O068: Implementation of antimicrobial copper in neonatal intensive care unit (NICU)

Efstathiou, P. A.; Anagnostakou, Marina; Kouskouni, Evangelia; Petropoulou, C.; Karageorgou, K; Manolidou, Zacharoula; Papanikolaou, S; Tseroni, Maria; Logothetis, E; Karyoti, V

doi:10.1186/2047-2994-2-s1-o68

Cited by 5 publications

(1 citation statement)

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“…For example, neonatal units who have identi ed sinks as stable ESBL-PE reservoirs should consider removing sinks and implementing "water-free" care for ICU patients,(18) placing sink covers, (23) or implementing anti-microbial alloys, such as copper, which has been shown to reduce microbial burden in NICUs. (24) This environmental sampling technique can be used to test microbial burden before and after implementation of these infection control interventions and track bioburden overtime.…”

Section: Discussionmentioning

confidence: 99%

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: 99%