The NICU flora: An effective technique to sample surfaces

Area of Science:

• Microbiology
• Infection Control
• Neonatal Care

Background:

• Environmental surface sampling is crucial in healthcare but lacks standardized, high-yield methods.
• Understanding the microbial flora of neonatal intensive care units (NICUs) is vital for infection prevention.
• The relationship between environmental contamination, infant colonization/infection, and healthcare worker workload requires further investigation.

Purpose of the Study:

• To compare the yield of swab and gauze pad methods for environmental surface sampling.
• To characterize the bacterial flora present on NICU surfaces.
• To correlate NICU flora with infant infection/colonization rates and healthcare worker workload.

Main Methods:

• Comparative analysis of swab versus gauze pad sampling techniques.
• Longitudinal environmental surface sampling in a NICU over six months.
• Bacterial identification using matrix-assisted laser desorption-ionization time-of-flight (MALDI-TOF).

Main Results:

• The gauze pad method yielded significantly more bacterial colonies than the swab method.
• 87 bacterial species were identified, with 18% being potential pathogens.
• Pathogens found on infant clinical/colonization cultures were also detected in the NICU environment.
• Higher bacterial counts correlated with lower nurse-to-patient ratios.

Conclusions:

• The gauze pad method is a robust and accessible technique for environmental sampling.
• NICU environmental flora is diverse and mirrors infant flora, posing a potential pathogen reservoir.
• Environmental sampling data may inform infection control strategies and workload assessments.