Antibiotic Resistance in Hospitals Is Worse Than We Thought

A recent study published in Frontiers in Microbiology revealed that regular cleaning with detergents is insufficient to completely eliminate bacteria, some of which pose serious risks, from hospital sink drains.

“Hospital environments can carry a significant level of microbial diversity, leading to the development of complex microbial communities. Bacteria forming the microbiome in these environments can have a multitude of origins, including human skin, from both patients and workers, and air from the outside environment or medical equipment. Another critical factor influencing the clinical microbiome is the environmental conditions, which affect the selection of certain microorganisms. Variables such as air temperature and relative humidity, patient flow, ventilation, and cleaning practices all contribute to the prevalence of potential pathogenic bacteria within hospital settings,” the authors, led by Margarita Gomila, from the University of the Balearic Islands, Palma, Spain, wrote. They emphasised that hospital departments can serve as reservoirs of potentially harmful bacteria and breeding grounds for antibiotic-resistant microorganisms.

Bacterial Presence

In their study, Gomila and colleagues focused on hospital sink wastewater, a major reservoir of microorganisms. Over the course of 1 year, they collected four samples from five different hospital departments: Intensive care, general medicine, haematology, a short-stay unit, and a microbiology laboratory. The samples were analysed using mass spectrometry and 16S ribosomal RNA sequencing techniques.

Their findings confirmed the presence of numerous bacterial species, which varied over time. However, the bacterial genera remained largely consistent across departments and sampling periods. Pseudomonas and Stenotrophomonas were the most prevalent, with the greatest bacterial diversity observed in the intensive care and general medicine departments of the hospital.

Antibiotic susceptibility testing revealed that nearly all tested isolates were multidrug resistant, including clinically relevant pathogens such as Klebsiella pneumoniae and Pseudomonas aeruginosa. P aeruginosa is a known cause of ventilator-associated pneumonia and sepsis and is classified by the World Health Organization as a major threat of antibiotic resistance.

Control Measures

“New strategies, such as antibiotic stewardship programmes, novel therapeutics (such as bacteriophage therapy), and ongoing education for healthcare workers, are essential to control bacterial contamination. Policy and regulatory measures should standardise and update infection control practices, with increased collaboration and data sharing to improve patient outcomes and public health,” the authors concluded. They stressed that implementing these measures can help healthcare facilities better control bacterial contamination and reduce nosocomial infections.

Situation in Italy

According to the Italian National Institute of Health estimates, half of these infections are preventable, a critical statistic not only for patient safety but also from an economic perspective, as estimates suggest annual direct costs of approximately €7 billion across Europe.

In Italy, the latest report shows that hospital-acquired infections affect 8.8% of patients in acute care settings. The most commonly reported infections were lower respiratory tract infections (19.2%), bloodstream infections (18.8%), urinary tract infections (17.1%), COVID-19 (16.3%), and surgical-site infections (1src.5%).

This story was translated from Univadis Italy using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.