ArticleAntimicrobial resistance and infection control2022
Characterizing the bioburden of ESBL-producing organisms in a neonatal unit using chromogenic culture media: a feasible and efficient environmental sampling method.
Article in Antimicrobial resistance and infection control, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 24 citations in OpenAlex.
- Observational
- Developing and implementing a family-led infection prevention bundle for hospitalized neonates.Antimicrobial resistance and infection control · 2026Article
- Molecular Relatedness of Maternal and Neonatal Multidrug-Resistant Gram-Negative Colonization Isolates in Low- and Middle-Income Countries: A Systematic Review.Open forum infectious diseases · 2026Review
- Stewarding the hospital sink drain: a narrative review of practical approaches for controlling gram negative pathogens in low- and middle-income countries.Antimicrobial resistance and infection control · 2026Review
- Carbapenem-resistantMicrobiology spectrum · 2026Article
- Integrated epidemiologic investigation and genomic confirmation of a Klebsiella pneumoniae neonatal sepsis outbreak in Botswana.PLOS global public health · 2026Article
- Parental involvement in infection prevention and control in low- and middle-income country neonatal units: a scoping review.Antimicrobial resistance and infection control · 2025Article
- Perinatal colonization with extended-spectrum beta-lactamase-producing and carbapenem-resistant Gram-negative bacteria: a hospital-based cohort study.Antimicrobial resistance and infection control · 2024Article
- Metagenome and Resistome Analysis of Beta-Lactam-Resistant Bacteria Isolated from River Waters in Surabaya, Indonesia.Microorganisms · 2024Article
- Multidrug-resistantHeliyon · 2023Article
- Performance of CHROMagar ESBL media for the surveillance of extended-spectrum cephalosporin-resistantJournal of medical microbiology · 2023Article
- Healthcare-Associated Infection Prevention Interventions for Neonates in Resource-Limited Settings.Frontiers in pediatrics · 2022Review
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Authors and funding
14 authors at 5 institutions in 4 countries.
Funding
Abstract
introductionInfections due to extended spectrum beta-lactamase producing organisms (ESBL) have emerged as the leading cause of sepsis among hospitalized neonates in Botswana and much of sub-Saharan Africa and south Asia. Yet, ESBL reservoirs and transmission dynamics within the neonatal intensive care unit (NICU) environment are not well-understood. This study aimed to assess the efficiency and feasibility of a chromogenic-culture-media-based environmental sampling approach to characterize the ESBL bioburden within a NICU.
methodsA series of four point-prevalence surveys were conducted at a 36-bed NICU at a public tertiary referral hospital in Botswana from January-June 2021. Samples were collected on 4 occasions under semi-sterile technique using 1) flocked swabs & templates (flat surfaces); 2) sterile syringe & tubing (water aspiration); and 3) structured swabbing techniques (hands & equipment). Swabs were transported in physiological saline-containing tubes, vortexed, and 10 µL was inoculated onto chromogenic-agar that was selective and differential for ESBL (CHROMagar™ ESBL, Paris, France), and streaking plates to isolate individual colonies. Bacterial colonies were quantified and phenotypically characterized using biochemical identification tests.
resultsIn total, 567 samples were collected, 248 (44%) of which grew ESBL. Dense and consistent ESBL contamination was detected in and around sinks and certain high-touch surfaces, while transient contamination was demonstrated on medical equipment, caregivers/healthcare worker hands, insects, and feeding stations (including formula powder). Results were available within 24-72 h of collection. To collect, plate, and analyse 50 samples, we estimated a total expenditure of $269.40 USD for materials and 13.5 cumulative work hours among all personnel.
conclusionsUsing basic environmental sampling and laboratory techniques aided by chromogenic culture media, we identified ESBL reservoirs (sinks) and plausible transmission vehicles (medical equipment, infant formula, hands of caregivers/healthcare workers, & insects) in this NICU environment. This strategy was a simple and cost-efficient method to assess ESBL bioburden and may be feasible for use in other settings to support ongoing infection control assessments and outbreak investigations.
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