Summary
Background
The increasing prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae
in the healthcare setting and in the community despite established infection control
guidelines indicates that these microorganisms may possess survival strategies that
allow them to persist in the environment.
Aims
To determine the extent and variation in endemic ESBL-carrying species in different
ward environments, and to investigate the potential for cephalosporin resistance to
be transferred from environmental isolates to human pathogens.
Methods
Conventional microbiological methods were used to sample 1436 environmental surfaces
for ESBL-producing bacteria. Transconjugation assays (broth mating experiments) were
performed using environmental ESBL-producing isolates as donors and streptomycin-resistant
Escherichia coli (NCTC 50237) as the recipient.
Findings
The prevalence of ESBL-producing bacteria on surfaces in a non-outbreak setting was
low (45/1436; 3.1%). The sites most likely to be contaminated were the drains of handwash
basins (28/105; 26.7%) and floors (14/160; 8.8%). Fifty-nine ESBL-carrying organisms
were isolated. Of these, Klebsiella spp. (33.9%), Enterobacter spp. (20.3%), Pantoea spp. (15.3%) and Citrobacter spp. (13.6%) were the most common isolates. ESBL determinants were transferred successfully
from three representative environmental isolates (Pantoea calida, Klebsiella oxytoca, Raoultella ornithinolytica) to the human pathogen E. coli.
Conclusion
ESBL-producing Gram-negative isolates were recovered from the hospital environment
in the absence of any ESBL infection on the wards. The drains of handwash basins should
be considered potential long-term reservoirs of multi-drug-resistant bacteria and
drug resistance genes. These genes can reside in various genera of hardy environmental
organisms and be a potential source of ESBL for more common human pathogens.
Keywords
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Article info
Publication history
Published online: September 16, 2016
Accepted:
September 3,
2016
Received:
April 25,
2016
Identification
Copyright
© 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
