Osman Abdul-Halim, Darkwah Samuel, Kotey Fleischer C N, Odoom Alex, Hotor Prince, Dayie Nicholas T K D, Donkor Eric S
Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana.
Environ Health Insights. 2024 May 30;18:11786302241243239. doi: 10.1177/11786302241243239. eCollection 2024.
Nosocomial pathogens are known to exacerbate morbidity and mortality in contemporary critical healthcare. Hospital fomites, which include inanimate surfaces, have been identified as "breeding grounds" for pathogens that cause nosocomial infections. This systematic review aimed to deliver incisive insights on nosocomial pathogens in intensive care units (ICUs) and the role of fomites as potential reservoirs for their transmission.
An extensive exploration of electronic databases, including PubMed and Scopus, from 1990 to 2023, was carried out between 25 and 29 May 2023, per standard PRISMA guidelines. Information were extracted from articles that reported on fomites in the ICU. Studies that did not quantitatively report the fomite contamination, and those that exclusively took samples from patients in the ICU were excluded from the analysis.
About 40% of the total samples collected on fomites from all the studies yielded microbial growth, with species of being the most predominant. Other prevalent microbes were , , , spp., sp., and sp. The neonatal intensive care unit (NICU) had the highest proportion of contaminated fomites. Among known fomites, the sphygmomanometer exhibited a 100% detection rate of nosocomial pathogens. This included , , coagulase-negative (CoNS), , and Multidrug-resistant (MDR) bacteria, such as methicillin-resistant (MRSA), vancomycin-resistant (VRE), extended-spectrum beta-lactamase (ESBL)-producing , and MDR were commonly isolated on fomites in the ICUs.
Many fomites that are readily used in patient care in the ICU harbour nosocomial pathogens. The most common fomite appeared to be mobile phones, sphygmomanometers, and stethoscopes, with being the most common contaminant. Consequently, the need for rigorous disinfection and sterilization protocols on fomites in the ICU cannot be overemphasized. Additionally, heightened awareness on the subject among health professionals is crucial to mitigating the risk and burden of nosocomial infections caused by drug-resistant bacteria.
已知医院病原体可加剧当代重症医疗中的发病率和死亡率。医院污染物，包括无生命的表面，已被确定为导致医院感染的病原体的“滋生地”。本系统评价旨在深入洞察重症监护病房（ICU）中的医院病原体以及污染物作为其传播潜在储存库的作用。
根据标准PRISMA指南，于2023年5月25日至29日对1990年至2023年的电子数据库进行了广泛检索，包括PubMed和Scopus。从报道ICU中污染物的文章中提取信息。未定量报告污染物污染情况的研究以及仅从ICU患者中采集样本的研究被排除在分析之外。
所有研究中从污染物上采集的样本约40%产生了微生物生长，其中[具体物种1]最为常见。其他常见微生物有[具体物种2]、[具体物种3]、[具体物种4]、[具体物种5]属、[具体物种6]种和[具体物种7]种。新生儿重症监护病房（NICU）的污染污染物比例最高。在已知的污染物中，血压计的医院病原体检测率为100%。这包括[具体病原体1]、[具体病原体2]、凝固酶阴性葡萄球菌（CoNS）、[具体病原体3]和[具体病原体4]。耐多药（MDR）细菌，如耐甲氧西林金黄色葡萄球菌（MRSA）、耐万古霉素肠球菌（VRE）、产超广谱β-内酰胺酶（ESBL）的[具体细菌]和MDR[具体细菌]在ICU的污染物上很常见。
许多在ICU中常用于患者护理的污染物都携带医院病原体。最常见的污染物似乎是手机、血压计和听诊器，其中[具体污染物]最为常见。因此，对ICU中污染物进行严格消毒和灭菌方案的必要性再怎么强调也不为过。此外，提高卫生专业人员对该主题的认识对于减轻耐药菌引起的医院感染风险和负担至关重要。
