Contamination of antimicrobial-resistant bacteria on toothbrushes used with mechanically ventilated patients: A cross sectional study |
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| Affiliation: | 1. Faculty of Nursing, Chiang Mai University, Chiangmai, Thailand;2. Division of Clinical Microbiology, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiangmai, Thailand;3. Nakornping Hospital, Donkaew Sub-district, Mae Rim, Chiangmai, Thailand;4. Infectious Diseases Research Unit (IDRU), Faculty of Associated Medical Sciences, Chiang Mai University, Chiangmai, Thailand;1. Hadassah Hebrew University Medical Center and School of Nursing, Israel;2. Hadassah Hebrew University School of Nursing and Jerusalem College of Technology, Israel;3. Sir Charles Gairdner Hospital, Perth, Australia;4. School of Public Health, Curtin University, Perth, Australia;5. School of Medicine, University of Western Australia, Australia;6. Intensive Care Unit Hospital San Javier, University of Guadalajara, Guadalajara, Jalisco, Mexico;7. Dipartimento di Scienze dell''Emergenza, Anestesiologiche e della Rianimazione Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy;8. University of Toronto, Faculty of Medicine, Interdepartmental Division of Critical Care, Sunnybrook Health Sciences Centre, Toronto, Canada;9. Uludağ University, Faculty of Medicine, Department of Anesthesiology and Intensive Care, Bursa, Turkey;10. Intensive Care Unit, Nordland Hospital, Bodø, Nord University, Bodø, Norway;11. University Hospital Gasthuisberg Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, Herestraat 49, B-3000 Leuven, Belgium;12. Intensive Care Medicine, Gabriel-Montpied University Hospital, Clermont-Ferrand, France;13. Intensive Medicine Department, University Hospital La Paz, Madrid, Spain;14. Urgent & Emergency Care Group, William Harvey Hospital, Ashford, Kent, UK;15. Intensive Care of Geneva, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva Hospital and University of Geneva, Switzerland;p. Department of Anesthesiology and Critical Care, Oslo University Hospital, Oslo, Norway;q. Department of Intensive Care, Hadassah Hebrew University Medical Center, Israel;1. Department of Emergency, The First Medical Center of PLA General Hospital, Beijing 100000, China;2. Endoscopy Center, Hainan Hospital of PLA General Hospital, Sanya 572013, China;1. Rapid Response Team, Dong-A University Medical Center, Busan, South Korea;2. College of Nursing, Dong-A University, Busan, South Korea;1. Critical Care Complex, Middlemore Hospital, Auckland, New Zealand;2. School of Nursing, Massey University, Auckland, New Zealand |
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| Abstract: | ObjectiveThe purpose of this study was to determine pathogenic and antimicrobial-resistant bacteria on used toothbrushes of mechanically ventilated patients.Research methodologyA cross-sectional study was conducted by collecting toothbrushes used with mechanically ventilated patients. The total bacterial count on each toothbrush was assessed by culturing on Trypticase soy agar (TSA). Gram stain and biochemical testing were used to identify bacterial species. Antibiotic susceptibility of pathogenic bacteria was assessed by the Kirby-Bauer disk diffusion method.ResultsThirty-five toothbrushes (97%) had bacterial contamination, 27 toothbrushes had at least two bacterial species, and 13 toothbrushes harboured antimicrobial-resistant bacteria. The most commonly isolated bacteria were Klebsiella spp. (21%), followed by Acinetobacter baumannii (18%). Five isolates of A. baumannii, six isolates of K. pneumoniae, and two isolates of Enterobacter cloacae were multidrug-resistant (MDR) strains. Four isolates of K. pneumoniae were identified as extended-spectrum beta-lactamase (ESBL) producing strains, and two isolates of P. aeruginosa were extensively drug-resistant (XDR). The average total bacterial count was 104–105 CFU/toothbrush head.ConclusionsAntimicrobial-resistant bacteria were detected on toothbrushes. Therefore, practice of toothbrush care should be reconsidered in associated to maintaining the oral hygiene of mechanically ventilated patients to prevent ventilator-associated pneumonia (VAP). |
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| Keywords: | Toothbrushes Antimicrobial-resistant bacteria Ventilator-associated pneumonia (VAP) Intensive care unit Oral hygiene Hospital-acquired infection |
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