P-1138. Assessing Clinically Relevant Environmental Bacterial and Viral Contamination in Neonatal Care Areas

TL;DR

This study found that over half of high-touch surfaces in NICUs were contaminated with bacteria or viruses, even though overall microbial levels were low.

Contribution

The study provides new insights into the extent of environmental contamination with clinically relevant pathogens in NICUs.

Findings

57% of environmental samples were positive for at least one target pathogen.

RSV and adenovirus were detected almost exclusively on patient-specific surfaces.

C. difficile was only found on shared surfaces within patient rooms.

Abstract

Despite prolonged hospitalization of premature neonates and numerous high-touch surfaces in Neonatal Intensive Care Units (NICU), the extent of environmental contamination with bacteria and viruses remains poorly characterized.Table 1.Environmental Samples’ Bioburden and proportion positive for target pathogens by NICU room type and sample surface categoryNICU, Neonatal Intensive Care Unit; CFU, Colony Forming Units; S. aureus, Staphylococcus aureus; C. difficile, Clostridiodes difficile; RSV, Respiratory Syncytial VirusEnvironmental Sample Bioburden and Target Identification by Neonatal Intensive Care Units’ surfaces

Environmental Samples’ Bioburden and proportion positive for target pathogens by NICU room type and sample surface category

NICU, Neonatal Intensive Care Unit; CFU, Colony Forming Units; S. aureus, Staphylococcus aureus; C. difficile, Clostridiodes difficile; RSV, Respiratory Syncytial Virus

Environmental Sample Bioburden and Target Identification by Neonatal Intensive Care Units’ surfaces

We completed a prospective microbiological analysis of high-touch surfaces in two NICU settings at a tertiary care center over a 2-week period: shared patient pods housing 2, 4 or 8 patients in a Level IV NICU and a low acuity level 2 NICU that houses up to 15 patients. In each care area, flocked swabs were used to collect samples from a variety of surface categories: patient-specific (PSS), shared within patient rooms (SPR), and shared across the unit (SU). Samples were plated on multiple media for overall and target bacterial species and underwent qPCR for virus detection. Target pathogens included S aureus, Enterococcus spp., Gram Negative bacteria, C. difficile, RSV, and Adenovirus.

A total of 99 samples were obtained; 74 (75%) from PSS, 19 (19%) from SPR, and 6 (6%) from SU. The median overall bioburden for all samples was 130 CFU (IQR: 30-660) and was generally similar between room types and surface categories. In total, 56 (57%) samples were positive for any target pathogen: 41 (55%) from PSS, 10 (53%) from SPR, and 5 (83%) from SU. Targeted bacteria, except C. difficile, were recovered similarly amongst room type and surface categories (Table 1). C. difficile was only recovered twice but both samples came from SPR; a diaper scale and a breast pump. RSV and Adenovirus were detected in 8 (8%) and 8 (8%) of samples, respectively. Of those, 8 (100%) for RSV and 7 (88%) for Adenovirus were detected from PSS samples (Table 2). Of the 34 patients housed in rooms where PSS and SPR samples were taken, none had a current infection or positive microbiological culture within 30 days prior to sampling.

Despite low overall bioburden, over half of samples (57%) were positive for at least one target pathogen, indicating that microbial contamination persists even in seemingly clean NICU environments. Bacterial detection rates were similar across room type and surface category; however, RSV and adenovirus were identified almost exclusively on PSS. These findings highlight the need for larger studies focused on environmental surveillance in NICUs.

All Authors: No reported disclosures

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