Korean J healthc assoc Infect Control Prev.  2020 Dec;25(2):105-114. 10.14192/kjicp.2020.25.2.105.

Environmental Culture of Bacteria at the Intensive Care Unit of a Tertiary Hospital in Korea: A Consideration for Improving Medical Environmental Safety and Healthcare-associated Infection

• Shi HJ
• Kim JH
• Kim NY
• Lee JB
• Eom JS

• KMID: 2510136
• DOI: http://doi.org/10.14192/kjicp.2020.25.2.105

Abstract

Background
Intensive care unit (ICU) infections cause major health and financial problems worldwide. Inanimate surfaces and environmental contamination can play a role in the crossinfection of pathogens and associated patient infection. Here, we aimed to identify the pathogens that are present in the ICUs.
Methods
This study analyzed bacterial cultures on 160 environmental samples from the ICU at a tertiary hospital in Incheon.
Results
From cultures of 160 samples, 407 bacteria of 38 species were isolated; of these, 109 (26.8%) were gram-negative and 298 (73.2%) were gram-positive. The common isolation sites were keyboards (38 strains), bed linen sheets (average head, waist, and foot seats) (36 strains), bedside rails (33 strains), and curtains (27 strains). The common bacteria isolated were coagulase-negative staphylococci (CNS) (222 strains, 54.5%), Acinetobacter baumannii (48 strains, 11.8%), Pseudomonas aeruginosa (33 strains, 8.1%), and Enterococcus faecium (24 strains, 5.9%). A total of 60 multidrug-resistant strains were isolated. There were multidrug-resistant Acinetobacter baumannii (MRAB) (n=32), multidrug-resistant Pseudomonas aeruginosa (MRPA) (n=2), vancomycin-resistant Enterococcus (VRE) (n=20), and carbapenem-resistant Enterobacteriaceae (CRE) (n=6).
Conclusion
It was confirmed that large numbers of multidrug-resistant bacteria, such as VRE and CRE, colonized the environment in the ICU of this tertiary hospital. Taken together, the findings of this study will inform consideration of new intervention plans for in-hospital medical infection control programs in the future, especially in critical care units.

Keyword

Bacteria; Multidrug resistance; Intensive care units; Cross infection; Infection control

Figure

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  Fig. 1 Sites of environmental culture. (1) Keyboard of computer, (2) mouse of computer, (3) monitor of a computer at bedside, (4) patient trays, (5) bed removable table, (6) infusion pump modulator, (7) bedside shelves, (8) bedside rails, (9) bed modulator (remote controller), (10) bed linen (head), (11) bed linen (body), (12) bed linen (leg), (13) mechanical ventilator, (14) patient monitoring modulator, (15) suction bottle, (16) ventilator and other infusion line area, (17) patient curtain, (18) washstands, (19) water tap, (20) infusion pump holder.

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