Comparing Resistant Microorganisms Isolated from Patients and Environment in an Intensive Care Unit

Abstract

Background: Recently, the probable involvement of surfaces from the hospital environment as a disseminating source of resistant bacteria has been highlighted. The aim of the study was to compare resistant microorganisms isolated from inanimate surfaces, equipments and patient blood culture samples in an Intensive Care Unit from Belo Horizonte, Brazil. Methods: A cross-sectional study was performed from July to October 2009. Data sources were microbiologic samples from environment and patient blood culture. Duplicate samples were obtained by swabs from up to seven different touch sites around two different patients in four different days. Jointly with the environmental samples, bacterial isolates from an adult ICU patients' routine blood cultures were obtained from hospital laboratory. The samples were identified, tested for sensitivity and compared by rep-PCR test to verify similarity. Results: Difference among the averages of Colony Forming Units was found within the environment samples (p < 0.004). In the environment were identified antibiotic resistant microorganisms such as Vancomycin resistant Enterococcus faecalis, imipenem and ciprofloxacin Pseudomonas aeruginosa and multidrug-resistant Acinetobacter baumannii. Similarities (60%-80%) were established among environmental and blood culture samples. Conclusion: The environmental sampling showed different averages of contamination of the surfaces and equipment. The similarity among the bacterial isolates of patients' blood cultures and environmental samples reinforces the hypothesis of the horizontal transference of pathogens.

Bacterial contamination of toilet door handles on Baze University campus Abuja Nigeria

“…In contrast the Cephalosporins (Ampicillin/ Cloxacillin, Amoxicillin/ Clavulanate, and Cefuroxime axetil) with the exception of Ceftriaxone, Imipenem and Cefoxitin, were not as effective, especially against the gram negative isolates, these results were consistent with the findings of other researchers [14,15]. This could be as a result of a growing resistance to the β-lactams component of these antibiotics, by β--lactamase producing bacteria such as Staphylococcus aureus [27], suggesting the development of Methicillin Resistant Staphylococcus aureus (MRSA); and especially extended-spectrum β-lactamases (ESBLs) producers such as Klebsiella pneumoniae, Klebsiella oxytoca, Escherichia coli and Proteus mirabilis, which possess grave consequences to public health [28,12,29].…”

Bacterial Contamination of Intensive Care Units at a Tertiary Hospital in Bauchi, Northeastern Nigeria

“…This clinical practice requires the frequent presence and attention of the mothers for breastfeeding and health care worker, thus increasing the unit occupancy density, traffic and human activities [15,24]. Different contamination rate had been reported in other similar studies, in Maiduguri, Nigeria, 62.5% and 26.9% was reported adult ICU [22,23] and 38% in neonatal ICU [22], 67.8% in NICU in Ilorin [19], 17.8%in Iraq [18], while 81% contamination rate from unused nonsterile gloves in ICU [26], and no bacterial contamination rate recorded in ICU in Labhore, Pakistan [25].…”

“…Human skin is known to harbour significant proportion of bacteriastaphylococci, gram-negative that are shed continuously during clinical activities [14]. Another source of contamination is colonised and infected health care worker and patients in which the pathogens can be shed and recovered from the immediate environment of the patient [14][15][16], while the dispersion depends on type of organism, source and contamination with the surface, humidity level and size of the inoculum [11,17] Wide range of bacterial pathogens have been implicated in ICU contamination, but potentially clinically relevant ones includes S.aureus, coagulase negative staphylococci, Enterobactericiae, Enterococci, as major causative agent of nosocomial infection, emerged as multidrug resistant pathogens(MDR) and compound infection control [5,[18][19][20][21]. These MDR pathogens like MRSA, VRSA, ESBL producing Enterobacteriae and Acineobacter baumanii, are used as indicators organism for evaluating the level of adherence to basic standard procedures in intensive care units [11,13,24], as failure in these basic procedure tends to increase the dissemination these pathogens within the units and hospital environment.…”

Patient participation in hand hygiene among health professionals

“…This finding is alarming, as it brings to light the limitation of perception of the HPs to the necessity of HH in the moments related to the handling of invasive devices during patient care, when moving from a contaminated body site to another, after contact with bodily fluids or excretions, mucous membrane, non-intact skin or wound dressings; after removal of gloves and, especially, after contact with inanimate objects and surfaces immediately next to the patient, understanding that environment and equipment can be considered as potential reservoirs of microorganisms (1)(2)(3)16) . In clinical practice, the application of the "Five Moments for Hand Hygiene" actually remains as a challenge, in which the HPs recognize HH as a fundamental measure for prevention/reduction of HAIs, of the dissemination of bacterial resistance.…”