#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Contamination of hospital surfaces with respiratory pathogens in Bangladesh


Autoři: Md. Zakiul Hassan aff001;  Katharine Sturm-Ramirez aff001;  Mohammad Ziaur Rahman aff001;  Kamal Hossain aff001;  Mohammad Abdul Aleem aff002;  Mejbah Uddin Bhuiyan aff003;  Md. Muzahidul Islam aff001;  Mahmudur Rahman aff004;  Emily S. Gurley aff005
Působiště autorů: icddr,b (formerly, International Centre for Diarrheal Disease Research, Bangladesh), Dhaka, Bangladesh aff001;  School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia aff002;  Division of Paediatrics, School of Medicine, The University of Western Australia, Perth, WA, Australia aff003;  Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh aff004;  Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0224065

Souhrn

With limited infection control practices in overcrowded Bangladeshi hospitals, surfaces may play an important role in the transmission of respiratory pathogens in hospital wards and pose a serious risk of infection for patients, health care workers, caregivers and visitors. In this study, we aimed to identify if surfaces near hospitalized patients with respiratory infections were contaminated with respiratory pathogens and to identify which surfaces were most commonly contaminated. Between September-November 2013, we collected respiratory (nasopharyngeal and oropharyngeal) swabs from patients hospitalized with respiratory illness in adult medicine and paediatric medicine wards at two public tertiary care hospitals in Bangladesh. We collected surface swabs from up to five surfaces near each case-patient including: the wall, bed rail, bed sheet, clinical file, and multipurpose towel used for care giving purposes. We tested swabs using real-time multiplex PCR for 19 viral and 12 bacterial pathogens. Case-patients with at least one pathogen detected had corresponding surface swabs tested for those same pathogens. Of 104 patients tested, 79 had a laboratory-confirmed respiratory pathogen. Of the 287 swabs collected from surfaces near these patients, 133 (46%) had evidence of contamination with at least one pathogen. The most commonly contaminated surfaces were the bed sheet and the towel. Sixty-two percent of patients with a laboratory-confirmed respiratory pathgen (49/79) had detectable viral or bacterial nucleic acid on at least one surface. Klebsiella pneumoniae was the most frequently detected pathogen on both respiratory swabs (32%, 33/104) and on surfaces near patients positive for this organism (97%, 32/33). Surfaces near patients hospitalized with respiratory infections were frequently contaminated by pathogens, with Klebsiella pneumoniae being most common, highlighting the potential for transmission of respiratory pathogens via surfaces. Efforts to introduce routine cleaning in wards may be a feasible strategy to improve infection control, given that severe space constraints prohibit cohorting patients with respiratory illness.

Klíčová slova:

Bacterial pathogens – Nosocomial infections – Nucleic acids – Pediatrics – Respiratory infections – Respiratory syncytial virus


Zdroje

1. Boone SA, Gerba CP. Significance of fomites in the spread of respiratory and enteric viral disease. Applied and environmental microbiology. 2007;73(6):1687–96. doi: 10.1128/AEM.02051-06 17220247

2. Boyce JM. Environmental contamination makes an important contribution to hospital infection. Journal of Hospital infection. 2007;65(2):50–4.

3. Weinstein RA, Hota B. Contamination, disinfection, and cross-colonization: are hospital surfaces reservoirs for nosocomial infection? Clinical infectious diseases. 2004;39(8):1182–9. doi: 10.1086/424667 15486843

4. Hassan MZ, Sazzad HM, Luby SP, Sturm-Ramirez K, Bhuiyan MU, Rahman MZ, et al. Nipah Virus Contamination of Hospital Surfaces during Outbreaks, Bangladesh, 2013–2014. Emerging infectious diseases. 2018;24(1):15. doi: 10.3201/eid2401.161758 29260663

5. Kramer A, Schwebke I, Kampf G. How long do nosocomial pathogens persist on inanimate surfaces? A systematic review. BMC Infectious Diseases. 2006;6(1):130.

6. Cheng V, Chau P, Lee W, Ho S, Lee D, So S, et al. Hand-touch contact assessment of high-touch and mutual-touch surfaces among healthcare workers, patients, and visitors. Journal of Hospital Infection. 2015;90(3):220–5. doi: 10.1016/j.jhin.2014.12.024 25929790

7. Rimi NA, Sultana R, Luby SP, Islam MS, Uddin M, Hossain MJ, et al. Infrastructure and contamination of the physical environment in three Bangladeshi hospitals: putting infection control into context. PloS one. 2014;9(2):e89085. doi: 10.1371/journal.pone.0089085 24586516

8. Islam MS, Luby SP, Sultana R, Rimi NA, Zaman RU, Uddin M, et al. Family caregivers in public tertiary care hospitals in Bangladesh: risks and opportunities for infection control. American journal of infection control. 2014;42(3):305–10. doi: 10.1016/j.ajic.2013.09.012 24406254

9. Ahmed SM, Hossain MA, RajaChowdhury AM, Bhuiya AU. The health workforce crisis in Bangladesh: shortage, inappropriate skill-mix and inequitable distribution. Human resources for health. 2011;9(1):3.

10. Mustafa A, Begum T. Universal Health Coverage Assessment People’s Republic of Bangladesh. 2014.

11. Rosenthal VD, Al-Abdely HM, El-Kholy AA, AlKhawaja SAA, Leblebicioglu H, Mehta Y, et al. International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010–2015: Device-associated module. American journal of infection control. 2016;44(12):1495–504. doi: 10.1016/j.ajic.2016.08.007 27742143

12. Bhuiyan MU, Luby SP, Zaman RU, Rahman MW, Sharker MY, Hossain MJ, et al. Incidence of and risk factors for hospital-acquired diarrhea in three tertiary care public hospitals in Bangladesh. The American journal of tropical medicine and hygiene. 2014;91(1):165–72. doi: 10.4269/ajtmh.13-0484 24778198

13. Organization WH. WHO interim global epidemiological surveillance standards for influenza. 2012. 2013.

14. Organization WH. Manual for the laboratory diagnosis and virological surveillance of influenza. 2011.

15. Huslage K, Rutala WA, Sickbert-Bennett E, Weber DJ. A quantitative approach to defining “high-touch” surfaces in hospitals. Infection Control & Hospital Epidemiology. 2010;31(8):850–3.

16. Bhuiyan MU, Luby SP, Alamgir NI, Homaira N, Mamun AA, Khan JA, et al. Economic burden of influenza‐associated hospitalizations and outpatient visits in Bangladesh during 2010. Influenza and other respiratory viruses. 2014;8(4):406–13. doi: 10.1111/irv.12254 24750586

17. Morris SK, Pell LG, Rahman MZ, Dimitris MC, Mahmud A, Islam MM, et al. Maternal vitamin D supplementation during pregnancy and lactation to prevent acute respiratory infections in infancy in Dhaka, Bangladesh (MDARI trial): protocol for a prospective cohort study nested within a randomized controlled trial. BMC pregnancy and childbirth. 2016;16(1):309. doi: 10.1186/s12884-016-1103-9 27737646

18. FTD Respiratory pathogens 33 Luxemburg: Fast track diagnostics. Available from: http://www.fast-trackdiagnostics.com/human-line/products/ftd-respiratory-pathogens-33/.

19. Pena C, Pujol M, Ardanuy C, Ricart A, Pallares R, Linares J, et al. An outbreak of hospital-acquired Klebsiella pneumoniae bacteraemia, including strains producing extended-spectrum β-lactamase. Journal of Hospital Infection. 2001;47(1):53–9. doi: 10.1053/jhin.2000.0862 11161899

20. Woodford N, Tierno PM, Young K, Tysall L, Palepou M-FI, Ward E, et al. Outbreak of Klebsiella pneumoniae producing a new carbapenem-hydrolyzing class A β-lactamase, KPC-3, in a New York medical center. Antimicrobial agents and chemotherapy. 2004;48(12):4793–9. doi: 10.1128/AAC.48.12.4793-4799.2004 15561858

21. Bhuiyan MU. Incidence and viral aetiology of hospital-acquired respiratory infections at three tertiary care hospitals in Bangladesh, 2008–2011. Health and Science Bulletin. 2014;12(3):1–8.

22. Gurley ES, Zaman RU, Sultana R, Bell M, Fry AM, Srinivasan A, et al. Rates of hospital-acquired respiratory illness in Bangladeshi tertiary care hospitals: results from a low-cost pilot surveillance strategy. Clinical infectious diseases. 2010;50(8):1084–90. doi: 10.1086/651265 20210642

23. Hirsch EB, Tam VH. Detection and treatment options for Klebsiella pneumoniae carbapenemases (KPCs): an emerging cause of multidrug-resistant infection. Journal of Antimicrobial Chemotherapy. 2010;65(6):1119–25. doi: 10.1093/jac/dkq108 20378670

24. Freeman JT, Nimmo J, Gregory E, Tiong A, De Almeida M, McAuliffe GN, et al. Predictors of hospital surface contamination with Extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae: patient and organism factors. Antimicrobial resistance and infection control. 2014;3(1):5. doi: 10.1186/2047-2994-3-5 24491119

25. Rahman MM, Haq JA, Hossain MA, Sultana R, Islam F, Islam AS. Prevalence of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae in an urban hospital in Dhaka, Bangladesh. International journal of antimicrobial agents. 2004;24(5):508–10. doi: 10.1016/j.ijantimicag.2004.05.007 15519486

26. Neely AN, Maley MP. Survival of enterococci and staphylococci on hospital fabrics and plastic. Journal of clinical microbiology. 2000;38(2):724–6. 10655374

27. Weemering ML. Survival of enterococci and staphylococci on hospital fabrics and plastic. Aorn Journal. 2001;73(2):515–.

28. Fux C, Costerton J, Stewart P, Stoodley P. Survival strategies of infectious biofilms. Trends in microbiology. 2005;13(1):34–40. doi: 10.1016/j.tim.2004.11.010 15639630

29. Silva RC, Carver RA, Ojano‐Dirain CP, Antonelli PJ. Efficacy of disinfecting solutions in removing biofilms from polyvinyl chloride tracheostomy tubes. The Laryngoscope. 2013;123(1):259–63. doi: 10.1002/lary.23612 22887035

30. Horng L, Unicomb L, Alam M-U, Halder A, Shoab A, Ghosh P, et al. Healthcare worker and family caregiver hand hygiene in Bangladeshi healthcare facilities: results from the Bangladesh National Hygiene Baseline Survey. Journal of Hospital Infection. 2016;94(3):286–94. doi: 10.1016/j.jhin.2016.08.016 27665311

31. French CE, McKenzie BC, Coope C, Rajanaidu S, Paranthaman K, Pebody R, et al. Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review. Influenza and other respiratory viruses. 2016;10(4):268–90. doi: 10.1111/irv.12379 26901358

32. Nabeya D, Kinjo T, Parrott GL, Uehara A, Motooka D, Nakamura S, et al. The clinical and phylogenetic investigation for a nosocomial outbreak of respiratory syncytial virus infection in an adult hemato‐oncology unit. Journal of medical virology. 2017;89(8):1364–72. doi: 10.1002/jmv.24800 28240370

33. Hassan MZ SH, Luby SP, Sturm-Ramirez K, Bhuiyan MU, Rahman MZ, et al. Nipah virus contamination of hospital surfaces during outbreaks, Bangladesh, 2013–2014. Emerg Infect Dis. 24(1). https://doi.org/10.3201/eid2401.161758.

34. Zaman RU, Alamgir A, Rahman M, Azziz-Baumgartner E, Gurley ES, Sharker MAY, et al. Influenza in outpatient ILI case-patients in national hospital-based surveillance, Bangladesh, 2007–2008. PloS one. 2009;4(12):e8452. doi: 10.1371/journal.pone.0008452 20041114

35. Ahmed M, Aleem MA, Roguski K, Abedin J, Islam A, Alam KF, et al. Estimates of seasonal influenza‐associated mortality in Bangladesh, 2010‐2012. Influenza and other respiratory viruses. 2017.

36. Services DGoH. Manual for implmentation of 5S in Hospital Setting. In: welfare MoHF, editor. Bangladesh: DGHS, Ministry of Health & Family welfare; 2015.

37. Gurley ES, Islam MS, Nahar N, Sultana R, Hossain MJ, Homaira N, et al. Behaviour change intervention to reduce caregivers’ exposure to patients’ oral and nasal secretions in Bangladesh. International Journal of Infection Control. 2013;9(2).

38. Horng L, Unicomb L, Alam M-U, Halder A, Ghosh P, Luby S, editors. Health Worker and Family Caregiver Hand Hygiene in Bangladesh Healthcare Facilities: Results From a Nationally Representative Survey. Open Forum Infectious Diseases; 2015: Oxford University Press.

39. (QIS) QiS. National Patient Safety Strategic Plan in Bangladesh. In: Welfare MoHF, editor. Bangladesh: Health Economics Unit, Health Sevices Division; 2018.


Článek vyšel v časopise

PLOS One


2019 Číslo 10
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

KOST
Koncepce osteologické péče pro gynekology a praktické lékaře
nový kurz
Autoři: MUDr. František Šenk

Sekvenční léčba schizofrenie
Autoři: MUDr. Jana Hořínková

Hypertenze a hypercholesterolémie – synergický efekt léčby
Autoři: prof. MUDr. Hana Rosolová, DrSc.

Svět praktické medicíny 5/2023 (znalostní test z časopisu)

Imunopatologie? … a co my s tím???
Autoři: doc. MUDr. Helena Lahoda Brodská, Ph.D.

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#