{"doi":"10.1186/s13756-021-01042-2","title":"Characterizing the bioburden of ESBL-producing organisms in a neonatal unit using chromogenic culture media: a feasible and efficient environmental sampling method","abstract":"INTRODUCTION: Infections 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. METHODS: A 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. RESULTS: In 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. CONCLUSIONS: Using 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.","journal":"Antimicrobial Resistance and Infection Control","year":2022,"id":244509,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":28,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.961,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":727055,"name":"Jonathan Strysko","orcid":"0000-0002-5258-7654","position":1,"is_corresponding":false},{"id":829064,"name":"Kgomotso Kgomanyane","orcid":null,"position":2,"is_corresponding":false},{"id":389849,"name":"One Bayani","orcid":"0009-0008-4335-2096","position":3,"is_corresponding":false},{"id":828773,"name":"Margaret Mokomane","orcid":"0000-0002-4406-3594","position":4,"is_corresponding":false},{"id":828774,"name":"Tichaona Machiya","orcid":"0009-0002-8839-3998","position":5,"is_corresponding":false},{"id":410934,"name":"Tonya Arscott‐Mills","orcid":"0000-0002-7873-9871","position":6,"is_corresponding":false},{"id":571502,"name":"David A. Goldfarb","orcid":"0000-0003-0835-9504","position":7,"is_corresponding":false},{"id":416596,"name":"Andrew P. Steenhoff","orcid":"0000-0001-9002-8207","position":8,"is_corresponding":false},{"id":828775,"name":"Carolyn McGann","orcid":"0000-0002-4066-0893","position":9,"is_corresponding":false},{"id":475036,"name":"Britt Nakstad","orcid":"0000-0002-6843-8100","position":10,"is_corresponding":false},{"id":475033,"name":"Alemayehu Mekonnen Gezmu","orcid":"0000-0002-6655-2620","position":11,"is_corresponding":false},{"id":732199,"name":"Melissa Richard‐Greenblatt","orcid":"0000-0001-6717-8856","position":12,"is_corresponding":false},{"id":399774,"name":"Susan Coffin","orcid":"0000-0001-9566-5600","position":13,"is_corresponding":false},{"id":829063,"name":"Moses Vurayai","orcid":null,"position":0,"is_corresponding":true}],"reference_count":24,"raw_metadata":null,"created_at":"2026-07-19T00:23:30.364338Z","pmid":"35074019","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}