Hand Colonization with Gram-Negative Organisms of Healthcare Workers Accessing the Cardiac Intensive Care Unit: A Cross-Sectional Study at the Uganda Heart Institute

Background. Hands of healthcare workers (HCWs) are vehicles for pathogens responsible for healthcare-associated infections (HAIs). Following the identification of Gram-negative organisms (GNOs) in all cases of HAIs in the cardiac intensive care unit (ICU), we sought to determine the burden of hand c...

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Main Authors: Lameck Ssemogerere, Cornelius Sendagire, Ceaser Mbabazi, Yvonne Namungoma, Anna Noland Oketayot, Judith Namuyonga, Cephas Mijumbi, Ritah Nkwine, Moses Othin, Michael Oketcho, John Paul Magala, Peter Lwabi, Arthur Kwizera, Martin W. Dünser, Christine Florence Najjuka
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Critical Care Research and Practice
Online Access:http://dx.doi.org/10.1155/2019/6081954
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author Lameck Ssemogerere
Cornelius Sendagire
Ceaser Mbabazi
Yvonne Namungoma
Anna Noland Oketayot
Judith Namuyonga
Cephas Mijumbi
Ritah Nkwine
Moses Othin
Michael Oketcho
John Paul Magala
Peter Lwabi
Arthur Kwizera
Martin W. Dünser
Christine Florence Najjuka
author_facet Lameck Ssemogerere
Cornelius Sendagire
Ceaser Mbabazi
Yvonne Namungoma
Anna Noland Oketayot
Judith Namuyonga
Cephas Mijumbi
Ritah Nkwine
Moses Othin
Michael Oketcho
John Paul Magala
Peter Lwabi
Arthur Kwizera
Martin W. Dünser
Christine Florence Najjuka
author_sort Lameck Ssemogerere
collection DOAJ
description Background. Hands of healthcare workers (HCWs) are vehicles for pathogens responsible for healthcare-associated infections (HAIs). Following the identification of Gram-negative organisms (GNOs) in all cases of HAIs in the cardiac intensive care unit (ICU), we sought to determine the burden of hand colonization with GNOs among healthcare workers who access the cardiac ICU. Methods. We retrospectively reviewed results from surveillance cultures of fingertip imprints of HCWs who access the cardiac ICU at the Uganda Heart Institute. We collected data on staff category, isolates, and susceptibility to antibiotics. We analyzed the data using Microsoft Excel, and the results are summarized in proportions and percentages and presented in charts and tables. Results. Fifty-six healthcare workers participated in the surveillance. 21 were ICU clinicians, 21 non-ICU clinicians, and 14 nonclinicians. GNOs were cultured in 19 (33.9%) HCWs, in which 8/19 (42.1%) were non-ICU clinicians, 6/19 (31.2%) ICU clinicians, and 5/19 (26.3%) nonclinicians. 32 isolates were identified, of which 47%, 28%, and 25% were cultured from non-ICU clinicians, nonclinicians, and ICU clinicians, respectively. Predominant isolates were Acinetobacter (34%), Citrobacter (21.9%), and Pseudomonas (21.9%). Antimicrobial resistance ranged from 4% to 90%. 9/28 (32.1%) isolates, predominantly Acinetobacter species (spp), were carbapenem resistant. 8/28 (28.6%) isolates, predominantly Citrobacter spp, were multidrug resistant. Resistance to ciprofloxacin and cefepime was low at 3.6% and 4.4%, respectively. Conclusion. Gram-negative organisms, predominantly Acinetobacter, Citrobacter, and Pseudomonas spp, were prevalent on the hands of HCWs who access the cardiac ICU irrespective of the staff category. Antimicrobial resistance was high, with multidrug resistance and carbapenem resistance common among Citrobacter spp and Acinetobacter spp, respectively. Resistance to cefepime and ciprofloxacin was low.
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spelling doaj-art-246a22f76dd74b51a132ac5a527ce1682025-08-20T02:04:41ZengWileyCritical Care Research and Practice2090-13052090-13132019-01-01201910.1155/2019/60819546081954Hand Colonization with Gram-Negative Organisms of Healthcare Workers Accessing the Cardiac Intensive Care Unit: A Cross-Sectional Study at the Uganda Heart InstituteLameck Ssemogerere0Cornelius Sendagire1Ceaser Mbabazi2Yvonne Namungoma3Anna Noland Oketayot4Judith Namuyonga5Cephas Mijumbi6Ritah Nkwine7Moses Othin8Michael Oketcho9John Paul Magala10Peter Lwabi11Arthur Kwizera12Martin W. Dünser13Christine Florence Najjuka14Department of Anaesthesia and Critical Care, Makerere University College of Health Science, Kampala, UgandaDepartment of Anaesthesia and Critical Care, Makerere University College of Health Science, Kampala, UgandaCardiac Critical Care Research Group-Uganda (CCCRG-Ug), Kampala, UgandaCardiac Critical Care Research Group-Uganda (CCCRG-Ug), Kampala, UgandaCardiac Critical Care Research Group-Uganda (CCCRG-Ug), Kampala, UgandaCardiac Critical Care Research Group-Uganda (CCCRG-Ug), Kampala, UgandaCardiac Critical Care Research Group-Uganda (CCCRG-Ug), Kampala, UgandaCardiac Critical Care Research Group-Uganda (CCCRG-Ug), Kampala, UgandaCardiac Critical Care Research Group-Uganda (CCCRG-Ug), Kampala, UgandaCardiac Critical Care Research Group-Uganda (CCCRG-Ug), Kampala, UgandaDepartment of Anaesthesia and Critical Care, Makerere University College of Health Science, Kampala, UgandaCardiac Critical Care Research Group-Uganda (CCCRG-Ug), Kampala, UgandaDepartment of Anaesthesia and Critical Care, Makerere University College of Health Science, Kampala, UgandaDepartment of Anaesthesiology and Intensive Care Medicine, Kepler University Hospital and Johannes Kepler University, Linz, AustriaDepartment of Medical Microbiology, Makerere University College of Health Science, Kampala, UgandaBackground. Hands of healthcare workers (HCWs) are vehicles for pathogens responsible for healthcare-associated infections (HAIs). Following the identification of Gram-negative organisms (GNOs) in all cases of HAIs in the cardiac intensive care unit (ICU), we sought to determine the burden of hand colonization with GNOs among healthcare workers who access the cardiac ICU. Methods. We retrospectively reviewed results from surveillance cultures of fingertip imprints of HCWs who access the cardiac ICU at the Uganda Heart Institute. We collected data on staff category, isolates, and susceptibility to antibiotics. We analyzed the data using Microsoft Excel, and the results are summarized in proportions and percentages and presented in charts and tables. Results. Fifty-six healthcare workers participated in the surveillance. 21 were ICU clinicians, 21 non-ICU clinicians, and 14 nonclinicians. GNOs were cultured in 19 (33.9%) HCWs, in which 8/19 (42.1%) were non-ICU clinicians, 6/19 (31.2%) ICU clinicians, and 5/19 (26.3%) nonclinicians. 32 isolates were identified, of which 47%, 28%, and 25% were cultured from non-ICU clinicians, nonclinicians, and ICU clinicians, respectively. Predominant isolates were Acinetobacter (34%), Citrobacter (21.9%), and Pseudomonas (21.9%). Antimicrobial resistance ranged from 4% to 90%. 9/28 (32.1%) isolates, predominantly Acinetobacter species (spp), were carbapenem resistant. 8/28 (28.6%) isolates, predominantly Citrobacter spp, were multidrug resistant. Resistance to ciprofloxacin and cefepime was low at 3.6% and 4.4%, respectively. Conclusion. Gram-negative organisms, predominantly Acinetobacter, Citrobacter, and Pseudomonas spp, were prevalent on the hands of HCWs who access the cardiac ICU irrespective of the staff category. Antimicrobial resistance was high, with multidrug resistance and carbapenem resistance common among Citrobacter spp and Acinetobacter spp, respectively. Resistance to cefepime and ciprofloxacin was low.http://dx.doi.org/10.1155/2019/6081954
spellingShingle Lameck Ssemogerere
Cornelius Sendagire
Ceaser Mbabazi
Yvonne Namungoma
Anna Noland Oketayot
Judith Namuyonga
Cephas Mijumbi
Ritah Nkwine
Moses Othin
Michael Oketcho
John Paul Magala
Peter Lwabi
Arthur Kwizera
Martin W. Dünser
Christine Florence Najjuka
Hand Colonization with Gram-Negative Organisms of Healthcare Workers Accessing the Cardiac Intensive Care Unit: A Cross-Sectional Study at the Uganda Heart Institute
Critical Care Research and Practice
title Hand Colonization with Gram-Negative Organisms of Healthcare Workers Accessing the Cardiac Intensive Care Unit: A Cross-Sectional Study at the Uganda Heart Institute
title_full Hand Colonization with Gram-Negative Organisms of Healthcare Workers Accessing the Cardiac Intensive Care Unit: A Cross-Sectional Study at the Uganda Heart Institute
title_fullStr Hand Colonization with Gram-Negative Organisms of Healthcare Workers Accessing the Cardiac Intensive Care Unit: A Cross-Sectional Study at the Uganda Heart Institute
title_full_unstemmed Hand Colonization with Gram-Negative Organisms of Healthcare Workers Accessing the Cardiac Intensive Care Unit: A Cross-Sectional Study at the Uganda Heart Institute
title_short Hand Colonization with Gram-Negative Organisms of Healthcare Workers Accessing the Cardiac Intensive Care Unit: A Cross-Sectional Study at the Uganda Heart Institute
title_sort hand colonization with gram negative organisms of healthcare workers accessing the cardiac intensive care unit a cross sectional study at the uganda heart institute
url http://dx.doi.org/10.1155/2019/6081954
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