title: Cockroaches as potential vectors of nosocomial infections.
abstract: OBJECTIVE
  To determine the possible role of cockroaches in the epidemiology of nosocomial infections.
  
  
  METHODS
  Epidemiologic investigation of bacteria and fungi in cockroaches and evaluation of the antibiotic resistance of the bacteria isolated from the insects.
  
  
  METHODS
  Ninety hospitals in Kaohsiung City and Kaohsiung County in Taiwan.
  
  
  METHODS
  Cockroaches were collected in clinical and nonclinical areas and microorganisms were isolated from their external surface and alimentary tract. The susceptibilities of Staphylococcus aureus, Enterococcus species, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Serratia marcescens, and Proteus species to 17 antibiotics were tested.
  
  
  RESULTS
  Cockroach infestation was found in 46.7% of the hospitals studied. Two hundred three cockroaches were collected (139 Periplaneta americana and 64 Blattella germanica). Periplaneta americana was found more often in nonclinical areas (64.5%) and B. germanica in clinical areas (78.1%). There was no statistically significant difference between Periplaneta americana (98.6%) and B. germanica (96.9%) regarding overall isolation rate (P > .05). However, 33 species of bacteria and 16 species of fungi were isolated from Periplaneta americana and only 23 and 12, respectively, from B. germanica. Resistance to ampicillin (13.7% to 100%), chloramphenicol (14.3% to 71.4%), tetracycline (14.3% to 73.3%), and trimethoprim-sulfamethoxazole (14.3% to 57.1%) was found in two gram-positive and five gram-negative bacteria.
  
  
  CONCLUSIONS
  Because cockroach infestation occurred in more than 40% of the hospitals and nearly all of the cockroaches harbored bacteria with multidrug resistance and fungi, cockroaches may play a potential role in the epidemiology of nosocomial infections in those hospitals.
authors.affiliation: Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China.
authors.forename: Hsiu-Hua
authors.initials: HH
authors.lastname: Pai
authors.forename: Wei-Chen
authors.initials: WC
authors.lastname: Chen
authors.forename: Chien-Fang
authors.initials: CF
authors.lastname: Peng
mesh_terms: D000818:Animals; D003058:Cockroaches / Q000145:classification / Q000382:microbiology*; D003428:Cross Infection / Q000453:epidemiology / Q000635:transmission*; D004351:Drug Resistance; D005658:Fungi / Q000302:isolation & purification; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007303:Insect Vectors / Q000382:microbiology*; D013045:Species Specificity; D013624:Taiwan / Q000453:epidemiology