Characterizing the bioburden of ESBL-producing organisms in a neonatal unit using chromogenic culture media: a feasible and efficient environmental sampling method.

Autor: Vurayai M; Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana. mvurayai@gmail.com., Strysko J; Department of Paediatric & Adolescent Health, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana.; Global Health Center, Children's Hospital of Philadelphia, Philadelphia, USA.; Botswana-UPenn Partnership, Gaborone, Botswana., Kgomanyane K; Ministry of Health and Wellness, Gaborone, Botswana., Bayani O; Department of Paediatric & Adolescent Health, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana., Mokomane M; Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana., Machiya T; Ministry of Health and Wellness, Gaborone, Botswana., Arscott-Mills T; Department of Paediatric & Adolescent Health, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana.; Global Health Center, Children's Hospital of Philadelphia, Philadelphia, USA.; Botswana-UPenn Partnership, Gaborone, Botswana., Goldfarb DM; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada., Steenhoff AP; Department of Paediatric & Adolescent Health, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana.; Global Health Center, Children's Hospital of Philadelphia, Philadelphia, USA.; Botswana-UPenn Partnership, Gaborone, Botswana.; Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA., McGann C; Global Health Center, Children's Hospital of Philadelphia, Philadelphia, USA.; Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA., Nakstad B; Department of Paediatric & Adolescent Health, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana.; Division of Paediatric and Adolescent Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Gezmu A; Department of Paediatric & Adolescent Health, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana., Richard-Greenblatt M; Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA., Coffin S; Global Health Center, Children's Hospital of Philadelphia, Philadelphia, USA.; Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
Jazyk: angličtina
Zdroj: Antimicrobial resistance and infection control [Antimicrob Resist Infect Control] 2022 Jan 24; Vol. 11 (1), pp. 14. Date of Electronic Publication: 2022 Jan 24.
DOI: 10.1186/s13756-021-01042-2
Abstrakt: Introduction: Infections due to extended spectrum beta-lactamase producing organisms (ESBL) have emerged as the leading cause of sepsis among hospitalized neonates in Botswana and much of sub-Saharan Africa and south Asia. Yet, ESBL reservoirs and transmission dynamics within the neonatal intensive care unit (NICU) environment are not well-understood. This study aimed to assess the efficiency and feasibility of a chromogenic-culture-media-based environmental sampling approach to characterize the ESBL bioburden within a NICU.
Methods: A series of four point-prevalence surveys were conducted at a 36-bed NICU at a public tertiary referral hospital in Botswana from January-June 2021. Samples were collected on 4 occasions under semi-sterile technique using 1) flocked swabs & templates (flat surfaces); 2) sterile syringe & tubing (water aspiration); and 3) structured swabbing techniques (hands & equipment). Swabs were transported in physiological saline-containing tubes, vortexed, and 10 µL was inoculated onto chromogenic-agar that was selective and differential for ESBL (CHROMagar™ ESBL, Paris, France), and streaking plates to isolate individual colonies. Bacterial colonies were quantified and phenotypically characterized using biochemical identification tests.
Results: In total, 567 samples were collected, 248 (44%) of which grew ESBL. Dense and consistent ESBL contamination was detected in and around sinks and certain high-touch surfaces, while transient contamination was demonstrated on medical equipment, caregivers/healthcare worker hands, insects, and feeding stations (including formula powder). Results were available within 24-72 h of collection. To collect, plate, and analyse 50 samples, we estimated a total expenditure of $269.40 USD for materials and 13.5 cumulative work hours among all personnel.
Conclusions: Using basic environmental sampling and laboratory techniques aided by chromogenic culture media, we identified ESBL reservoirs (sinks) and plausible transmission vehicles (medical equipment, infant formula, hands of caregivers/healthcare workers, & insects) in this NICU environment. This strategy was a simple and cost-efficient method to assess ESBL bioburden and may be feasible for use in other settings to support ongoing infection control assessments and outbreak investigations.
(© 2022. The Author(s).)
Databáze: MEDLINE
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