27The hospital environment is an important reservoir of microorganisms, including 28 multidrug-resistant pathogens, which can cause in-patient contamination and healthcare-29 related infections. The objective of this study was to analyze the epidemiology of bacterial 30 contamination (contaminated sites, pathogen species and their antimicrobial 31 susceptibility, and tracking of multidrug-resistant microorganisms -MDR) of inert 32 hospital surfaces and medical equipment in two public hospitals in Northern Brazil. 33 This was a cross-sectional study with 243 samples (n = 208, from Hospital A; and n = 35, 34 from Hospital B) collected by friction with swabs moistened in Brain Heart Infusion from 35 inert surfaces and equipment. The samples were cultivated and bacterial species were 36identified by the classical approach and tested for their susceptibility through agar 37 diffusion assay according to the Clinical and Laboratory Standards Institute (CLSI). 38Most inert surfaces and equipment analyzed presented bacterial contamination (95.5%). 39Staphylococcus aureus was the main pathogen of clinical significance detected both in 40 Hospital A (61.8%) and B (68.6%). Hospital A showed higher rates of isolated MDR 41 bacteria than Hospital B, especially in the Adult Intensive Care Unit, which included 42 methicillin-resistant Staphylococcus aureus (MRSA) (52.7%), Enterobacteria resistant to 43 4 th generation cephalosporins (19.4%), and multidrug-resistant Pseudomonas aeruginosa 44 (2.78%). The failures in the prevention and control of infections in the two hospitals 45 analyzed reinforce the need for a revised protocol for cleaning and disinfection of inert 46 surfaces and medical equipment, and for regulation of antibiotic dispensing, mainly in the 47 AICU of Hospital A, which was found to be a reservoir of MDR pathogens. This study is 48 innovative because it is the pioneer in Western Bahia that describes the epidemiology of 49 contamination of hospital surfaces, opportuning futures studies in this field. 50 Introduction 51Healthcare-associated infections (HAI) are a major public health concern 52 commonly associated with extended length of hospital stay. HAI account for high hospital 53 costs and contribute to increased morbidity and mortality of infected patients [1]. 54HAI are usually caused by pathogenic bacteria that may emerge from the patient's 55 endogenous microflora during antibiotic therapy in approximately 70% of the cases [2,3]. 56HAI may also be acquired from the exogenous environment (30% of the cases) in that the 57 hospital setting plays a significant role in contagion and transmission outbreaks [3,4]. 58In the hospital setting, patients, staff and visitors represent the main reservoir of 59 microorganisms, whereas secondary reservoirs include all environments where nutrients, 60 moisture, and temperature are suitable for microbial survival, such as air humidifiers and 61 nebulizers [5,6]. In addition, dry and inanimate surfaces can also serve as a reservoir of 62 pathogens [3,5,7-9], as in mattre...

Aims: The hospital environment is an important reservoir of microorganisms, including multidrug-resistant pathogens, which can cause in-patient contamination and healthcare-related infections.  The objective of this study was to describe the epidemiology of bacterial contamination (contaminated sites, pathogen species and their antimicrobial susceptibility, and identifying of multidrug-resistant microorganisms - MDR) of inert hospital surfaces and medical equipment in two public hospitals in Northern Brazil. Methods: This was a cross-sectional study with 243 samples (n = 208, from Hospital A; and n = 35, from Hospital B) collected by friction with humidified swabs from inert surfaces and equipment. Sequentially the samples were cultivated and bacterial species were identified by culture-based methods and tested for their susceptibility through agar diffusion assay according to the Clinical and Laboratory Standards Institute (CLSI). Results: Most inert surfaces and equipment analyzed presented bacterial contamination (95.5%). Staphylococcus aureus was the main pathogen of clinical significance detected both in Hospital A (61.8%) and B (68.6%). Hospital A showed higher rates of isolated MDR bacteria than Hospital B, especially in the Adult Intensive Care Unit, which included methicillin-resistant Staphylococcus aureus (MRSA) (52.7%), Enterobacteria resistant to 4th generation cephalosporins (19.4%), and multidrug-resistant Pseudomonas aeruginosa (2.8%). Conclusion: The failures in the control of bacterial contamination of inert surfaces and equipment in the two hospitals analyzed reinforce the need for a revised protocol for cleaning and disinfection of the inert surfaces and equipment, and for regulation of antibiotic dispensing, mainly in the AICU of Hospital A, which was found to be a reservoir of MDR pathogens.