Multidrug-resistant Gram-negative bacteria from patients, hospital environment and healthcare workers: a six-month cross-sectional study

Sereia, A. F. R.; da Cunha, P. A.; Tartari, D. C.; Zamparette, C. P.; Estigarribia, D. A.; Klein, T. C. R.; Masukawa, I. I.; Silva, C. I.; Vieira, M. L. V.; Scheffer, M. C.; Boberg, D. R.; Christoff, A. P.; de Oliveira, L. F. V.; Grisard, E. C.; Sincero, T. C. M.

doi:10.1101/425330

bioRxiv · 10.1101/425330

Multidrug-resistant Gram-negative bacteria from patients, hospital environment and healthcare workers: a six-month cross-sectional study

Sereia, A. F. R.·da Cunha, P. A.·Tartari, D. C.·Zamparette, C. P.·Estigarribia, D. A.·Klein, T. C. R.·Masukawa, I. I.·Silva, C. I.·Vieira, M. L. V.·Scheffer, M. C.·Boberg, D. R.·Christoff, A. P.·de Oliveira, L. F. V.·Grisard, E. C.·Sincero, T. C. M.

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Abstract

Healthcare-associated infections (HAI) are an important public health threat with the multidrug-resistant (MDR) gram-negative bacteria (GNB) being of particular concern. Here we present the antimicrobial resistance profile of HAI-related GNB (HAIrB) isolated from patients (PT), healthcare workers (HCW) and hospital environment (HE) in a six-month screening program. From the 180 sampling points distributed in six hospital units, a total of 1,080 swabs were collected allowing the isolation of 390 HAIrB: 50.5% from HE, 42.6% from PT and 6.9% from HCW. Among the HAIrB, 32.6% were characterized as MDR and 38.7% as extended-spectrum cephalosporins resistant (ESC-R), showing no differences in the distribution between PT, HE and HCW. Carbapenem resistance (CARB-R) was detected for 17.7% of all HAIrB, being higher among Acinetobacter spp. isolates (36.5%), followed by Enterobacteriaceae (14.5%) and Pseudomonas spp. (11.8%). Except for the ICU, that revealed higher MDR, CARB-R and ESC-R rates, HAIrB-resistant profiles were similarly detected within the hospital units. Prevalence of blaKPC-like and blaCTX-M-1 {beta}-lactamases-resistance genes was higher in K. pneumoniae and E. cloacae complex, while blaOXA-23-like and blaSPM-like were higher in A. baumannii and P. aeruginosa, respectively. This study reveals that the spreading of HAIrB within a hospital environment is higher than predicted, indicating that healthcare workers, hospital areas and equipment are key players on dissemination of MDR gram-negative bacteria and shows that an active surveillance program can provide precise understanding and direct actions towards control of HAI.

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Sereia, A. F. R., da Cunha, P. A., Tartari, D. C., Zamparette, C. P., Estigarribia, D. A., Klein, T. C. R., Masukawa, I. I., Silva, C. I., Vieira, M. L. V., Scheffer, M. C., Boberg, D. R., Christoff, A. P., de Oliveira, L. F. V., Grisard, E. C., Sincero, T. C. M.. 2018-09-24. Multidrug-resistant Gram-negative bacteria from patients, hospital environment and healthcare workers: a six-month cross-sectional study. https://doi.org/10.1101/425330

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