Phenotypic identification of bacteria of the family Enterobacteriaceae with resistance profile on inanimate surfaces in a University Hospital

Abstract

The aim of this study was to identify bacteria belonging to the family Enterobacteriaceae with resistance profile on inanimate surfaces and utensils of sectors from a University Hospital of Pernambuco. Initially, the samples were collected on 25 inanimate surfaces and utensils of the Intensive Care Unit (ICU), Hemodialysis Center and Medical Clinic in 2018. The samples were plated on MacConkey and SS agar and incubated at 35 ± 2 °C for 24 hours. After incubation, they were submitted to biochemical tests to confirm the presence of bacteria to the family Enterobacteriaceae. Subsequently, Klebsiella pneumoniae carbapenemase (KPC) was identified by the disc diffusion method, as well as by Hodge test; extended-spectrum beta-lactamase producing bacteria (ESBL) by the disk diffusion and double disk diffusion tests; and metallo-beta-lactamase producing bacteria (MBL) through the disc diffusion method according to the Clinical and Laboratory Standards Institute (CLSI). Eight surfaces or utensils of the 18 samples with Enterobacteriaceae presented resistance profile (44.4%). KPC was identified in 46.7% of the samples that presented bacteria with resistance profile, one presented simultaneously KPC and ESBL (6.65%), another one KPC and MBL concomitantly (6.65%) and 6 samples presented only ESBL (40%). Medical Clinic and Hemodialysis Center had the highest presence of resistant Enterobacteriaceae. The detection of resistant microorganisms in hospitals is worrying and emphasizes the importance of health professionals in acquiring knowledge about preventive measures to minimize hospital infections.

Phenotypic Detection of Extended-Spectrum β-lactamases (ESBLs) and Aminopenicillin Cephalosporinase (AmpC)-Producing Bacterial Isolates from Surfaces of Hospital Fomites and Hands of Healthcare Workers

“…However, it is worth noting that the same survey reported a prevalence rate of 33.3% for ESBL-producing GNBs, which contrasts our study results [17]. Studies in Brazil have reported lower prevalence rates of ESBL-producing GNBs from contaminated hospital surfaces, e.g., 15.2% [15] and 24.8% [18]. Another study from Algeria [16] reported a prevalence rate of 21.4% for ESBL among GNBs isolated from the hospital environment.…”

“…These findings highlight the potential role of fomites and human contact in transmitting antibiotic-resistant GNB within healthcare settings. This finding supports the well-established notion that GNBs, such as E. coli, P. aeruginosa, and Klebsiella pneumoniae, are responsible for nosocomial infection, especially among patients with extended hospitalization [14,15].…”

“…ESBLs have emerged as a leading public health concern in nosocomial infections associated with Enterobacteriaceae. They are widely disseminated worldwide and reported in developing and developed countries [15,19]. Numerous studies have postulated that various factors, such as healthcare processes or facilities and commonly-touched surfaces, among others, may serve as risk factors for acquiring and being infected with ESBL-producing GNBs [16,20,21].…”

“…In the context of our study, the detection of GNB with ESBL and AmpC-producing potentials could pose a higher risk for hospital patients who are already immunocompromised and increase the risk of treatment failure. This is because potential ESBL-producing organisms may carry mobile genetic elements capable of transferring or acquiring other resistance genes with grave consequences [15,32,33].…”