Evidence map›Paper›PMID 34490507›Full record

ArticleEuropean journal of pediatrics2022

Role of environmental surfaces and hands of healthcare workers in perpetuating multi-drug-resistant pathogens in a neonatal intensive care unit.

Marwa A Elkady, Wafaa M K Bakr, Hesham Ghazal, Eman A Omran

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Article in European journal of pediatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 12 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Marwa A ElkadyDepartment of Microbiology, High Institute of Public Health, Alexandria University, El-Ibrahimia, 165 El-Horreya Avenue, Alexandria, Egypt.
Wafaa M K BakrDepartment of Microbiology, High Institute of Public Health, Alexandria University, El-Ibrahimia, 165 El-Horreya Avenue, Alexandria, Egypt.ORCID http://orcid.org/0000-0003-4523-7813
Hesham GhazalDepartment of Paediatrics, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Eman A OmranDepartment of Microbiology, High Institute of Public Health, Alexandria University, El-Ibrahimia, 165 El-Horreya Avenue, Alexandria, Egypt. eman79omran@gmail.com.ORCID http://orcid.org/0000-0003-3173-304X
Alexandria University · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Neonates admitted to neonatal intensive care units are at a risk of developing healthcare-associated infections, leading to increased risk of mortality. This study aimed to identify organisms causing such late-onset infections in neonates and determine whether these isolates were genetically identical to those from the surrounding environmental surfaces and hands of healthcare workers (HCWs). A cross-sectional study was carried out over a period of 4 months in a university neonatal intensive care unit (NICU). Samples were collected from all neonates with symptoms of late-onset infections (n = 180). Fingerprint samples of 21 healthcare workers as well as 330 random environmental samples were also taken from the unit. Isolates from neonates, environment and fingerprints were subjected to protein electrophoresis followed by sequencing to detect genetic similarities. Almost half of neonatal samples were culture positive (91/180, 50.6%), out of which 72% of bacterial isolates (49/68) were multi-drug resistant. Klebsiella pneumoniae (32.6%) and Candida spp. (28.4%) were the commonest neonatal isolates. A cluster of two homologous Klebsiella pneumoniae strains was isolated from a neonate and an examining bed, while another homologous cluster was from a neonatal sample and a portal incubator. A third cluster was isolated from hands and three neonatal samples. This cluster (caused by Klebsiella pneumoniae strain NH54 chromosome) was found to perpetuate over the 4 months of the study. All three clusters were multi-drug-resistant Klebsiella pneumoniae. A homologous pair of each of Candida tropicalis and Candida glabrata was isolated from the blood of two neonates, and one neonatal and a crash cart sample, respectively. Overall, 8.8% (8/91) of neonatal samples were found to be homologous to other neonatal/environmental/hand isolates, denoting perpetuation of pathogens between neonates themselves and also other reservoirs of infections.Conclusion: The hands of HCWs, crash carts and incubators are reservoirs of pathogens and can lead to nosocomial infections. Clusters of multi-drug-resistant Klebsiella pneumoniae and Candida spp. were the predominant neonatal pathogens in this NICU. What is Known: • The role of hands and the environment in transmission of infections to neonates is a subject of debate. • Genetic sequencing provides solid evidence for detecting homologous strains. What is New: • K. pneumoniae was the most frequently isolated pathogen, and concomitant isolation was found in two cases from the neonatal surroundings (bed/incubator) and hands. • Candida spp. with homology were also found in different neonates and environmental samples suggesting risk of transmission.

Indexed as

Cross InfectionKlebsiella InfectionsPharmaceutical PreparationsCross-Sectional StudiesHealth PersonnelHumansInfant, NewbornIntensive Care Units, NeonatalKlebsiella pneumoniaeMicrobial Sensitivity TestsPharmaceutical PreparationsDendogramHealthcare-associated infectionsNeonatesProtein electrophoresisSequencing

Identifiers

PMID34490507
OpenAlexW3135841165

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.