Reservoirs of nosocomial pathogens in neonatal intensive care unit

A total of 256 swabs taken from different areas of neonatal intensive care units (ICU) in KCG Hospital and AMC Hospital, Bangalore were bacteriologically investigated for prevalence, source and spread of nosocomial bacteria. Culture studies revealed growth in 217 (84.8%) swab samples indicating considerable contamination of different areas of the units and sources of infection. Klebsiella pneumoniae (27.3%) was the predominant organism followed by Esch coli (16.8%), Staph aureus (11.7%), Staph epidermidis and Pseudomonas aeruginosa (10.2%), enterococcus and proteus (4.7%), Citrobacter freundi (3.5%) and Clostridium tetani (2.4%) isolated from the equipment, cradles, other inanimate objects and environmental surfaces. Out of 312 isolates, monobacterial prevalence was 43.6% in contrast to polybacterial prevalence of 56.4%. Klebsiella pneumoniae (74.3%) was the predominant monobacterial isolate. The indoor air of the units was found to carry common nosocomial bacteria of 4 or more different bacterial species at dangerous levels as observed by colony counts of 15 to 30 on exposed blood agar plates. Almost all sources in ICU revealed the presence of Klebsiella Pneumoniae, Esch coli, pseudomonas and staphylococcus thus forming the potential reservoirs of nosocomial infections to babies and this could be attributed to overcrowding, poor ventilation system and failure to follow basic principles of strict protective barrier nursing.