for the NICU, whereas Pseudomonas was the main biomarker for ICU. Correlation analyses revealed a distinct pattern of microbe-microbe interactions for each unit, including bacteria able to form multi-genera biofilms. Furthermore, we evaluated the effect of concurrent cleaning over the ICU bacterial community. The results showed that, although some bacterial populations decreased after cleaning, various HAI-related genera were quite stable to sanitization, suggesting being well-adapted to the ICU environment. Overall, these results enabled identification of discrete ICU and NICU reservoirs of potentially pathogenic bacteria and provided evidence for the presence of a set of biomarkers genera that distinguish these units. Moreover, the study exposed the inconsistencies of the routine cleaning to minimize HAI-related genera contamination.

Keywords: Intensive Care Unit, ICU cleaning, Healthcare-associated infections (HAI), Polyhexamethylene biguanide, 16s r RNA gene sequencing

Received: 10 Jun 2019; Accepted: 12 Aug 2019.

Copyright: © 2019 Ribeiro, Lopes, Kishi, Ribeiro, Menegueti, Gaspar, Silva-Rocha and Guazzaroni. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mx. María-Eugenia Guazzaroni, University of São Paulo, São Paulo, Brazil,