Risk Factors for the Environmental Spread of Different Multi-Drug-Resistant-Organisms (MDRO)

BackgroundSubstantial scientific evidence has accumulated that the contamination of environmental surfaces in hospitals plays an important role in the transmission of MDRO. To date, all studies have failed to identify the risk factors associated with environmental contamination. In this work, we aimed to evaluate, compare and identify factors associated with environmental contamination around carriers of different MDRO.MethodsWe conducted a prospective cohort study from May 2018 to February 2020. We included 125 patients admitted to Avicenne Hospital and Hotel Dieu de France de Beyrouth Hospital, fecal carriers of MDRO (ESBL-PE, CPE, VRE). For each patient, we did a quantification of MDRO in stool, a qualitative evaluation of presence of MDRO in 6 different environmental sites and collected several clinical data.ResultsESBL-PE represented 34% of the carried MDRO, CPE 45% and VRE 21%. The most frequent MDRO species was E.coli . Contamination of at least one environmental site was observed for 22 (18%) patients. Only carriage of VanA was associated with a significantly higher risk of dissemination. Having a urinary catheter, carriage of OXA48 and E.coli were protective factors against environmental contamination. We didn’t find any statistically significant difference in environmental contamination between E.coli and other Enterobacteriaceae carriers, also between ESBL-PE and CPE carriers.ConclusionsIn conclusion, our results showed that hospital environmental contamination rates are substantially higher for patients with VRE, compared to the low environment dissemination rates around ESBL-PE and CPE. Further studies on a larger scale are needed to confirm the validity of our findings.