Abstract:
OBJECTIVE To investigate the current status of contamination with carbapenem-resistant gram-negative bacteria in environment of intensive care units (ICU) of tertiary hospitals in Shanghai and find out the potential contamination sources so as to provide bases for prevention and control of multidrug-resistant organisms infections in the ICUs.
METHODS The surroundings of the ICU patients detected with CRGNB and environmental objects surfaces in public area were sampled by mSuperCARBA chromogenic media from Dec. 2024 to Jan. 2025, the strains were isolated, and the targeted strains were identified by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometer.
RESULTS A total of 653 samples were collected in the survey, 76 of which were positive for bacterial culture, 60 were detected with CRGNB, and the isolation rate of CRGNB was 9.19%. The isolation rate of CRGNB was 53.40% in the water-source group, 0.91% in the non-water-source group, and there was significant difference(χ2=286.450, P < 0.001). The result of whole genome sequencing for 17 strains of CRKP showed that ST11 and ST15 were the two major types of multilocus typing (MT), respectively carrying 2-12 types of drug resistance genes.
CONCLUSIONS The CRGNB strains are detected in some environmental sites of the ICUs of 15 tertiary hospitals in Shanghai, and the isolation rate of CRKP is highest among them. The colonization rate of CRGNB is relatively low on the highly frequent-contact object surfaces of the ICUs, however, sink drain holes poses a risk of hospital-acquired CRGNB infections transmissions. Additionally, the basins and towels of the CRGNB patients are hard to be thoroughly cleaned, disinfected and dried, resulting in a high contamination rate.
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