Variation in skin and environmental survival of hospital gentamicin-resistant enterobacteria

Abstract

SUMMARYDuring a period when 245 patients were infected by or harboured gentamicinresistant enterobacteria, random sampling showed hand carriage in 33 % of affected patients but in only 5 % of attendant staff. Only klebsiellae were isolated from the latter. Recovery was commoner from the hands of bed-ridden patients or faecal carriers and significantly more frequent for klebsiellae (37 %) and enterobacter (33 %) than citrobacter (5-6 %) and E. coli (5-0 %). Similarly, survival on forearms of volunteers was much longer for klebsiellae and enterobacter than for citrobacter or E. coli (means respectively were 70, 45, 10 and 13 min), and on dry surfaces (means respectively were 28, 26, 3 and 7 h). Klebsiellae were isolated from 17 of the 56 dry environmental surfaces sampled. The presence of plasmid resistance determinants had no effect on survival times, either on the skin or following drying onto formica surfaces. On dry surfaces 9-5 % of E. coli but only 1-3 % of klebsiellae lost resistance to gentamicin. These findings accord well with recent experience in which gentamicin-resistant klebsiellae have been involved to a much greater extent than other resistant enterobacteria in hospital infection.

An extended model for transfer of micro-organisms via the hands: differences between organisms and the effect of alcohol disinfection

“…The second stage of transfer usually took only about 15 s to carry out, compared with the 300 s over which loss of viability was measured, but it is possible that once the inoculum was divided between the hands and the recipient fabric the further loss of moisture increased the rate of death. This result confirms what other workers have found -that E. coli is not typical of the Gram-negative rods in ability to survive on the skin and in the environment (Hart, Gibson & Buckles, 1981). The streptococcus transferred very poorly to the hands.…”

Faecal contamination of water and fingertip-rinses as a method for evaluating the effect of low-cost water supply and sanitation activities on faeco-oral disease transmission. I. A case study in rural north-east Thailand

“…The relatively low numbers of E. coli reflect the results from laboratory experiments designed to test the survival time of these bacteria on human skin. In 16 separate tests 99 % of E. coli died within 10 min and only twice did any organisms survive longer than 30 min; similar findings are reported elsewhere [27,28]. In contrast, an average of 50% of faecal streptococci died off in the first 30 min while still 10-30% of these organisms remained viable after 2-4 h. These results would imply that E. coli is less likely to survive remote cross-371 contamination and therefore, it should show a closer association with activities conducted immediately before or during water use.…”

Extended Spectrum β Lactamase Producing Klebsiella pneumoniae and Escherichia coli in Neonatal Intensive Care Unit

“…These strains are able to survive on skin & watery surfaces and resist dessication making them easily transferable through equipments and the hands of health care workers [6,8]. The Klebsiella and E. coli species, in addition to their virulence and ability to acquire antibiotic resistance determinants [3], are able to survive on skin and watery surfaces and resist dessication [9], making them easily transferable through equipments and the hands of health care workers.…”