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

Joanna Francyne Silva De Barros,Isabella Macário Ferro Cavalcanti,Isabel Cristina Da Silva,Wheverton Ricardo Correia Do Nascimento,José Jamildo De Arruda Filho,Alyson Mykael Albuquerque Florenço,Sandrelli Meridiana De Fátima Ramos Dos Santos Medeiros Medeiros

doi:10.33448/rsd-v10i11.18508

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.

Highlights

Bacterial resistance has been rising worldwide and it has become an increasingly worrying problem
Microorganisms that produce these enzymes, such as Klebsiella pneumoniae carbapenemase (KPC), extendedspectrum beta-lactamase producing bacteria (ESBL) and metallo-beta-lactamase producing bacteria (MBL) can degrade antimicrobials from the beta-lactam group, but these drugs are most often used in the treatment of severe infections (Bush, 2015)
The aim of this study was to identify bacteria belonging to the family Enterobacteriaceae with resistance profile on inanimate surfaces and utensils of the Clinical Medicine, Hemodialysis, and Intensive Care Unit sectors used in the care of patients at a University Hospital in Pernambuco

Summary

Introduction

Bacterial resistance has been rising worldwide and it has become an increasingly worrying problem. The bacteria belonging to the family Enterobacteriaceae are pathogens capable of causing different types of hospitalacquired infections, a situation that is aggravated by the bacterial resistance in this family, resulting in a challenging therapeutic plan (Rodríguez-Baño, et al, 2018). Microorganisms that produce these enzymes, such as Klebsiella pneumoniae carbapenemase (KPC), extendedspectrum beta-lactamase producing bacteria (ESBL) and metallo-beta-lactamase producing bacteria (MBL) can degrade antimicrobials from the beta-lactam group, but these drugs are most often used in the treatment of severe infections (Bush, 2015). The presence of resistant microorganisms in hospital environments has caused great impact both in the clinical aspect, due to the high mortality rates associated with the infections caused by these microorganisms (Geisinger, et al, 2017), and in the economic aspect, due to the increase of costs with drug therapy and with time hospitalization (Bush, et al, 2015; Falcone, et al, 2018)

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