Carriage of ESBL-producing Gram-negative bacteria by flies captured in a hospital and its suburban surroundings in Ethiopia

Tufa, Tafese Beyene; Fuchs, André; Wienemann, Tobias; Eggers, Yannik; Abdissa, Sileshi; Schneider, Marlen; Jensen, Björn‐Erik Ole; Bode, Johannes G.; Pfeffer, Klaus; Häussinger, Dieter; MacKenzie, Colin R.; Orth, Hans Martin; Feldt, Torsten

doi:10.21203/rs.3.rs-33313/v3

Cited by 1 publication

(1 citation statement)

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“…For example, cockroaches have been implicated in outbreaks of neonatal K. pneumoniae infections, (21) and ESBL-PE colonization of fruit ies is welldocumented. (22) In our study setting, LED-light insect traps have proved to be an effective measure, along with window screens, at reducing the presence of insects in the patient care environment.…”

Section: Discussionmentioning

confidence: 88%

Characterizing the ESBL-Producing Enterobacterales Bioburden in a Neonatal Unit Using Chromogenic Culture Media: A Feasible and Efficient Environmental Sampling Method

Strysko

Vurayai

Kgomanyane

et al. 2021

Preprint

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Introduction: Infections due to extended spectrum beta-lactamase producing Enterobacterales (ESBL-PE) have emerged as the leading cause of sepsis among hospitalized neonates in Botswana and much of sub-Saharan Africa and south Asia. Yet, ESBL-PE reservoirs and transmission dynamics within the neonatal intensive care unit (NICU) environment are not well-understood. This study aimed to assess the efficiency and feasibility of a chromogenic-culture-media-based environmental sampling approach to characterize the ESBL-PE bioburden within a NICU. Methods A series of four point-prevalence surveys were conducted at a 36-bed NICU at a public tertiary referral hospital in Botswana from January-June 2021. Samples were collected on 3 occasions under semi-sterile technique using 1) flocked swabs & templates (flat surfaces); 2) sterile syringe & tubing (water aspiration); and 3) structured swabbing techniques (hands & equipment). Swabs were transported in physiological saline-containing tubes, vortexed, and 10 µL was inoculated onto chromogenic-agar that was selective and differential for ESBL-PE (CHROMagar™ ESBL, Paris, France), streaking plates to isolate individual colonies. Bacterial colonies were quantified and phenotypically characterized using biochemical identification tests. Results In total, 567 samples were collected, 248 (44%) of which grew ESBL-PE. Dense and consistent ESBL-PE contamination was detected in and around sinks and certain high-touch surfaces, while transient contamination was demonstrated on medical equipment, caregivers/healthcare worker hands, insects, and feeding stations (including formula powder). Results were available within 24–72 hours of collection. To collect, plate, and analyse 50 samples, we estimated a total expenditure of $269.40 USD for materials and 13.5 cumulative work hours among all personnel. Conclusions Using basic environmental sampling and laboratory techniques aided by chromogenic culture media, we identified ESBL-PE reservoirs (sinks) and plausible transmission vehicles (medical equipment, infant formula, hands of caregivers/healthcare workers, & insects) in this NICU environment. This strategy was a simple and cost-efficient method to assess ESBL-PE bioburden and may be feasible for use in other settings to support ongoing infection control assessments and outbreak investigations.

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Section: Discussionmentioning

confidence: 88%