Multi-drug resistant microbes are resident on nose masks used as preventive protocols for COVID-19 in selected Ghanaian cohort

Abstract

Background: Use of nose masks was an effective and significant part of the World Health Organization (WHO) coronavirus disease (COVID-19) preventive protocols; however, unhygienic practices by the user could lead to microbial contamination of masks. This study profiled bacteria and fungi resident on nose masks and established unhygienic practices; which was not prioritized during the COVID-19 pandemic. Methods: This was a cross-sectional exploratory study, and questionnaires on unhygienic practices toward mask use were completed by 100 consenting participants from which their nose masks were collected for microbial assessment. The isolated microorganisms were characterized with phenotypic and molecular assays. Data were analyzed with descriptive statistics and presented in graphs. Results: Overall, 65% out of the 100 participants reported using a single nose mask for more than a day and 31% washed the mask to reuse. The bacterial load on the exterior (9.9 x 104 CFU/ml) mask interior (9.1 x 104 CFU/ml) was higher than the threshold outlined by WHO. Streptococcus, Staphylococcus, Bacillus, Proteus, Citrobacter, Salmonella, Penicillium, and Aspergillus species were isolated from the mask, and about 80-100% of these isolates were resistant to 18 antimicrobials tested. Uncommon bacterial and fungal isolates, including Providencia, Morganella, Edwardsiella, Rhodotorula and Fusarium species, were also resident on the masks. Conclusions: Diverse multidrug-resistant pathobionts resided on the used mask. These microbes can be opportunistic and cause infections. Nose masks have become a common social accessory; thus strategies are required to ease user discomfort and encourage hygiene practices.