Intensive care unit environmental surfaces are contaminated by multidrug-resistant bacteria in biofilms: combined results of conventional culture, pyrosequencing, scanning electron microscopy, and confocal laser microscopy.

H. Hu, K. Johani, I. B. Gosbell, A. S. W. Jacombs, A. Almatroudi, G. S. Whiteley, A. K. Deva, S. Jensen, K. Vickery

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Hospital-associated infections cause considerable morbidity and mortality, and are expensive to treat. Organisms causing these infections can be sourced from the inanimate environment around a patient. Could the difficulty in eradicating these organisms from the environment be because they reside in dry surface biofilms? Aim: The intensive care unit (ICU) of a tertiary referral hospital was decommissioned and the opportunity to destructively sample clinical surfaces was taken in order to investigate whether multidrug-resistant organisms (MDROs) had survived the decommissioning process and whether they were present in biofilms. Methods: The ICU had two 'terminal cleans' with 500. ppm free chlorine solution; items from bedding, surrounds, and furnishings were then sampled with cutting implements. Sections were sonicated in tryptone soya broth and inoculated on to chromogenic plates to demonstrate MDROs, which were confirmed with the Vitek2 system. Genomic DNA was extracted directly from ICU samples, and subjected to polymerase chain reaction (PCR) for femA to detect Staphylococcus aureus and the microbiome by bacterial tag-encoded FLX amplicon pyrosequencing. Confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM) were performed on environmental samples. Findings: Multidrug-resistant bacteria were cultured from 52% (23/44) of samples cultured. S. aureus PCR was positive in 50%. Biofilm was demonstrated in 93% (41/44) of samples by CLSM and/or SEM. Pyrosequencing demonstrated that the biofilms were polymicrobial and contained species that had multidrug-resistant strains. Conclusion: Dry surface biofilms containing MDROs are found on ICU surfaces despite terminal cleaning with chlorine solution. How these arise and how they might be removed requires further study.

LanguageEnglish
Pages35-44
Number of pages10
JournalJournal of Hospital Infection
Volume91
Issue number1
DOIs
Publication statusPublished - 1 Sep 2015

Fingerprint

Biofilms
Confocal Microscopy
Electron Scanning Microscopy
Intensive Care Units
Bacteria
Chlorine
Staphylococcus aureus
Polymerase Chain Reaction
Microbiota
Cross Infection
Tertiary Care Centers
Morbidity
Mortality
DNA
Infection

Cite this

@article{0d641d351a8b4137a042343a00981e72,
title = "Intensive care unit environmental surfaces are contaminated by multidrug-resistant bacteria in biofilms: combined results of conventional culture, pyrosequencing, scanning electron microscopy, and confocal laser microscopy.",
abstract = "Background: Hospital-associated infections cause considerable morbidity and mortality, and are expensive to treat. Organisms causing these infections can be sourced from the inanimate environment around a patient. Could the difficulty in eradicating these organisms from the environment be because they reside in dry surface biofilms? Aim: The intensive care unit (ICU) of a tertiary referral hospital was decommissioned and the opportunity to destructively sample clinical surfaces was taken in order to investigate whether multidrug-resistant organisms (MDROs) had survived the decommissioning process and whether they were present in biofilms. Methods: The ICU had two 'terminal cleans' with 500. ppm free chlorine solution; items from bedding, surrounds, and furnishings were then sampled with cutting implements. Sections were sonicated in tryptone soya broth and inoculated on to chromogenic plates to demonstrate MDROs, which were confirmed with the Vitek2 system. Genomic DNA was extracted directly from ICU samples, and subjected to polymerase chain reaction (PCR) for femA to detect Staphylococcus aureus and the microbiome by bacterial tag-encoded FLX amplicon pyrosequencing. Confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM) were performed on environmental samples. Findings: Multidrug-resistant bacteria were cultured from 52{\%} (23/44) of samples cultured. S. aureus PCR was positive in 50{\%}. Biofilm was demonstrated in 93{\%} (41/44) of samples by CLSM and/or SEM. Pyrosequencing demonstrated that the biofilms were polymicrobial and contained species that had multidrug-resistant strains. Conclusion: Dry surface biofilms containing MDROs are found on ICU surfaces despite terminal cleaning with chlorine solution. How these arise and how they might be removed requires further study.",
author = "H. Hu and K. Johani and Gosbell, {I. B.} and Jacombs, {A. S. W.} and A. Almatroudi and Whiteley, {G. S.} and Deva, {A. K.} and S. Jensen and K. Vickery",
year = "2015",
month = "9",
day = "1",
doi = "10.1016/j.jhin.2015.05.016",
language = "English",
volume = "91",
pages = "35--44",
journal = "Journal of Hospital Infection",
issn = "0195-6701",
publisher = "W.B. Saunders Ltd",
number = "1",

}

Intensive care unit environmental surfaces are contaminated by multidrug-resistant bacteria in biofilms : combined results of conventional culture, pyrosequencing, scanning electron microscopy, and confocal laser microscopy. / Hu, H.; Johani, K.; Gosbell, I. B.; Jacombs, A. S. W.; Almatroudi, A.; Whiteley, G. S.; Deva, A. K.; Jensen, S.; Vickery, K.

In: Journal of Hospital Infection, Vol. 91, No. 1, 01.09.2015, p. 35-44.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Intensive care unit environmental surfaces are contaminated by multidrug-resistant bacteria in biofilms

T2 - Journal of Hospital Infection

AU - Hu,H.

AU - Johani,K.

AU - Gosbell,I. B.

AU - Jacombs,A. S. W.

AU - Almatroudi,A.

AU - Whiteley,G. S.

AU - Deva,A. K.

AU - Jensen,S.

AU - Vickery,K.

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Background: Hospital-associated infections cause considerable morbidity and mortality, and are expensive to treat. Organisms causing these infections can be sourced from the inanimate environment around a patient. Could the difficulty in eradicating these organisms from the environment be because they reside in dry surface biofilms? Aim: The intensive care unit (ICU) of a tertiary referral hospital was decommissioned and the opportunity to destructively sample clinical surfaces was taken in order to investigate whether multidrug-resistant organisms (MDROs) had survived the decommissioning process and whether they were present in biofilms. Methods: The ICU had two 'terminal cleans' with 500. ppm free chlorine solution; items from bedding, surrounds, and furnishings were then sampled with cutting implements. Sections were sonicated in tryptone soya broth and inoculated on to chromogenic plates to demonstrate MDROs, which were confirmed with the Vitek2 system. Genomic DNA was extracted directly from ICU samples, and subjected to polymerase chain reaction (PCR) for femA to detect Staphylococcus aureus and the microbiome by bacterial tag-encoded FLX amplicon pyrosequencing. Confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM) were performed on environmental samples. Findings: Multidrug-resistant bacteria were cultured from 52% (23/44) of samples cultured. S. aureus PCR was positive in 50%. Biofilm was demonstrated in 93% (41/44) of samples by CLSM and/or SEM. Pyrosequencing demonstrated that the biofilms were polymicrobial and contained species that had multidrug-resistant strains. Conclusion: Dry surface biofilms containing MDROs are found on ICU surfaces despite terminal cleaning with chlorine solution. How these arise and how they might be removed requires further study.

AB - Background: Hospital-associated infections cause considerable morbidity and mortality, and are expensive to treat. Organisms causing these infections can be sourced from the inanimate environment around a patient. Could the difficulty in eradicating these organisms from the environment be because they reside in dry surface biofilms? Aim: The intensive care unit (ICU) of a tertiary referral hospital was decommissioned and the opportunity to destructively sample clinical surfaces was taken in order to investigate whether multidrug-resistant organisms (MDROs) had survived the decommissioning process and whether they were present in biofilms. Methods: The ICU had two 'terminal cleans' with 500. ppm free chlorine solution; items from bedding, surrounds, and furnishings were then sampled with cutting implements. Sections were sonicated in tryptone soya broth and inoculated on to chromogenic plates to demonstrate MDROs, which were confirmed with the Vitek2 system. Genomic DNA was extracted directly from ICU samples, and subjected to polymerase chain reaction (PCR) for femA to detect Staphylococcus aureus and the microbiome by bacterial tag-encoded FLX amplicon pyrosequencing. Confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM) were performed on environmental samples. Findings: Multidrug-resistant bacteria were cultured from 52% (23/44) of samples cultured. S. aureus PCR was positive in 50%. Biofilm was demonstrated in 93% (41/44) of samples by CLSM and/or SEM. Pyrosequencing demonstrated that the biofilms were polymicrobial and contained species that had multidrug-resistant strains. Conclusion: Dry surface biofilms containing MDROs are found on ICU surfaces despite terminal cleaning with chlorine solution. How these arise and how they might be removed requires further study.

UR - http://www.scopus.com/inward/record.url?scp=84938258235&partnerID=8YFLogxK

U2 - 10.1016/j.jhin.2015.05.016

DO - 10.1016/j.jhin.2015.05.016

M3 - Article

VL - 91

SP - 35

EP - 44

JO - Journal of Hospital Infection

JF - Journal of Hospital Infection

SN - 0195-6701

IS - 1

ER -