Colonisation of hospital surfaces from low- and middle-income countries by extended spectrum β-lactamase- and carbapenemase-producing bacteria

Nieto-Rosado, Maria, Sands, Kirsty, Portal, Edward A. R., Thomson, Kathryn M., Carvalho, Maria J., Mathias, Jordan, Milton, Rebecca, Dyer, Calie, Akpulu, Chinenye, Boostrom, Ian, Hogan, Patrick, Saif, Habiba, Sanches Ferreira, Ana D., Hender, Thomas, Portal, Barbra, Andrews, Robert, Watkins, W. John ORCID: https://orcid.org/0000-0003-3262-6588, Zahra, Rabaab, Shirazi, Haider, Muhammad, Adil, Ullah, Syed Najeeb, Jan, Muhammad Hilal, Akif, Shermeen, Iregbu, Kenneth C., Modibbo, Fatima, Uwaezuoke, Stella, Audu, Lamidi, Edwin, Chinago P., Yusuf, Ashiru H., Adeleye, Adeola, Mukkadas, Aisha S., Mazarati, Jean Baptiste, Rucogoza, Aniceth, Gaju, Lucie, Mehtar, Shaheen, Bulabula, Andrew N. H., Whitelaw, Andrew, Roberts, Lauren, Chan, Grace, Bekele, Delayehu, Solomon, Semaria, Abayneh, Mahlet, Metaferia, Gesit, Group BARNARDS and Walsh, Timothy R. ORCID: https://orcid.org/0000-0003-4315-4096 2024. Colonisation of hospital surfaces from low- and middle-income countries by extended spectrum β-lactamase- and carbapenemase-producing bacteria. Nature Communications 15 , 2758. 10.1038/s41467-024-46684-z

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Abstract

Hospital surfaces can harbour bacterial pathogens, which may disseminate and cause nosocomial infections, contributing towards mortality in low- and middle-income countries (LMICs). During the BARNARDS study, hospital surfaces from neonatal wards were sampled to assess the degree of environmental surface and patient care equipment colonisation by Gram-negative bacteria (GNB) carrying antibiotic resistance genes (ARGs). Here, we perform PCR screening for extended-spectrum β-lactamases (blaCTX-M-15) and carbapenemases (blaNDM, blaOXA-48-like and blaKPC), MALDI-TOF MS identification of GNB carrying ARGs, and further analysis by whole genome sequencing of bacterial isolates. We determine presence of consistently dominant clones and their relatedness to strains causing neonatal sepsis. Higher prevalence of carbapenemases is observed in Pakistan, Bangladesh, and Ethiopia, compared to other countries, and are mostly found in surfaces near the sink drain. Klebsiella pneumoniae, Enterobacter hormaechei, Acinetobacter baumannii, Serratia marcescens and Leclercia adecarboxylata are dominant; ST15 K. pneumoniae is identified from the same ward on multiple occasions suggesting clonal persistence within the same environment, and is found to be identical to isolates causing neonatal sepsis in Pakistan over similar time periods. Our data suggests persistence of dominant clones across multiple time points, highlighting the need for assessment of Infection Prevention and Control guidelines.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Medicine Centre for Trials Research (CNTRR)
Additional Information:	License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by/4.0/, Type: open-access
Publisher:	Nature Research
ISSN:	2041-1723
Date of First Compliant Deposit:	2 April 2024
Date of Acceptance:	6 March 2024
Last Modified:	03 Apr 2024 01:13
URI:	https://orca.cardiff.ac.uk/id/eprint/167655

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