Bacterial contamination in neonatal intensive care units in Misurata, Libya: analysis of causative organisms, biofilm formation, and antimicrobial susceptibility

Abstract

Abstract Background: Intensive care units (ICUs) play a critical role in treating life-threatening conditions. The presence of bacteria on objects and instruments in ICUs is a significant cause of hospital-acquired infections. Aim: This study aimed to assess the level of bacterial contamination on objects and instruments frequently touched by healthcare workers (HCWs) and in contact with neonates. Resistance profile and biofilm producibility were also measured. Methods: A total of 150 swabs were collected from various surfaces in the neonatal intensive care units (NICU) of three hospitals in the city of Misurata, Libya. These samples formed the basis of the study. Standard techniques were used to isolate, identify, and determine biofilm formation ability and antibiotic susceptibility of the bacterial isolates. Results: Out of the 150 samples, bacterial growth was observed in 100. The most commonly isolated potential pathogens were Pseudomonas aeruginosa at a rate of 31.33%, followed by Klebsiella pneumonia (18%), Staphylococcus aureus (9.33%), E. coli (4.66%), and finally Acinetobacter baumanni (3.33%) of the total swabs taken. Bed, ICU floor, doorknob, ICU window, and CPAP were the main sources of bacterial contamination in the ICU unit. Among the S. aureus isolates, 50% (7 out of 14) were found to be methicillin resistant. Most of the bacterial isolates showed resistance to Cefotaxime and Augmentin. The gram-negative bacteria showed high adhesion ability (70.9 %) significantly (P= 0.035) more than S. aureus isolates (35.7%). Conclusion: The study revealed a high level of bacterial contamination on objects and instruments in the NICU. The isolated pathogens like Pseudomonas aeruginosa, Klebsiella pneumonia, S. aureus and Acinetobacter baumanni pose a significant risk of hospital-acquired infections. The extremely high prevalence of beta-lactam antibiotics resistance among isolated bacteria accounts for a great public health danger.