Prevalence of Antimicrobial Drug-resistant Bacteria in Intensive Care Unit Environment and Its Impact on Clinical Infections in Bangladesh.

AIMS AND BACKGROUND: The hospital environment, particularly the intensive care unit (ICU), constitutes a dynamic reservoir for drug-resistant bacteria that pose a significant threat to inpatients and staff. Monitoring these microorganisms are the principal strategy for controlling infection spreading and outbreaks. But, we know sparse about the ICU environment-bacteria in Bangladesh. We aimed for microbiological study of ICU environmental samples at Bangladesh Medical University (BMU, former BSMMU) in Dhaka, Bangladesh. MATERIALS AND METHODS: We bought 34 ICU environmental samples in Japan and cultured on ESBL-CHROMagar and VRE-CHROMagar media to isolate the drug-resistant bacteria. We also confirmed their susceptibility to antimicrobials using the BD Phoenix-100 system. RESULTS: Forty-eight ESBL-bacteria and two VRE were isolated from 34 samples. Clinically relevant ESBL-bacteria were identified in almost all samples. Klebsiellae pneumoniae, Enterobacter cloacae, and Pseudomonas aeruginosa were the dominant MDR-bacteria in ICU environment. K. pneumoniae was found in the ICU bed railings (3/6, 50%), at nursing desks (2/6, 33.3%), and on infusion pump panels (1/6, 16.7%). Enterobacter cloacae was found on ICU bed railings (2/6, 33.3%), on ventilator panels (2/6, 33.3%), in the water of oxygen flowmeters (1/6, 16.7%) and at the nurse desk (1/6, 16.7%). Pseudomonas aeruginosa was mostly found in the water of oxygen flowmeters (4/5, 80%) and on ICU bed railings (1/5, 20%). CONCLUSION: The ICU environment in the BMU Hospital is highly contaminated with antimicrobial-resistant bacteria, which is a contributory route for the dissemination of resistance genes among bacterial communities in the hospital. CLINICAL SIGNIFICANCE: An understanding of environmental bacteria, their resistance patterns, and their clinical impact will necessarily guide to constitute an effective infection prevention and control guidelines for the hospital.