Prevalence of Plasmid Mediated Multi Drug Resistant Enterobacteriaceae in Hospital Environment at Bangalore, India

Air being a major medium allows pathogens to disseminate and cause infections. An initial prevalence survey conducted in the air samples of the hospital environment especially in the out patient unit/ department (OPD) of 2 government and 2 private hospitals in Bangalore using a centrifugal air sampler system, when subjected to different standard morphological studies, staining procedures and biochemical techniques showed existence of nosochomial infection causing organisms in government hospital environment only. The highest frequency of nosochomial infection causing organisms in government hospitals are gram negative enterobacteriaceae and was recorded to be the dominant (81%). The organisms thus isolated were subjected to multidrug antibiotic resistance test which include a group of ß-lactam antibiotics that are frequently used in the treatment. Susceptibility testing revealed that the isolates from government hospitals are resistant to old ß lactams penicillin (95%), ampicillin (100%) as well to the first and second generation cephalosporins (cephaloxin-40%, cephalothin-60%, cefoxitin-45%). The plasmids were isolated from these resistant strains and were observed that around 90% of the isolates had plasmid. The possible reason of antibiotic resistance in the organism being plasmid meditated. Incidences of these multidrug resistant enterobacteriaceae are serious threat to the hospital community. The organism can become endemic within the hospital setting with continued presence in the OPD environment and nosochomial spread. Hence the administration and management of the hospital must give top priority to support the hospital infection control program by establishing a committee to constantly monitor on hygienic conditions and apply the appropriate methods for preventing nosochomial infections.