The overall bioburden by total colony count does not predict presence of pathogens with high clinical relevance in the environment of hospitals and community.

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The overall bioburden by total colony count does not predict presence of pathogens with high clinical relevance in the environment of hospitals and community.

J Hosp Infect. 2018 Nov 27;:

Authors: Widmer FC, Frei R, Romanyuk A, Sutter ST, Widmer AF

Abstract
BACKGROUND: Healthcare associated infections (HAIs) affect millions of patients, increasing morbidity and mortality. Pathogens of HAIs originate from both the patient's own flora and the environment, including multidrug-resistant organisms.
AIM: This study aimed (i) to determine the bioburden on different types of high-touch surfaces and (ii) to identify cultures to the species level and stratify strains in low and high clinical relevance.
DESIGN: Comparing bioburden with presence of pathogens of high clinical relevance (PHCR) in a tertiary care center and urban environment.
METHODS: The overall bioburden measured by total colony count (TCC) was assessed by Tryptic Soy contact plates and two selective agars to improve detection of PHCR. Isolates were routinely identified to the species level by matrix-assisted laser desorption/ionization - time of flight mass spectrometry (MALDI-TOF). Definition of PHCR was based on listings outlined by the Centers for Disease Control & Prevention (CDC).
FINDINGS: 1 431 contact plates were processed from 477 surface areas: 153 from hospitals and 324 from publicly accessible institutions or devices. In 73 samples, ≥1 PHCR was identified from cultures. TCC poorly correlated with presence of PHCR.
CONCLUSION: TCC poorly predicted presence of PHCR, rendering results from environmental sampling with TCC difficult to interpret. MALDI-TOF technique allows identifying large numbers of isolates at low cost from the environment. Further studies on environmental contamination should use MALDI-TOF to identify all grown pathogens for identification.

PMID: 30500387 [PubMed - as supplied by publisher]

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