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

Maria Nieto-Rosado (), Kirsty Sands, Edward A. R. Portal, Kathryn M. Thomson, Maria J. Carvalho, Jordan Mathias, Rebecca Milton, Calie Dyer, Chinenye Akpulu, Ian Boostrom, Patrick Hogan, Habiba Saif, Ana D. Sanches Ferreira, Thomas Hender, Barbra Portal, Robert Andrews, W. John Watkins, Rabaab Zahra, Haider Shirazi, Adil Muhammad, Syed Najeeb Ullah, Muhammad Hilal Jan, Shermeen Akif, Kenneth C. Iregbu, Fatima Modibbo, Stella Uwaezuoke, Lamidi Audu, Chinago P. Edwin, Ashiru H. Yusuf, Adeola Adeleye, Aisha S. Mukkadas, Jean Baptiste Mazarati, Aniceth Rucogoza, Lucie Gaju, Shaheen Mehtar, Andrew N. H. Bulabula, Andrew Whitelaw, Lauren Roberts, Grace Chan, Delayehu Bekele, Semaria Solomon, Mahlet Abayneh, Gesit Metaferia and Timothy R. Walsh
Additional contact information
Maria Nieto-Rosado: University of Oxford
Kirsty Sands: University of Oxford
Edward A. R. Portal: University of Oxford
Kathryn M. Thomson: University of Oxford
Maria J. Carvalho: Cardiff University
Jordan Mathias: Cardiff University
Rebecca Milton: Cardiff University
Calie Dyer: Cardiff University
Chinenye Akpulu: University of Oxford
Ian Boostrom: Cardiff University
Patrick Hogan: Cardiff University
Habiba Saif: Cardiff University
Ana D. Sanches Ferreira: Cardiff University
Thomas Hender: Cardiff University
Barbra Portal: Cardiff University
Robert Andrews: Cardiff University
W. John Watkins: Cardiff University
Rabaab Zahra: Quaid-i-Azam University
Haider Shirazi: Pakistan Institute of Medical Sciences
Adil Muhammad: Quaid-i-Azam University
Syed Najeeb Ullah: Quaid-i-Azam University
Muhammad Hilal Jan: Quaid-i-Azam University
Shermeen Akif: Quaid-i-Azam University
Kenneth C. Iregbu: National Hospital Abuja
Fatima Modibbo: Lekki
Stella Uwaezuoke: Federal Medical Centre Jabi
Lamidi Audu: National Hospital Abuja
Chinago P. Edwin: Medway Maritime Hospital NHS Foundation Trust
Ashiru H. Yusuf: Aminu Kano Teaching Hospital
Adeola Adeleye: Murtala Muhammad Specialist Hospital
Aisha S. Mukkadas: Murtala Muhammad Specialist Hospital
Jean Baptiste Mazarati: Rwanda Biomedical Centre
Aniceth Rucogoza: Rwanda Biomedical Centre
Lucie Gaju: Rwanda Biomedical Centre
Shaheen Mehtar: Stellenbosch University
Andrew N. H. Bulabula: Infection Control Africa Network
Andrew Whitelaw: Stellenbosch University
Lauren Roberts: Stellenbosch University
Grace Chan: Harvard Medical School
Delayehu Bekele: Harvard T.H. Chan School of Public Health
Semaria Solomon: St Paul’s Hospital Millennium Medical College
Mahlet Abayneh: St Paul’s Hospital Millennium Medical College
Gesit Metaferia: St Paul’s Hospital Millennium Medical College
Timothy R. Walsh: University of Oxford

Nature Communications, 2024, vol. 15, issue 1, 1-12

Abstract: 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.

Date: 2024
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DOI: 10.1038/s41467-024-46684-z

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