Colonization and antimicrobial resistance of pathogens in nasal vestibular of health care workers in intensive care unit

Abstract:

ObjectiveTo understand colonization of pathogens in nasal vestibular of health care workers (HCWs) in intensive care unit(ICU), and provide evidence for strengthening the prevention and control of healthcareassociated infection (HAI) in ICU. MethodsOn may 2015, colonization status of pathogens in nasal vestibular of uninfected HCWs in ICU were actively screened, bacterial culture, isolation and identification were performed. The surveyed results were analyzed and compared with antimicrobial resistance of pathogens from patients at the same stage. ResultsA total of 96 HCWs were surveyed, 43 pathogenic strains were isolated from different HCWs’  nasal vestibular, isolation rate and carriage rate were both 44.79%. The main pathogenic bacteria was Staphylococcus aureus(n=15， 34.88%）, followed by Enterobacter aerogenes(n=9， 20.93%） and Klebsiella pneumoniae(K. pneumoniae,  n=7，16.28%）. There was a high detection rate of pathogens from nasal vestibular of doctors, HCWs who smoked frequently and those who never exercised (all P<0.05). There were 1 strain of imipenemresistant K. pneumoniae among 43 pathogenic strains. Resistance rate of 7 K. pneumoniae from HCWs to ampicillin/sulbactam, cefazolin, and furantoin were all >50.00%, resistance rates to cefotaxime and imipenem were 28.57% and 14.29% respectively； resistance rates of 11 strains of K. pneumoniae from patients to furantoin was 100.00% during the same stage, but were sensitive to other commonly used antimicrobial agents. Resistance rate of 4 strains of Escherichia coli (E. coli)to ampicillin was 75.00%, to gentamicin, tobramycin, levofloxacin, ciprofloxacin, and compound sulfamethoxazole were all 50.00%， 6 strains of E. coli isolated from patients during the same period were found to be resistant to most commonly used antimicrobial agents. ConclusionColonization rate of pathogens is high in nasal vestibular of HCWs in ICU, active screening and monitoring on colonization of pathogens in HCWs’  nasal vestibular is significant for preventing the occurrence and cross transmission of HAI among HCWs and patients.