Survey on environmental prevalence of carbapenem-resistant Klebsiella pneumoniae in intensive care unit of a general hospital

Abstract:

Objective To survey the enviromental contamination of carbapenem-resistant Klebsiella pneumoniae(CRKP) in intensive care unit (ICU) and carriage of drug resistance genes of CRKP. Methods Specimens collected from high-touch object surface, object surface in public area, wall and drain holes of sink in 5 surgical ICUs were performed microbial isolation by mSuper CARBA chromogenic medium, targeted strains were identified by MALDI-TOF mass spectrometry, carbapenemase phenotype of CRKP was identified by double-disk synergy method, KPC and NDM resistance genes were detected by polymerase chain reaction (PCR). Results The isolation proportion of CRKP from high-touch object surface (1/73), object surface in public area (1/89), attendants' clothing (1/24) were very low, but from drain hole of sink was higher (25/29). Identification of carbapenemase phenotype showed that 5 strains produced class A enzyme and 11 strains produced class B metalloenzyme; PCR results showed that 2 strains carried KPC resistance genes and 3 strains carried NDM resistance genes. Conclusion Colonization rate of CRKP on high-touch object surface in ICU is low, but contamination rate of drain hole of sink is high. The results of resis-tance phenotype enzyme identification and PCR revealed that cross transmission of CRKP in ICU may be low if environmental cleaning and disinfection measures are strictly implemented.