Abstract
Background: Here, we describe an integrative method to detect carbapenemase-producing Gram-negative bacteria (gn-Cp) on surfaces/fomites in the patient environment. We examined environmental samples from 28 patient rooms occupied with patients who were proven to be colonised with gn-Cp by rectal screening. Methods: We took samples after 24 h, 72 h and one week. For sampling, we divided the patient environment into four parts and took samples from near- and extended patient areas. To obtain a representative bacterial swab from a larger surface, such as the patient cabinet, we used Polywipes. Bacterial DNA was isolated. Carbapenemase was detected with specific qPCR primers. Results: With this culture- and molecular-based approach, we could control the effectiveness of cleaning and disinfection in everyday clinical practice. Therefore, we could track the spread of gn-Cp within the patient room. The number of positive detections fluctuated between 30.5% (mean value positive results after 72 h) and 35.2% (after 24 h and one week). Conclusion: The method used to detect multidrug-resistant bacteria in the environment of patients by using PolywipesTM is reliable and can therefore be used as an effective, new tool in hygiene and infection control.
Highlights
The fact that surface contamination and transmission by fomites play a major role in healthcare-associated infections (HAIs) is evident from many studies [1]
The dramatic increase in the prevalence of infections caused by Gram-negative bacteria, including Enterobacteriaceae, as well as nonfermenters, such as Pseudomonas aeruginosa, producing carbapenemases is a global health problem [9]
529 samples collected within the hospital patient rooms were examined
Summary
The fact that surface contamination and transmission by fomites play a major role in healthcare-associated infections (HAIs) is evident from many studies [1]. Nosocomial pathogens persist in high-touch, that means near-patient surfaces as well as low-touch environments and may foster an exchange of antimicrobial resistance-conferring plasmids [6]. According to German guidelines [8], within the clinical setup, high-risk patients (patients who have recently had contact with the health system in countries with endemic occurrence; patients who have had contact with multidrug-resistant Gramnegative bacteria (MDR-gn)-carrying patients) are actively screened and isolated in singlepatient rooms until MDR-gn colonisation is ruled out. The dramatic increase in the prevalence of infections caused by Gram-negative bacteria, including Enterobacteriaceae, as well as nonfermenters, such as Pseudomonas aeruginosa, producing carbapenemases (gn-Cp) is a global health problem [9]. The gn-Cp acquisition rate of 3.2% among close
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