title: Are community environmental surfaces near hospitals reservoirs for gram-negative nosocomial pathogens?
abstract: BACKGROUND
  Hospital visitors and staff visit neighboring businesses, creating the potential for contamination of surfaces with hospital flora.
  
  
  METHODS
  Cultures were obtained from environmental surfaces in hospital lobbies and the surrounding community of 6 hospitals in Brooklyn, NY. As a control, cultures were taken from surfaces >1.5 miles from any hospital. Screening for β-lactamases was done by polymerase chain reaction (PCR), and select isolates were fingerprinted by the repetitive extragenic palindromic sequence-PCR method.
  
  
  RESULTS
  Of 493 cultures, most (70%) involved doors from local businesses. Cephalosporin-resistant Citrobacter freundii (n = 3), Escherichia coli (n = 2), and Enterobacter sp (n = 2) were recovered from surfaces near hospitals, but not from control sites. One isolate of Stenotrophomonas maltophilia harbored an integron-associated VIM-2. Acinetobacter baumannii was recovered in 15 samples, including 4.5% of swabs from ≤0.5 miles of the hospitals versus 0% from ≥0.6 miles (P = .004). Eleven A baumannii isolates were clonally related by repetitive extragenic palindromic sequence-PCR and were also related to a known clinical isolate.
  
  
  CONCLUSIONS
  Strains of A baumannii and cephalosporin-resistant Enterobacteriaceae can be recovered from environmental surfaces surrounding hospitals. Finding these pathogens in the perihospital environment suggests hand cleansing should be emphasized for all people entering and leaving hospitals. The finding of integron-associated VIM-2 in our region is disconcerting, and further vigilance is warranted.
authors.affiliation: Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY.
authors.forename: Michael
authors.initials: M
authors.lastname: Rose
authors.affiliation: Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY.
authors.forename: David
authors.initials: D
authors.lastname: Landman
authors.affiliation: Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY. Electronic address: jquale@downstate.edu.
authors.forename: John
authors.initials: J
authors.lastname: Quale
mesh_terms: D004783:Environmental Microbiology; D006090:Gram-Negative Bacteria / Q000145:classification / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D006761:Hospitals; D006801:Humans; D058889:Molecular Typing; D009519:New York City; D016133:Polymerase Chain Reaction; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D001618:beta-Lactamases
keywords: Acinetobacter; Environmental contamination