Multidrug-resistant organisms on in-use medical textiles in a Shanghai tertiary hospital: surveillance and genomic characterization.

BACKGROUND

Medical textiles are frequently handled in healthcare settings and may serve as reservoirs for multidrug-resistant organisms (MDROs). This study investigated bacterial contamination, MDRO prevalence and genomic characteristics of MDRO isolates recovered from medical textiles in a tertiary hospital.

METHODS

A cross-sectional study was conducted between April and August 2024. Medical textile samples were collected from the outpatient department, general wards and intensive care unit (ICU). Bacterial contamination and bacterial load were assessed by microbiological culture, organism identification and antimicrobial susceptibility testing. MDRO isolates were further characterized using multilocus sequence typing, core-SNP phylogenetic analysis, antimicrobial resistance gene detection and virulence gene analysis.

RESULTS

A total of 359 samples from 21 types of medical textiles were collected. The overall MDRO detection rate was 8.64%, with the ICU showing the highest rate compared with general wards and outpatient departments. CRAB, MRSA, and CRKP were detected in 5.57, 2.23, and 0.84% of samples, respectively. Multivariable logistic regression showed that outpatient department sampling was associated with lower odds of MRSA detection (OR = 0.05, 95% CI: 0.01-0.48; p = 0.01), while airway opening was associated with lower odds of CRAB detection (OR = 0.21, 95% CI: 0.05-0.89; p = 0.03).

CONCLUSION

By integrating environmental surveillance of in-use hospital textiles with genomic characterization of MDRO isolates, this study provides evidence for risk-based textile management and infection prevention strategies.