Contamination of hospital surfaces by third-generation cephalosporin-resistant gram-negative bacteria in district hospitals in Mwanza, Tanzania: Urgent need for enhanced infection prevention and control

Summary: Background: Hospital surfaces are critical reservoirs of multidrug-resistant pathogens, including third-generation cephalosporin-resistant Gram-negative bacteria (3GC-R-GNB), significantly contributing to healthcare-associated infections (HCAIs). This challenge is pronounced in low- and mi...

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Main Authors: Ezekiel Gamuya, Mulki S. Salum, Beatrice Augustino Mtewele, Baraka Minja, Prisca Damiano, Conjester I. Mtemisika, Kulwa P. Mnibi, Reuben N. Abednego, Bernard C. Okamo, Vitus Silago, Stephen E. Mshana, Heike Claus, Jeremiah Seni
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Infection Prevention in Practice
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Online Access:http://www.sciencedirect.com/science/article/pii/S2590088925000393
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Summary:Summary: Background: Hospital surfaces are critical reservoirs of multidrug-resistant pathogens, including third-generation cephalosporin-resistant Gram-negative bacteria (3GC-R-GNB), significantly contributing to healthcare-associated infections (HCAIs). This challenge is pronounced in low- and middle-income countries, where resource constraints limit effective infection prevention and control (IPC) measures. This study screened hospital surfaces for 3GC-R-GNB in selected District Hospitals (DHs) in Mwanza, Tanzania. Methods: This cross-sectional hospital-based study was conducted between June and July, 2023. Door handles, hand-washing sinks, patients' beds, and ward floors were sampled. Isolation of 3GC-R-GNB was done on MacConkey agar supplemented with cefotaxime (2 μg/ml). Bacterial identification was done by MALDI-TOF on Vitek MS while antimicrobial susceptibility testing was done by the Kirby-Bauer method. A multiplex PCR assay was applied for the detection of extended-spectrum beta-lactamase (ESBL) genes (blaCTX-M, blaSHV, and blaTEM). Results: A total of 892 swabs were collected from hospital surfaces, of which 243 (27.2%) were 3GC-R-GNB positive. From the 243 positive samples, 55 samples exhibited polymicrobial growth making a total of 300 bacterial isolates. The most prevalent species was Acinetobacter baumannii (26.0%, 78/300), followed by Klebsiella pneumoniae (11.0%, 33/300), Escherichia coli (8.0%, 24/300), and Leclercia adecarboxylata (7.0%, 21/300). Multiplex PCR of selected isolates (n=243) revealed that 99.6% (242/243), 93.4% (227/243), and 2.9% (7/243) 3GC-R-GNB harbored blaTEM, blaCTX-M, and blaSHV genes encoding ESBLs, respectively. Conclusion: This study reveals substantial dispersion of highly resistant Gram-negative bacteria to hospital surfaces, showing the need to prevent dispersion of such contamination and targeted hospital hygiene measures to protect patients.
ISSN:2590-0889