Abstract:

Background: Beta-lactamase producing Gram negative bacteria contaminating inanimate hospital surfaces can lead to multi drug resistance (MDR) infections, of which these infections leads to serious illnesses, treatment failure, prolonged hospital stays and increased health care cost. However, there are scant studies showing evidence of hospital surface contamination by beta-lactamase producing Gram-negative bacteria at district hospitals in Mwanza, Tanzania. So, this study aims to determine the prevalence of hospital surface contamination with extended spectrum beta-lactamases (ESBL) and carbapenemase resistant (CR) producing Gram-negative bacteria (ESBL-GNB and CR-GNB) at Misungwi district hospital.

Methods: A cross-sectional hospital-based study was conducted by swabbing inanimate hospital surfaces such as beds, sinks, door knobs and floor at Misungwi district hospital between May and August 2023. Swab samples were collected from medical, surgical and pediatric wards, twice a day at 0830hrs and 1400hrs in Monday and Friday. The inanimate surfaces were swabbed by using a sterile cotton swabs which were transported in Stuart transport media to Microbiology laboratory at Catholic University of Health and Allied Sciences for processing in the same day. Each swab sample was firstly inoculated on MacConkey agar (MCA) supplemented with cefotaxime 2ug/ml and then on MCA supplemented with meropenem 1ug/ml for isolation of potential ESBL-GNB and CR-GNB respectively. Bacteria isolates were identified to species by in-house prepared biochemical identification testing followed by antibiotic susceptibility testing of non-beta-lactam antibiotics by disk diffusion method. Disk combination method was used for phenotypic confirmation of ESBL-GNB and CR-GNB strains. Further, multiplex PCR amplification and detection were done to characterize genes coding for ESBL and carbapenemases production. Data was entered in Microsoft excel and analyzed by using STATA version 15.0.

Result: We found out that the prevalence of 3GC-R-GNB and CR-GNB was 29.3% and 16.7% respectively. Acinetobacter spp., Klebsiella pneumoniae and Enterobacter aerogenes were frequently detected among 3GC-R-GNB while Acinetobacter spp., and Pseudomonas aeruginosa were frequently detected among CR-GNB contaminating inanimate hospital surfaces at this setting. Pediatric ward, floor and patient’s beds were highly contaminated by the 3GC-R-GNB and CR-GNB.

Conclusion. High proportion of inanimate hospital surfaces contaminated by 3GC-GNB and CR-GNB at Misungwi district hospital. Therefore, the finding supports for improved infection and control measures particularly environmental cleaning.