Intensive care unit environmental surfaces are contaminated by multidrug-resistant bacteria in biofilms: combined results of conventional culture, pyrosequencing, scanning electron microscopy, and confocal laser microscopy

Hu, Honghua; Johani, Khalid; Gosbell, Iain B; Jacombs, Anita; Almatroudi, Ahmad; Whiteley, Greg S.; Deva, Anand K.; Jensen, Slade O.; Vickery, Karen

doi:10.1016/j.jhin.2015.05.016

Cited by 169 publications

(185 citation statements)

References 36 publications

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“…In the hospital environment, it is difficult to avoid this type of contamination with bacterial flora of pieces of departmental equipment [25][26][27]. The duty of hospital managers is to provide access to effective disinfectants and their proper use.…”

Section: Discussionmentioning

confidence: 99%

Bacteria contamination of touch surfaces in polish hospital wards

Różańska¹,

Romaniszyn²,

Chmielarczyk³

et al. 2017

Med Pr

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Background: The objective of the study has been to evaluate the pathogenic bacteria contamination of touch surfaces in hospital wards. Material and Methods: Samples were taken from frequently touched surfaces in the hospital environment in 13 units of various types. Culturing was carried out on solid blood agar and in growth broth (tryptic soy broth -TSB). Species identification was performed using the analytical profile index (API) biochemical testing and confirmed with matrix assisted laser desorption ionization time-flight mass spectrometry (MALDI-TOF-MS) system. Results: The total of 161 samples were taken for the study. Fifty-two of them, after 24 h of culture on a solid medium, demonstrated bacterial growth and further 60 samples had growth after prior multiplication in TSB. Overall, 69.6% of samples exhibited growth of 19 bacterial species. Pathogenic species -representing indicator organisms of efficiency of hospital cleaning -was demonstrated by 21.4% of samples. Among them Acinetobacter spp., Enterocococci spp. and Staphylococcus aureus were identified. Coagulase-negative staphylococci (CNS) were predominant. The proportion of various groups of bacteria significantly varied in respective hospitals, and in various types of wards. Disturbing observation is a large proportion of resistance of isolated CNS strains as a potential reservoir of resistance genes. Conclusions:The results show that touch surfaces in hospital units are contaminated by both potentially pathogenic and pathogenic bacterial species. In connection with the reported, also in Poland, frequent omission or incorrect execution of hand hygiene by hospital staff, and probably patients, touch surfaces still constitute important reservoir of pathogenic bacteria. Improving hand hygiene compliance of health-care workers with recommendations is necessary for increasing biological safety of hospital environment. Med Pr 2017;68(4):459-467

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Section: Discussionmentioning

confidence: 99%

Bacteria contamination of touch surfaces in polish hospital wards

Różańska¹,

Romaniszyn²,

Chmielarczyk³

et al. 2017

Med Pr

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“…; Hu et al . ). Biofilms can also cause serious problems in any medical system that involves aqueous liquid conduits, which therefore require rigorous cleaning and disinfection (Cappelli et al .…”

Section: Introductionmentioning

confidence: 97%

Comparative testing of disinfectant efficacy on planktonic bacteria and bacterial biofilms using a new assay based on kinetic analysis of metabolic activity

et al. 2016

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Although bacterial biofilms are the predominant manner of bacterial colonization, most standard procedures for antimicrobial susceptibility testing and efficacy testing of disinfectants are adapted for application to planktonic bacteria. To our knowledge, this is the first study to use a newly developed microplate-based biofilm test system that uses kinetic analysis of the metabolic activity in biofilms, after disinfectant exposure, to evaluate disinfectant efficacy. Our study shows that findings obtained from disinfectant efficacy testing on planktonic bacteria cannot be extrapolated to predict disinfectant efficacy on bacterial biofilms of clinically relevant multidrug-resistant organisms.

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“…There is increasing evidence that environmental colonization may play a significant role in the transmission of MDR bacteria such as MRSA and VRE [33, 34], whereas data is limited regarding the contribution of environmental colonization to the spread of S. epidermidis [35–37]. Studies have shown that Staphylococcus spp.…”

Section: Discussionmentioning

confidence: 99%

Colonization of patients, healthcare workers, and the environment with healthcare-associated Staphylococcus epidermidis genotypes in an intensive care unit: a prospective observational cohort study

et al. 2016

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BackgroundDuring the last decades, healthcare-associated genotypes of methicillin-resistant Staphylococcus epidermidis (HA-MRSE) have been established as important opportunistic pathogens. However, data on potential reservoirs on HA-MRSE is limited. The aim of the present study was to investigate the dynamics and to which extent HA-MRSE genotypes colonize patients, healthcare workers (HCWs) and the environment in an intensive care unit (ICU).MethodsOver 12 months in 2006–2007, swab samples were obtained from patients admitted directly from the community to the ICU and patients transferred from a referral hospital, as well as from HCWs, and the ICU environment. Patients were sampled every third day during hospitalization. Antibiotic susceptibility testing was performed according to EUCAST guidelines. Pulsed-field gel electrophoresis and multilocus sequence typing were used to determine the genetic relatedness of a subset of MRSE isolates.ResultsWe identified 620 MRSE isolates from 570 cultures obtained from 37 HCWs, 14 patients, and 14 environmental surfaces in the ICU. HA-MRSE genotypes were identified at admission in only one of the nine patients admitted directly from the community, of which the majority subsequently were colonized by HA-MRSE genotypes within 3 days during hospitalization. Almost all (89%) of HCWs were nasal carriers of HA-MRSE genotypes. Similarly, a significant proportion of patients transferred from the referral hospital and fomites in the ICU were widely colonized with HA-MRSE genotypes.ConclusionsPatients transferred from a referral hospital, HCWs, and the hospital environment serve as important reservoirs for HA-MRSE. These observations highlight the need for implementation of effective infection prevention and control measures aiming at reducing HA-MRSE transmission in the healthcare setting.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-2094-x) contains supplementary material, which is available to authorized users.

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Intensive care unit environmental surfaces are contaminated by multidrug-resistant bacteria in biofilms: combined results of conventional culture, pyrosequencing, scanning electron microscopy, and confocal laser microscopy

Cited by 169 publications

References 36 publications

Bacteria contamination of touch surfaces in polish hospital wards

Bacteria contamination of touch surfaces in polish hospital wards

Comparative testing of disinfectant efficacy on planktonic bacteria and bacterial biofilms using a new assay based on kinetic analysis of metabolic activity

Colonization of patients, healthcare workers, and the environment with healthcare-associated Staphylococcus epidermidis genotypes in an intensive care unit: a prospective observational cohort study

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