A recent study published in Nature Communications makes a compelling case about the prevalence of antibiotic-resistant bacteria on hospital surfaces, notably within neonatal wards of low- and middle-income countries (LMICs). The study focuses predominantly on identifying Gram-negative bacteria (GNB) carrying antibiotic resistance genes (ARGs), which can contribute significantly to nosocomial infections and subsequent mortality rates. During the study, hospital surfaces and patient care equipment were sampled in order to determine the degree of bacterial colonization.
Through PCR screening, whole genome sequencing, as well as MALDI-TOF MS identification, researchers aimed to identify bacterial strains and determine if any prominent clones persist across multiple time points. Among the disturbing findings, countries like Pakistan, Bangladesh, and Ethiopia demonstrated alarming prevalence of carbapenemases. These organisms were primarily found on surfaces around the sink drain.
Bacterial species like Klebsiella pneumoniae, Enterobacter hormaechei, Acinetobacter baumannii, Serratia marcescens, and Leclercia adecarboxylata were found to be dominant strains. In particular, the study revealed the repeated identification of an identical strain of K. pneumoniae, in the same ward on numerous occasions, suggestive of clonal persistence within the environment.
The researchers also found that hospital-acquired infection (HAI) rates are markedly higher in LMICs compared to high-income countries (HICs). This highlights the urgent need for strict enforcement of infection prevention and control (IPC) guidelines, which include effective cleaning, disinfection and hygiene practices. Unfortunately, without observing these practices, problematic reservoirs of multidrug-resistant (MDR) bacteria may flourish, thereby contributing to HAIs such as surgical site infections and bloodstream infections.
Interestingly, the gathered data suggests the persistence of dominant strains across several time points. The implication here is that without a rigorous reassessment and reinforcement of Infection Prevention and Control guidelines, the struggle against antibiotic-resistant bacteria might prove an uphill battle. In summary, this study sheds light on the growing concern surrounding antibiotic-resistant bacteria on hospital surfaces, emphasizing the critical role of preventive measures and effective IPC protocols in curbing their spread within hospital settings, especially in LMICs.