Contamination of hospital surfaces with respiratory pathogens in Bangladesh

Abstract

With limited infection control practices in overcrowded Bangladeshi hospitals, surfaces may play an important role in the transmission of respiratory pathogens in hospital wards and pose a serious risk of infection for patients, health care workers, caregivers and visitors. In this study, we aimed to identify if surfaces near hospitalized patients with respiratory infections were contaminated with respiratory pathogens and to identify which surfaces were most commonly contaminated. Between September-November 2013, we collected respiratory (nasopharyngeal and oropharyngeal) swabs from patients hospitalized with respiratory illness in adult medicine and paediatric medicine wards at two public tertiary care hospitals in Bangladesh. We collected surface swabs from up to five surfaces near each case-patient including: the wall, bed rail, bed sheet, clinical file, and multipurpose towel used for care giving purposes. We tested swabs using real-time multiplex PCR for 19 viral and 12 bacterial pathogens. Case-patients with at least one pathogen detected had corresponding surface swabs tested for those same pathogens. Of 104 patients tested, 79 had a laboratory-confirmed respiratory pathogen. Of the 287 swabs collected from surfaces near these patients, 133 (46%) had evidence of contamination with at least one pathogen. The most commonly contaminated surfaces were the bed sheet and the towel. Sixty-two percent of patients with a laboratory-confirmed respiratory pathgen (49/79) had detectable viral or bacterial nucleic acid on at least one surface. Klebsiella pneumoniae was the most frequently detected pathogen on both respiratory swabs (32%, 33/104) and on surfaces near patients positive for this organism (97%, 32/33). Surfaces near patients hospitalized with respiratory infections were frequently contaminated by pathogens, with Klebsiella pneumoniae being most common, highlighting the potential for transmission of respiratory pathogens via surfaces. Efforts to introduce routine cleaning in wards may be a feasible strategy to improve infection control, given that severe space constraints prohibit cohorting patients with respiratory illness.

Multi-route transmission potential of SARS-CoV-2 in healthcare facilities

“…The viral survival, the transmission efficiency of the virus from surfaces and hands to respiratory mucosa, and the dose-response rate after the virus is introduced onto the mucosa are all important factors that influence the exposure risk of the susceptible individuals. Our results are in line with that of a previous study that revealed that towels in hospitals are frequently contaminated with respiratory pathogens ( Hassan et al, 2019 ). These findings suggest that personal necessities function as potential vehicles for virus transmission.…”

High-Content Imaging to Phenotype Antimicrobial Effects on Individual Bacteria at Scale

“…For example, there were notable differences in adhesion between the nonmotile K. pneumoniae and motile S. Typhimurium. K. pneumoniae possesses an array of adhesins that allow it to adhere and persist in different environments, which have contributed to its emergence as an important nosocomial pathogen (17,18). In contrast, S. Typhimurium relies on motility and more specific cellular interactions and invasion for causing infection (9).…”

Bacteria Contamination and Distribution in Patient Care Environment at Mbagathi Hospital Surgical and New-born Units

“…The overall contamination was 40%, which is slightly higher than that found in the beds in this study (36.5%). Hassan [17] also found that the most regularly contaminated surfaces were the bed tops, and bed sides. These findings are also true as postulated in a study by Saka [18].…”