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Cartography of opportunistic pathogens and antibiotic resistance genes in a tertiary hospital environment

Journal Article · · Nature Medicine
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  1. Genome Inst. of Singapore (Singapore)
  2. Singapore Univ. of Technology and Design (Singapore)
  3. Singapore General Hospital (Singapore); National Univ. of Singapore (Singapore). Graduate Medical School
  4. National Univ. Hospital (Singapore)
  5. Cornell Univ., Ithaca, NY (United States). Weill Medical College
  6. National Centre for Infectious Diseases (Singapore); Tan Tock Seng Hospital (Singapore); Nanyang Technological Univ. (Singapore)
  7. National Centre for Infectious Diseases (Singapore); Tan Tock Seng Hospital (Singapore); National Univ. of Singapore (Singapore)
  8. National Centre for Infectious Diseases (Singapore); Tan Tock Seng Hospital (Singapore)
  9. Genome Inst. of Singapore (Singapore); National Univ. of Singapore (Singapore)

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.

Research Organization:
Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States)
Sponsoring Organization:
USDOE Office of Science (SC); US Naval Medical Research Center (NMRC); WorldQuant Foundation; Bill and Melinda Gates Foundation; Alfred P. Sloan Foundation
Contributing Organization:
MetaSUB Consortium
Grant/Contract Number:
AC02-05CH11231
OSTI ID:
1766495
Journal Information:
Nature Medicine, Journal Name: Nature Medicine Journal Issue: 6 Vol. 26; ISSN 1078-8956
Publisher:
Nature Publishing GroupCopyright Statement
Country of Publication:
United States
Language:
English

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