Cross-sectional descriptive study of multidrug-resistant bacteria in the ICU environment of two medium-sized hospitals in the interior of São Paulo

Authors

DOI:

https://doi.org/10.33448/rsd-v11i12.34600

Keywords:

Hospital infection; IRAs; Bacterial resistance.

Abstract

The hospitals of Dracena (SCD) and Presidente Venceslau (SCPV) are the largest hospitals in the west region of the state of São Paulo and, due to the high number of patients seen in these hospitals, this work aimed to research multidrug-resistant bacteria in the ICU bed environment of these two hospitals. This is a descriptive and transversal observational research, where samples were collected from the environment of the 10 ICU beds of the SCD and the 10 ICU beds of the SCPV, in regions with frequent contact with hands and fomites. Isolated grown colonies were identified at the genus and species level. Antimicrobial susceptibility testing was performed following the recommendations of the Clinical and Laboratory Standards Institute (2021). Forty-five bacteria were isolated, 25 from SCD and 20 from SCPV. Most bacteria were Gram-negative bacilli (N = 27; 60%), followed by Staphylococcus aureus (N = 12; 26.7%) and Enterococcus faecalis (N = 6; 13.3%). Bacteria were found in the environment of the 10 ICU beds of the SCD and in nine of the 10 ICU beds of the SCPV. Most of the isolated bacteria showed resistance to several antimicrobials, being identified 34 MR, being 23 of SCD and 11 of SCPV. The isolates were grouped into seven groups of resistance phenotype, showing a possible clonal dispersion. The presence of MR in the hospital environment generates permanent concern, since they can infect hospitalized patients, especially after a breach of the protocol to prevent the transmission of infectious agents. This work will contribute to the improvement of hygiene protocols, offering more security to users of these hospitals.

References

Adams, C. E., & Dancer, S. J. (2020). Dynamic Transmission of Staphylococcus Aureus in the Intensive Care Unit. International journal of environmental research and public health, 17(6), 2109. https://doi.org/10.3390/ijerph17062109.

Clinical and Laboratory Standards Institute – CLSI. Performance Standards for Antimicrobial Susceptibility Testing. Document M100, 2021.

Costa, D. M., Johani, K., Melo, D. S., Lopes, L., Lopes Lima, L., Tipple, A., Hu, H., & Vickery, K. (2019). Biofilm contamination of high-touched surfaces in intensive care units: epidemiology and potential impacts. Letters in applied microbiology, 68(4), 269–276. https://doi.org/10.1111/lam.13127.

De Angelis, G., Del Giacomo, P., Posteraro, B., Sanguinetti, M., & Tumbarello, M. (2020). Molecular Mechanisms, Epidemiology, and Clinical Importance of β-Lactam Resistance in Enterobacteriaceae. International journal of molecular sciences, 21(14), 5090. https://doi.org/10.3390/ijms21145090.

De Oliveira, D., Forde, B. M., Kidd, T. J., Harris, P., Schembri, M. A., Beatson, S. A., Paterson, D. L., & Walker, M. J. (2020). Antimicrobial Resistance in ESKAPE Pathogens. Clinical microbiology reviews, 33(3), e00181-19. https://doi.org/10.1128/CMR.00181-19.

Flores-Paredes, W., Luque, N., Albornoz, R., Rojas, N., Espinoza, M., Pons, M. J., & Ruiz, J. (2021). Evolution of Antimicrobial Resistance Levels of ESKAPE Microorganisms in a Peruvian IV-Level Hospital. Infection & chemotherapy, 53(3), 449–462. https://doi.org/10.3947/ic.2021.0015.

Koneman, E. W.; Allen, S. D.; Janda, W. M.; Schreckenberger, D. C.; Winn JR., W. C. Diagnóstico microbiológico: texto e atlas colorido. 6. ed. Rio de Janeiro: Guanabara Koogan, 2008.

Mancuso, G., Midiri, A., Gerace, E., & Biondo, C. (2021). Bacterial Antibiotic Resistance: The Most Critical Pathogens. Pathogens (Basel, Switzerland), 10(10), 1310. https://doi.org/10.3390/pathogens10101310.

Martín-Loeches, I., Diaz, E., & Vallés, J. (2014). Risks for multidrug-resistant pathogens in the ICU. Current Opinion in Critical Care, 20(5), 516–524. doi:10.1097/mcc.0000000000000124.

Mei-Sheng Riley M. (2021). Infection Control and Prevention Considerations for the Intensive Care Unit. Critical care nursing clinics of North America, 33(4), ix–x. https://doi.org/10.1016/j.cnc.2021.09.003.

Morrison, L., & Zembower, T. R. (2020). Antimicrobial Resistance. Gastrointestinal Endoscopy Clinics of North America. doi:10.1016/j.giec.2020.06.004.

Pendleton, J. N., Gorman, S. P., & Gilmore, B. F. (2013). Clinical relevance of the ESKAPE pathogens. Expert review of anti-infective therapy, 11(3), 297–308. https://doi.org/10.1586/eri.13.12.

Pons, MJ & Ruiz J (2019) Current trends in epidemiology and antimicrobial resistance in intensive care units. Journal of Emergency and Critical Care Medicine. https://doi: 10.21037/jeccm.2019.01.05.

Santajit, S., & Indrawattana, N. (2016). Mechanisms of Antimicrobial Resistance in ESKAPE Pathogens. BioMed research international, 2016, 2475067. https://doi.org/10.1155/2016/2475067.

Strich, J. R., & Palmore, T. N. (2017). Preventing Transmission of Multidrug-Resistant Pathogens in the Intensive Care Unit. Infectious Disease Clinics of North America, 31(3), 535–550. doi:10.1016/j.idc.2017.05.010.

Published

13/09/2022

How to Cite

LOPES , A. J. .; REMONATO, R. R. .; ALVES, U. O. .; RODRIGUES, B. R. .; FAVERI, J. Z. de .; OLIVEIRA, C. F. de . Cross-sectional descriptive study of multidrug-resistant bacteria in the ICU environment of two medium-sized hospitals in the interior of São Paulo. Research, Society and Development, [S. l.], v. 11, n. 12, p. e254111234600, 2022. DOI: 10.33448/rsd-v11i12.34600. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/34600. Acesso em: 12 nov. 2024.

Issue

Section

Health Sciences