Epidemiology of Bacterial Contamination of Inert Hospital Surfaces and Equipment in Critical and Non-critical Care Units: A Brazilian Study
Dayane Otero Rodrigues *
Centro de Ciências Biológicas e da Saúde, Universidade Federal do Oeste da Bahia, Barreiras, Bahia, Brazil.
Laís da Paixao Peixoto
Laboratório de Microbiologia, Curso de Biomedicina, Centro Universitário Luterano de Palmas, Palmas, Tocantins, Brazil.
Erica Tatiane Mourao Barros
Laboratório de Microbiologia, Curso de Biomedicina, Centro Universitário Luterano de Palmas, Palmas, Tocantins, Brazil.
Julianne Rodrigues Guimaraes
Laboratório de Microbiologia, Curso de Biomedicina, Centro Universitário Luterano de Palmas, Palmas, Tocantins, Brazil.
Bruna Clemente Gontijo
Curso de Medicina, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Oeste da Bahia, Barreiras, BA, Brazil.
Jaisa Leite Almeida
Curso de Medicina, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Oeste da Bahia, Barreiras, BA, Brazil.
Lucas Guimaraes de Azevedo
Curso de Medicina, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Oeste da Bahia, Barreiras, BA, Brazil.
Julia Cristina Oliveira e Lima
Curso de Medicina, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Oeste da Bahia, Barreiras, BA, Brazil.
Deyse Silva Camara
Curso de Medicina, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Oeste da Bahia, Barreiras, BA, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Aims: The hospital environment is an important reservoir of microorganisms, including multidrug-resistant pathogens, which can cause in-patient contamination and healthcare-related infections. The objective of this study was to describe the epidemiology of bacterial contamination (contaminated sites, pathogen species and their antimicrobial susceptibility, and identifying of multidrug-resistant microorganisms - MDR) of inert hospital surfaces and medical equipment in two public hospitals in Northern Brazil.
Methods: This was a cross-sectional study with 243 samples (n = 208, from Hospital A; and n = 35, from Hospital B) collected by friction with humidified swabs from inert surfaces and equipment. Sequentially the samples were cultivated and bacterial species were identified by culture-based methods and tested for their susceptibility through agar diffusion assay according to the Clinical and Laboratory Standards Institute (CLSI).
Results: Most inert surfaces and equipment analyzed presented bacterial contamination (95.5%). Staphylococcus aureus was the main pathogen of clinical significance detected both in Hospital A (61.8%) and B (68.6%). Hospital A showed higher rates of isolated MDR bacteria than Hospital B, especially in the Adult Intensive Care Unit, which included methicillin-resistant Staphylococcus aureus (MRSA) (52.7%), Enterobacteria resistant to 4th generation cephalosporins (19.4%), and multidrug-resistant Pseudomonas aeruginosa (2.8%).
Conclusion: The failures in the control of bacterial contamination of inert surfaces and equipment in the two hospitals analyzed reinforce the need for a revised protocol for cleaning and disinfection of the inert surfaces and equipment, and for regulation of antibiotic dispensing, mainly in the AICU of Hospital A, which was found to be a reservoir of MDR pathogens.
Keywords: Infections, pathogens, cross-transmission, reservoir.