Environmental sampling reveals reservoirs of antimicrobial resistance in a tertiary care Indian hospital: an observational study to strengthen infection control practices.

OBJECTIVES

This study was designed to assess the bacterial profile and their phenotypic and genotypic antimicrobial resistance pattern in samples from a level I trauma center in India.

METHODS

A total of 387 samples were collected from surfaces, equipment, water, and hand swabs of intensive care units (ICUs), wards, and other hospital locations between May 2021 and July 2022 and analyzed for bacterial identification (MALDI-TOF), antimicrobial susceptibility (Vitek2), extended-spectrum beta-lactamase (ESBL and AmpC), and carbapenemase genes.

RESULTS

The majority of isolates (91.5%) were Gram-negative; 44.1% of Gram-negative isolates were either multidrug-resistant (MDR) or extensively drug-resistant (XDR), with MDR being most common in Acinetobacter spp. (54.5%) and XDR in Escherichia coli (37.8%). Isolates also have a high prevalence of ESBL (55.5%), AmpC (45%), and carbapenemase (64.7%) genes. Isolates from ICUs and equipment had a significantly higher resistance and MDR percentage (34.5%, 38.7%). ICU isolates also have a significantly higher prevalence of carbapenemase genes (76%).

CONCLUSIONS

This study provides baseline data on antimicrobial resistance within the hospital and underlines the role of ICUs and equipment in cross-contamination, which can be used to devise evidence-based infection control practices.