1887

Abstract

Multidrug-resistant organisms (MDROs) pose significant infection-control challenges in settings with high prevalence and limited isolation facilities. This observational study in an 800-bed hospital determined the prevalence, bacterial density and genetic relatedness of MDROs isolated from ward surfaces, medical devices and the hands of healthcare professionals. The targeted MDROs were meticillin-resistant (MRSA), vancomycin-resistant enterococci (VRE), and resistant to extended-spectrum cephalosporins, and carbapenem-resistant (CR) . During a 2-month period, microbiological sampling and molecular typing were performed on environment isolates, clinical isolates and isolates recovered from the hands of healthcare professionals. The target MDROs were recovered from 79 % of sampled surfaces, predominantly MRSA (74 % of all tested surfaces) and CR (29 %) but also VRE (2 %) and (1 %). MRSA was recovered from most tested surfaces throughout the ward, whilst CR was significantly more likely to be recovered from near-patient surfaces. Hand sampling demonstrated infrequent recovery of MRSA (5 %), CR (1 %) and VRE (1 %). Molecular typing of the study isolates identified seven MRSA and five clonal clusters, respectively, and typing identified similar strains from the environment, patients and hands. Thus, in a healthcare setting with endemic circulation of MDROs, MRSA and CR were the predominant organisms recovered from ward surfaces, with MRSA in particular demonstrating widespread environmental dissemination. Molecular typing demonstrated the presence of related strains in patients, in the environment and on the hands of healthcare workers.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.052860-0
2013-05-01
2019-10-18
Loading full text...

Full text loading...

/deliver/fulltext/jmm/62/5/766.html?itemId=/content/journal/jmm/10.1099/jmm.0.052860-0&mimeType=html&fmt=ahah

References

  1. Aygün G., Demirkiran O., Utku T., Mete B., Urkmez S., Yilmaz M., Yaşar H., Dikmen Y., Oztürk R.. ( 2002;). Environmental contamination during a carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit. . J Hosp Infect 52:, 259–262. [CrossRef][PubMed]
    [Google Scholar]
  2. Boyce J. M., Potter-Bynoe G., Chenevert C., King T.. ( 1997;). Environmental contamination due to methicillin-resistant Staphylococcus aureus: possible infection control implications. . Infect Control Hosp Epidemiol 18:, 622–627. [CrossRef][PubMed]
    [Google Scholar]
  3. Brady R. R., Verran J., Damani N. N., Gibb A. P.. ( 2009;). Review of mobile communication devices as potential reservoirs of nosocomial pathogens. . J Hosp Infect 71:, 295–300. [CrossRef][PubMed]
    [Google Scholar]
  4. Carling P. C., Bartley J. M.. ( 2010;). Evaluating hygienic cleaning in health care settings: what you do not know can harm your patients. . Am J Infect Control 38: (Suppl. 1), S41–S50. [CrossRef][PubMed]
    [Google Scholar]
  5. Creamer E., Dorrian S., Dolan A., Sherlock O., Fitzgerald-Hughes D., Thomas T., Walsh J., Shore A., Sullivan D. et al. ( 2010;). When are the hands of healthcare workers positive for methicillin-resistant Staphylococcus aureus?. J Hosp Infect 75:, 107–111. [CrossRef][PubMed]
    [Google Scholar]
  6. Dancer S. J.. ( 2004;). How do we assess hospital cleaning? A proposal for microbiological standards for surface hygiene in hospitals. . J Hosp Infect 56:, 10–15. [CrossRef][PubMed]
    [Google Scholar]
  7. Dancer S. J.. ( 2008;). Importance of the environment in meticillin-resistant Staphylococcus aureus acquisition: the case for hospital cleaning. . Lancet Infect Dis 8:, 101–113. [CrossRef][PubMed]
    [Google Scholar]
  8. Dancer S. J., White L. F., Lamb J., Girvan E. K., Robertson C.. ( 2009;). Measuring the effect of enhanced cleaning in a UK hospital: a prospective cross-over study. . BMC Med 7:, 28. [CrossRef][PubMed]
    [Google Scholar]
  9. Das I., Lambert P., Hill D., Noy M., Bion J., Elliott T.. ( 2002;). Carbapenem-resistant Acinetobacter and role of curtains in an outbreak in intensive care units. . J Hosp Infect 50:, 110–114. [CrossRef][PubMed]
    [Google Scholar]
  10. Francois P., Huyghe A., Charbonnier Y., Bento M., Herzig S., Topolski I., Fleury B., Lew D., Vaudaux P. et al. ( 2005;). Use of an automated multiple-locus, variable-number tandem repeat-based method for rapid and high-throughput genotyping of Staphylococcus aureus isolates. . J Clin Microbiol 43:, 3346–3355. [CrossRef][PubMed]
    [Google Scholar]
  11. Getchell-White S. I., Donowitz L. G., Gröschel D. H.. ( 1989;). The inanimate environment of an intensive care unit as a potential source of nosocomial bacteria: evidence for long survival of Acinetobacter calcoaceticus. . Infect Control Hosp Epidemiol 10:, 402–407. [CrossRef][PubMed]
    [Google Scholar]
  12. Grundmann H. J., Towner K. J., Dijkshoorn L., Gerner-Smidt P., Maher M., Seifert H., Vaneechoutte M.. ( 1997;). Multicenter study using standardized protocols and reagents for evaluation of reproducibility of PCR-based fingerprinting of Acinetobacter spp. . J Clin Microbiol 35:, 3071–3077.[PubMed]
    [Google Scholar]
  13. Harris A. D., McGregor J. C., Furuno J. P.. ( 2006;). What infection control interventions should be undertaken to control multidrug-resistant Gram-negative bacteria?. Clin Infect Dis 43: (Suppl. 2), S57–S61. [CrossRef][PubMed]
    [Google Scholar]
  14. Lemmen S. W., Häfner H., Zolldann D., Stanzel S., Lütticken R.. ( 2004;). Distribution of multi-resistant Gram-negative versus Gram-positive bacteria in the hospital inanimate environment. . J Hosp Infect 56:, 191–197. [CrossRef][PubMed]
    [Google Scholar]
  15. Malik R. E., Cooper R. A., Griffith C. J.. ( 2003;). Use of audit tools to evaluate the efficacy of cleaning systems in hospitals. . Am J Infect Control 31:, 181–187. [CrossRef][PubMed]
    [Google Scholar]
  16. Paavilainen T., Alanen M., Mäkelä M., Routamaa M., Järvinen H., Huovinen P., Kotilainen P.. ( 2001;). Infrequent isolation of multiresistant Acinetobacter baumannii from the staff tending a colonized patient with severe burns. . Infect Control Hosp Epidemiol 22:, 388–391. [CrossRef][PubMed]
    [Google Scholar]
  17. Po J. L., Burke R., Sulis C., Carling P. C.. ( 2009;). Dangerous cows: an analysis of disinfection cleaning of computer keyboards on wheels. . Am J Infect Control 37:, 778–780. [CrossRef][PubMed]
    [Google Scholar]
  18. Salgado C. D., Farr B. M.. ( 2006;). What proportion of hospital patients colonized with methicillin-resistant Staphylococcus aureus are identified by clinical microbiological cultures?. Infect Control Hosp Epidemiol 27:, 116–121. [CrossRef][PubMed]
    [Google Scholar]
  19. Sexton T., Clarke P., O’Neill E., Dillane T., Humphreys H.. ( 2006;). Environmental reservoirs of methicillin-resistant Staphylococcus aureus in isolation rooms: correlation with patient isolates and implications for hospital hygiene. . J Hosp Infect 62:, 187–194. [CrossRef][PubMed]
    [Google Scholar]
  20. Waterman T. R., Smeak D. D., Kowalski J., Hade E. M.. ( 2006;). Comparison of bacterial counts in glove juice of surgeons wearing smooth band rings versus those without rings. . Am J Infect Control 34:, 421–425. [CrossRef][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.052860-0
Loading
/content/journal/jmm/10.1099/jmm.0.052860-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error