Multi Drug Resistant bacteria: prevalence and associated risk factors amongst ICU health care workers of a tertiary care hospital
Keywords:
Health Care Worker, Multi drug resistant Bacteria, hand hygiene, bacterial colonization
Abstract
Background: MDR bacteria pose serious threat to patient safety worldwide.HCW is an important source of dissemination and transmission of these organisms to patients. Although many studies have been carried out in India which have determined the prevalence of one or two MDR bacteria colonizing the HCW, but no study so far has determined the prevalence and common risk factors for acquisition of the most prevalent type of MDR. Methods: Hand swabs from 198 HCW were obtained, processed and isolates identified by automated method using Vitek II (Biomerieux, Durham,NC).Risk factor assessment was done based on a questionnaire using Fischer’s exact /Chi square test.Result: A total of 24 HCWs (12.1%) were found positive for MDR bacteria.MDR Acinetobacter baumanii 10(5.1%), MDR Pseudomonas aeruginosa 7(3.4%) MRSA were 5(3.2%), and Vancomycin Resistant Enterococcus 2(0.6%).Majority of MDR (16.1%) was isolated from hands of doctors. Male sex, presence of chronic /open wound and close contact with patients were factors found significantly associated with colonization of hands of HCW.Conclusion: HCAI in the vulnerable ICU patient population can be linked to the MDR bacterial flora of the HCWs. The contamination of healthcare workers’ hands during patient care with multidrug- resistant organisms is most frequent with A. baumannii. Compliance with contact precautions and more aggressive environmental cleaning may decrease transmission.DOI:10.21276/APALM.1485References
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13.Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev 2008; 21:538–582.
14.Kamble R. Acinetobacter species in health care setting: Clinical significance and antimicrobial sensitivity. Int J Curr Microbiolo App Sci 2015;4(4):861-869.
15.Pters C, Dulon M, Kleinmuller O, Nienhaus A, Scblon A. MRSA prevelance and risk factors among health personnel and residents in nursing homes in Hanburg , Germany- a cross sectional study. PLOS ONE 2017;12(1) :e0169425.
16.Robicsek A, Beaumont JL, Paule SM, et al. Universal surveillance for methicillin-resistant Staphylocloccus aureus in 3 affiliated hospitals. Ann Intern Med 2008;148:409–418.
2.Gaynes R, Edwards JR. National Nosocomial Infections Surveillance System. Overview of nosocomial infections caused by gram-negative bacilli. Clin Infect Dis 2005;41: 848–854.
3.Harbarth S, Fankhauser C, Schrenzel J, et al. Universal screening for methicillin-resistant Staphylococcus aureus at hospital admission and nosocomial infection in surgical patients. JAMA 2008; 299:1149-57.
4.Barbolla RE, Centron D, Maimone S, et al. Molecular epidemiology of Acinetobacter baumannii spread in an adult intensive care unit under an endemic setting. Am J Infect Control 2008;36: 444–452.
5.Olsen R, Lynch P, Coyle M, Cummings J, Bokete T, Stamm W. Examination gloves as barriers to hand contamination in clinical practice. JAMA 1993; 270:350–353.
6.Sassmannshausen R, Deurenberg RH, Kock R, et al. MRSA Prevelance and associated risk factors among Health care workers in non outbreak situations in the Dutch –German EUREGIO. Frontiers in Microbiology. 2016;7:1273
7.Clinical and laboratory Standards Institute. Performance Standards for antimicrobial testing; fifteenth informational supplement M10-S14, wayne , PA, CLSI. 2016
8.Go ES, Urbans C, Burns J, Kreiswirth B, Eisner W, Mariano N, et al. Clinical and molecular epidemiology of acinetobacter infections sensitive only to polymyxin B and sulbactum. Lancet. 1994; 344:1329-32.
9.Malini J, Shruti A, Padmavathy M, Umapathy B.L,NAvaneeth B.V, et al. Methicillin resistant Staphylococcus carriage among the health workers in a tertiary care hospital. JCDR 2012 June;6:791-93.
10.Mathanraj S, Sujatha S, Sivasangeetha K, Parija SC. Screening for methicillin resistant Staphylococcus aureus carriers among the patients and health care workers of a tertiary care hospital in south Indian J Med Microbiology 2009;27(1):62-64.
11.Sood S, Malhotra M, Das BK, Kapil A. Enterococcal infections and antimicrobial resiatnace. Indian J Med Res 2008;128:111-21.
12.Khodavaisy S, Nabili M, Davari B, Vahedui M. Evaluation of bacterial anti-fungal contamination in health care worker’s hands and ring s in the intensive care unit. J prev Med Hyg 2011;52:215-218.
13.Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev 2008; 21:538–582.
14.Kamble R. Acinetobacter species in health care setting: Clinical significance and antimicrobial sensitivity. Int J Curr Microbiolo App Sci 2015;4(4):861-869.
15.Pters C, Dulon M, Kleinmuller O, Nienhaus A, Scblon A. MRSA prevelance and risk factors among health personnel and residents in nursing homes in Hanburg , Germany- a cross sectional study. PLOS ONE 2017;12(1) :e0169425.
16.Robicsek A, Beaumont JL, Paule SM, et al. Universal surveillance for methicillin-resistant Staphylocloccus aureus in 3 affiliated hospitals. Ann Intern Med 2008;148:409–418.
Published
27-10-2017
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