| Summary: | Data on colonization and hospital contamination of carbapenem-resistant Gram-negative bacteria (CR-GNB) are limited in low- and middle-income countries. We designed this study to determine the prevalence and co-existence of carbapenemase genes among CR-GNB isolated from clinical, colonization, and hospital environmental samples at a tertiary hospital in Mwanza, Tanzania. The modified Hodge test (MHT), the combined disk test (CDT), and the double-disk synergy test (DDST) were used for the phenotypic detection of carbapenemases. A multiplex PCR assay was used to detect <i>bla</i><sub>IMP</sub> and <i>bla</i><sub>KPC</sub>, and a singleplex PCR assay was used to detect <i>bla</i><sub>OXA-48</sub>. Data were analyzed by STATA version 13.0. Overall, 68.8% (44/64) of the CR-GNB had at least one phenotype by phenotypic methods, whereby 60.9% (39/64) were both CDT and DDST positive and 31.3% (20/64) were MHT positive. A total of 23/64 (35.9%) had at least one of the genes tested with the predominance of <i>bla</i><sub>IMP</sub> (91.3%; 21/23). In addition, 47.7% (21/44) of the CR-GNB phenotypes had at least one gene. Around 47.8% (11/23) of the CR-GNB carried multiple genes encoding for carbapenem resistance, with the maximum co-existence of <i>bla</i><sub>IMP</sub>/<i>bla</i><sub>KPC</sub>/<i>bla</i><sub>OXA-48</sub> (45.5%; 5/11). The majority of carbapenem-resistant genes were detected in <i>Acinetobacter</i> spp. (82.6%; 19/23) and isolated from bed swabs (69.6%; 16/23). <i>Acinetobacter</i> spp. carrying the <i>bla</i><sub>IMP</sub> gene predominantly contaminated the hospital environment. Therefore, we recommend routine decontamination of inanimate hospital surfaces, including patient beds.
|
|---|