Antibiotic-resistant organisms establish reservoirs in new hospital built environments and are related to patient blood infection isolates.

BACKGROUND

Healthcare-associated infections due to antibiotic-resistant organisms pose an acute and rising threat to critically ill and immunocompromised patients. To evaluate reservoirs of antibiotic-resistant organisms as a source of transmission to patients, we interrogated isolates from environmental surfaces, patient feces, and patient blood infections from an established and a newly built intensive care unit.

METHODS

We used selective culture to recover 829 antibiotic-resistant organisms from 1594 environmental and 72 patient fecal samples, in addition to 81 isolates from blood cultures. We conducted antibiotic susceptibility testing and short- and long-read whole genome sequencing on recovered isolates.

RESULTS

Antibiotic-resistant organism burden is highest in sink drains compared to other surfaces. is the most frequently cultured organism from surfaces in both intensive care units. From whole genome sequencing, different lineages of dominate in each unit; one lineage of ST1894 is found in multiple sink drains in the new intensive care unit and 3.7% of blood isolates analyzed, suggesting movement of this clone between the environment and patients.

CONCLUSIONS

These results highlight antibiotic-resistant organism reservoirs in hospital built environments as an important target for infection prevention in hospitalized patients.