Drug-resistant bacteria lingers in hospitals even after deep cleaning leaving vulnerable patients at greater risk of infection, a study has found.
Scientists at the University of Cambridge and the London School of Hygiene and Tropical Medicine used genome sequencing to reveal the extent to which a drug-resistant gastrointestinal bacterium can spread within a hospital, highlighting the challenge hospitals face in controlling infections.
They followed 149 haematology patients admitted to Addenbrooke’s Hospital, in Cambridge, over a six-month period and took stool samples from the patients and swabs from the hospital to find evidence of E. faecium, a bacterium commonly found in the gastrointestinal tract where it usually resides without causing the host problems. However, in immunocompromised patients, such as those with cancer, it can lead to potentially life-threatening infection.
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The hospital undertook deep cleaning on one ward over a three-day period during the study, when patients were moved elsewhere. However, when the team sampled locations – including beds and communal bathrooms – prior to patients returning to the ward, they found that 9 per cent of samples still tested positive for the bacteria. Within three days of patients returning to the ward, around half of the sampled sites tested positive.
Dr Theodore Gouliouris from the Department of Medicine at the University of Cambridge, and joint first author on the study, said: “We’ve known for over two decades that patients in hospital can catch and spread drug-resistant E. faecium. Preventing its spread requires us to understand where the bacteria lives – its ‘reservoirs’ – and how it is transmitted.
“Most studies to date have relied on culturing the bacteria from samples. But as we’ve shown, whole genome sequencing—looking at the DNA of the bacteria—combined with detailed patient and environmental sampling can be a powerful tool to help us chart its spread and inform ways to prevent further outbreaks.”
Senior author Professor Sharon Peacock said: “Patient screening, adequate provision of isolation and ensuite toilet facilities, improved and more frequent cleaning procedures, and stricter health-care worker hygiene practices will all be needed to curtail this global epidemic.
“But this is also a sign of how urgently we need to tackle inappropriate use of antibiotics worldwide, which is widely recognised as posing a catastrophic threat to our health and our ability to control infections.”
The study is published in Nature Microbiology.