Abstract:

Background: Multidrug resistant bacteria strain which confreres beta-lactamase enzymes serves as potential source of exogenous MDR infection among hospitalized patients. MDR bacterial infections are normally acquired in the hospital as HCAIs from contaminated inanimate hospital surfaces. However extended spectrum beta-lactamase and carbapenemase producing gram negative bacteria contaminating inanimate hospital surface at Sumve district hospital is not clearly understood. This study therefore aimed to determine Extended spectrum beta-lactamase (ESBL) and Carbapenemase producing gram negative bacteria contaminating inanimate hospital surface at Sumve district hospital in Mwanza, Tanzania.

Methodology: This cross-sectional hospital-based study was conducted between May and July 2023 at Sumve designated district hospital in Mwanza, Tanzania. Swab samples were collected from hospital’s inanimate surfaces such as patients’ beds, door knobs, hand washing sinks and wards’ floors twice a day, in the morning between 0800 and 0900 hours and in the afternoon between 1400 and 1500 hours. MacConkey agar supplemented with cefotaxime or meropenem (MCA-C/MCA-M) were used for isolation of third-generation cephalosporins resistant and carbapenem-resistant Gram-negative bacteria (3GCs-R-GNB and CR-GNB) respectively. Biochemical identification tests and disk diffusion method were used for identification of bacteria species and susceptibility testing of non-beta-lactam antibiotics respectively. Disk combination methods were used for phenotypic confirmation of extended spectrum beta-lactamase (ESBL) producing Enterobacterales and carbapenemase-producing Gram-negative bacteria.

Results: A total of 308 hospital surface samples were collected during this study. The overall prevalence of hospital surfaces contamination by 3GCs-R-GNB and CR0-GNB was 24% (n=74) and 14% (n=46) respectively. The most frequent 3GCs-R-GNB species identified was Acinetobacter spp (50.5%) while the most frequent CR-GNB species identified was Acinetobacter spp (73.2%). Inanimate surfaces in female surgical ward 39.2% (n=29) followed by pediatric ward 31.1% (n=23) were more contaminated than other wards. The proportion of ESBL phenotypes among Enterobacterales (46.4%; n=45) was 75.6% (n=34) and the proportion of carbapenem-resistant phenotypes among CR-GNB was 73.2% (n=41). Generally, 3GC-R-GNB and CR-GNB exhibited more resistance (>50%) towards trimethoprim-sulfamethoxazole, ciprofloxacin, tetracycline and gentamicin and less resistance (<20%) towards amikacin.

Conclusion: This study highlights the existence of 3GC-R-GNB and CR-GNB contaminating inanimate hospital surfaces at Sumve designated district hospital in Mwanza, Tanzania. Acinetobacter spp., is the predominant MDR bacteria contaminating inanimate hospital surfaces at this setting. Whereby, female surgical ward, patients’ beds and wards’ floors were commonly contaminated.