Investigation of environmental contamination with staphylococci in the intensive care unit of Sanandaj hospitals
نویسندگان: Sareh Kholaseh, Safoura Derakhshan ©
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Background and Aim
Nosocomial infections with staphylococci, especially in the ICU, are one of the main factors increasing the cost of treatment and transmission of the infection to the community. The aim of this study was to determine the level of environmental contamination of the ICUs of teaching hospitals in Sanandaj with three important species of Staphylococcus (Staphylococcus aureus, Staphylococcus epidermidis and Staphylococcus saprophyticus) and their antibiotic resistance.
In this cross-sectional study, samples were collected by swab for 3 months at two-week intervals from different parts of the ICU and after culture, were incubated at 37° C for 24 to 48 hours. Suspicious colonies were identified using standard methods such as catalase, coagulase, mannitol fermentation, etc. Identification of heat-resistant nuclease gene (nuc) by polymerase chain reaction (PCR) was used to confirm S. aureus. Antibiotic susceptibility was determined by disk diffusion method for 7 antibiotics and methicillin resistance was determined using cefoxitin disk according to CLSI 2020 standard. Methicillin resistance gene mecA and class 1 integron were also identified by PCR.
In this study, out of 90 samples contaminated with the bacteria; 29 samples (32.2%) were contaminated with S. aureus and 25 samples (27.8%) with S. epidermidis. S. saprophyticus was not identified. S. aureus showed the highest sensitivity to linezolid (100%), followed by cotrimoxazole (96.5%) and ciprofloxacin and gentamicin (93.1%, each). Seventeen isolates were resistant to cefoxitin (58.6%) (MRSA), of them 16 isolates carried mecA. S. epidermidis also showed the highest susceptibility to linezolid (100%), followed by cotrimaxazole and gentamicin (52% each) and ciprofloxacin (44%). Sixteen isolates were resistant to cefoxitin (64%) (MRSE), of them 14 isolates harbored mecA gene. Also, 4 S. aureus (13.8%) and 3 S. epidermidis isolates (12%) contained class 1 integron.
Our study showed a high prevalence of S. aureus and S. epidermidis isolates in ICU. Also, a high percentage of strains were resistant to methicillin. Given the risk of transmitting nosocomial infections, detecting contamination of environmental surfaces in hospitals can help reduce the risk of these types of infections.
Methicillin-resistance; Nosocomial infections; Environmental surfaces; ICU
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