The Presence of gram-negative bacteria carrying the New Delhi metallo-β-lactamase gene on abiotic touch surfaces at a tertiary care center

A. Agrawal, C. Varun, Anjali Shette, D. John, Ravikumar Raju
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Abstract

Objectives: New Delhi metallo-β-lactamase (NDM), which has emerged as a major mechanism of resistance to carbapenems in Gram-negative bacteria (GNB), challenges effective patient management of health-care systems. Nonpathogenic environmental bacteria present on abiotic touch surfaces in hospitals may serve as reservoirs for the NDM gene and contribute to the emergence and spread of resistance to carbapenems. The aim of this study was to determine the presence of NDM-positive GNB in the environment of a tertiary care center. Materials and Methods: Fifty-eight swab samples were collected from various touch surfaces in 12 different wards between January and February 2017. The swabs were cultured in nutrient broth and subsequently subcultured onto McConkey agar plates. Both lactose and nonlactose fermenting colonies grown were identified by biochemical methods. The polymerase chain reaction method was used to detect NDM carriage. Results: Twenty-seven (46%) of the samples were positive for microbial growth, of which 21 (36%) samples yielded bacterial growth on McConkey agar plates. Of the 30 isolates identified, 25 (83%) were nonfermenting GNB (NFGNB) and 5 (17%) were Klebsiella spp., of which 1 was Klebsiella oxytoca. NFGNB were isolated mostly from tables and infusion stands in various wards. Four of the five Klebsiella spp. were from patients' beds. Two isolates of NFGNB and one Klebsiella spp. were positive for the NDM gene. Conclusion: In addition to serving as potential pathogens of nosocomial infections, environmental bacteria present on abiotic touch surfaces in hospitals may serve as reservoirs for the NDM gene.
携带新德里金属β-内酰胺酶基因的革兰氏阴性细菌在三级保健中心非生物接触表面的存在
新德里金属-β-内酰胺酶(NDM)已成为革兰氏阴性菌(GNB)对碳青霉烯类耐药的主要机制,对卫生保健系统的有效患者管理提出了挑战。存在于医院非生物接触表面的非致病性环境细菌可能是NDM基因的储存库,并有助于碳青霉烯类耐药性的出现和传播。本研究的目的是确定三级保健中心环境中ndm阳性GNB的存在。材料与方法:2017年1 - 2月,在12个不同病房的不同接触表面采集了58份拭子样本。拭子在营养液中培养,随后传代到McConkey琼脂板上。用生化方法鉴定了培养的乳糖菌落和非乳糖菌落。采用聚合酶链反应法检测NDM载体。结果:27份(46%)样品的微生物生长呈阳性,其中21份(36%)样品在McConkey琼脂板上产生细菌生长。30株分离菌中,非发酵GNB (NFGNB) 25株(83%),克雷伯氏菌5株(17%),其中1株为氧化克雷伯氏菌。NFGNB主要分离于各病区的工作台和输液台。五种克雷伯氏菌中有四种来自病人的病床。2株NFGNB和1株克雷伯菌NDM基因阳性。结论:除了作为医院感染的潜在病原体外,存在于医院非生物接触表面的环境细菌可能是NDM基因的储存库。
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