Recognizing the significant role environmental contamination by carbapenem-resistant gram-negative bacteria (CR-GNB) plays in healthcare-associated infections in intensive care units (ICUs), this article presents findings from a comprehensive surveillance study conducted in the ICU of a tertiary hospital over a four-year period, extending from January 2019 to December 2022.
The study began by collecting clinical specimens, including sputum, urine, blood samples, and environmental samples such as inanimate surfaces, and healthcare workers’ hands every month. The collected gram-negative bacteria underwent carbapenem sensitivity testing. Out of 5,097 clinical specimens, 898 (17.6%) GNB isolates and 405 (8.0%) CR-GNB isolates emerged, with Klebsiella pneumoniae and carbapenem-resistant Acinetobacter baumannii (CRAB) standing out as the most common species.
Turning to the 2,215 environmental samples, 144 (6.5%) GNB and 90 (4.1%) CR-GNB strains were identified. A. baumannii and CRAB constituted the majority. Upon further breakdown, the highest contamination rates of CR-GNB were found on work coats (6.8%), nonisolated patient medical devices (5.8%), bed units of nonisolated patients (4.3%), mobile phones (4.1%), doctors’ offices and nurses’ stations (3.6%), and finally healthcare workers’ hands (2.0%).
Through the application of Spearman’s correlation analysis, the study unveiled a significant positive correlation between the monthly count of positive A. baumannii or CRAB isolates obtained from environmental samples and clinical specimens. The study underscores the fact that CR-GNB, particularly CRAB, contaminates ICU environments including non-isolated patient areas and healthcare stations.
In conclusion, the findings reiterate the compelling need for an enhanced environmental surveillance system in the ICU. Combating the challenge of such rampant contamination calls for the collective effort of healthcare professionals, incorporating robust methods of disinfection, stringent hand hygiene practices and consistent, careful monitoring of bacterial presence on inanimate objects within the hospital environment. While these measures may appear resource-intensive, they’re indeed a small price to pay to restrict the spread of CR-GNB and ensure the safety of patients in ICUs.