Prevalence of Antimicrobial Drug-resistant Bacteria in Intensive Care Unit Environment and Its Impact on Clinical Infections in Bangladesh.

AIMS AND

BACKGROUND

The hospital environment, particularly the intensive care unit (ICU), constitutes a dynamic reservoir for drug-resistant bacteria that pose a significant threat to inpatients and staff. Monitoring these microorganisms are the principal strategy for controlling infection spreading and outbreaks. But, we know sparse about the ICU environment-bacteria in Bangladesh. We aimed for microbiological study of ICU environmental samples at Bangladesh Medical University (BMU, former BSMMU) in Dhaka, Bangladesh.

MATERIALS AND

METHODS

We bought 34 ICU environmental samples in Japan and cultured on ESBL-CHROMagar and VRE-CHROMagar media to isolate the drug-resistant bacteria. We also confirmed their susceptibility to antimicrobials using the BD Phoenix-100 system.

RESULTS

Forty-eight ESBL-bacteria and two VRE were isolated from 34 samples. Clinically relevant ESBL-bacteria were identified in almost all samples. Klebsiellae pneumoniae, Enterobacter cloacae, and Pseudomonas aeruginosa were the dominant MDR-bacteria in ICU environment. K. pneumoniae was found in the ICU bed railings (3/6, 50%), at nursing desks (2/6, 33.3%), and on infusion pump panels (1/6, 16.7%). Enterobacter cloacae was found on ICU bed railings (2/6, 33.3%), on ventilator panels (2/6, 33.3%), in the water of oxygen flowmeters (1/6, 16.7%) and at the nurse desk (1/6, 16.7%). Pseudomonas aeruginosa was mostly found in the water of oxygen flowmeters (4/5, 80%) and on ICU bed railings (1/5, 20%).

CONCLUSION

The ICU environment in the BMU Hospital is highly contaminated with antimicrobial-resistant bacteria, which is a contributory route for the dissemination of resistance genes among bacterial communities in the hospital.

CLINICAL SIGNIFICANCE: An understanding of environmental bacteria, their resistance patterns, and their clinical impact will necessarily guide to constitute an effective infection prevention and control guidelines for the hospital.