Significance and Impact of the Study: Contamination of healthcare facilities surfaces has been shown to play a major role in transmission of pathogens. The findings of this study show that dry surface biofilms are widespread and can incorporate pathogens and multidrug-resistant organisms (MROs). Biofilms on highly touched surfaces pose a risk to patients, as dry surface biofilms persist for long period and microorganisms within biofilm have been shown to be transmitted. This study also provides a better understanding of microbial populations in hospital environments, reinforcing that pathogens and MROs are found incorporated into biofilm, which impacts the difficulty in cleaning/disinfection.
AbstractThe aim of this study was to determine the epidemiology (location, microbial load, microbiome, presence/absence of biofilm and pathogens, including ESKAPE-Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species, and antimicrobial susceptibility profiles) of the bacterial contamination on intensive care units (ICUs) surfaces. Fifty-seven high-touched surfaces were collected from adult, paediatric and neonatal ICUs from two large public Brazilian hospitals from central and north regions. Samples (c. 4 cm 2 ) were subjected to culture (qualitative), qPCR targeting 16s rRNA gene (microbial load-bacteria per cm 2 ), 16s rRNA amplicon sequencing (microbiome analysis) and scanning electron (SEM) or confocal laser scanning microscopy (CLSM) (biofilm presence). Multidrug resistant organisms (MROs) were detected using specific chromogenic agar. The average bacterial load was 1Á32 9 10 4 bacteria per cm 2 , container for newborn feeding bottles, stretcher mattress, humidicrib mattress filling and computer keyboards presented the higher bioburden. However, only 45Á6% (26/57) were culture-positive, including 4/26 with MROs. ESKAPE organisms were detected in 51Á8% of the samples subjected to next-generation sequencing. Viability staining and CLSM demonstrated live bacteria on 76Á7% of culture-negative samples. Biofilm was present on all surfaces subjected to microscopy (n = 56), demonstrating that current cleaning practices are suboptimal and reinforcing that MROs are incorporated into hospital surfaces biofilm.
Bacterial biofilms and MDROs were found on ICU surfaces despite regular cleaning in Saudi Arabia, suggesting that biofilm development is not controlled by current cleaning practices.
The evaluation of workers as potential reservoirs and disseminators of pathogenic
bacteria has been described as a strategy for the prevention and control of
healthcare-associated infections (HAIs). The aim of this study was to evaluate the
presence of Enterobacteriaceae in the oral cavity of workers at an
oncology hospital in the Midwest region of Brazil, as well as to characterize the
phenotypic profile of the isolates. Saliva samples of 294 workers from the hospital’s
healthcare and support teams were collected. Microbiological procedures were
performed according to standard techniques. Among the participants, 55 (18.7%) were
colonized by Enterobacteriaceae in the oral cavity. A total of 64
bacteria were isolated, including potentially pathogenic species. The most prevalent
species was Enterobacter gergoviae (17.2%). The highest rates of
resistance were observed for β-lactams, and 48.4% of the isolates were considered
multiresistant. Regarding the enterobacteria isolated, the production of ESBL and KPC
was negative. Nevertheless, among the 43 isolates of the CESP group, 51.2% were
considered AmpC β-lactamase producers by induction, and 48.8% were hyper-producing
mutants. The significant prevalence of carriers of
Enterobacteriaceae and the phenotypic profile of the isolates
represents a concern, especially due to the multiresistance and production of AmpC
β-lactamases.
Objective:
Assess the accumulation of protein and biofilm on the inner surfaces of new flexible gastroscope (FG) channels after 30 and 60 days of patient use and full reprocessing.
Design:
Clinical use study of biofilm accumulation in FG channels.
Setting:
Endoscopy service of a public hospital.
Methods:
First, we tested an FG in clinical use before the implementation of a revised reprocessing protocol (phase 1 baseline; n = 1). After replacement of the channels by new ones and the implementation of the protocol, 3 FGs were tested after 30 days of clinical use (phase 2; n = 3) and 3 FGs were tested after 60 days of clinical use (phase 3; n = 3), and the same FGs were tested in phase 2 and 3. Their biopsy, air, water, and air/water junction channels were removed and subjected to protein testing (n = 21), bacteriological culture (n = 21), and scanning electron microscopy (SEM) (n = 28). Air–water junction channels fragments were subjected to SEM only.
Results:
For the FGs, the average number of uses and reprocessing cycles was 60 times. Extensive biofilm was detected in air, water, and air–water junction channels (n = 18 of 28). All channels (28 of 28) showed residual matter, and structural damage was identified in most of them (20 of 28). Residual protein was detected in the air and water channels of all FG evaluated (phases 1–3), except for 1 air channel from phase 2. Bacteria were recovered from 8 of 21 channels, most air or water channels.
Conclusions:
The short time before damage and biofilm accumulation in the channels was evident and suggests that improving the endoscope design is necessary. Better reprocessing methods and channel maintenance are needed.
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