title: Non-fermentative gram-negative bacteria in hospital tap water and water used for haemodialysis and bronchoscope flushing: prevalence and distribution of antibiotic resistant strains.
abstract: This study provides a detailed description of the distribution of non-fermentative gram-negative bacteria (NFGNB) collected in water sources (tap water and water used for haemodialysis and bronchoscope flushing) from different wards of a tertiary care hospital. The aim is to identify risk practices for patients or to alert clinicians to the possible contamination of environment and medical devices. The resistance profile of NFGNB environmental isolates has shown that more than half (55.56%) of the strains isolated were resistant to one or more antibiotics tested in different antimicrobial categories. In particular, 38.89% of these strains were multidrug resistant (MDR) and 16.67% were extensively drug resistant (XDR). The most prevalent bacterial species recovered in water samples were Pseudomonas aeruginosa, Pseudomonas fluorescens, Ralstonia pickettii and Stenotrophomonas maltophilia. Analysis of antibiotic resistance rates has shown remarkable differences between Pseudomonadaceae (P. aeruginosa and P. fluorescens) and emerging pathogens, such as S. maltophilia and R. pickettii. Multidrug resistance can be relatively common among nosocomial isolates of P. aeruginosa, which represent the large majority of clinical isolates; moreover, our findings highlight that the emergent antibiotic resistant opportunistic pathogens, such as R. pickettii and S. maltophilia, isolated from hospital environments could be potentially more dangerous than other more known waterborne pathogens, if not subjected to surveillance to direct the decontamination procedures.
authors.affiliation: Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome 00168, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Vincenti
authors.affiliation: Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome 00168, Italy.
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Quaranta
authors.affiliation: Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome 00168, Italy. Electronic address: concetta.demeo87@gmail.com.
authors.forename: Concetta
authors.initials: C
authors.lastname: De Meo
authors.affiliation: Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome 00168, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Bruno
authors.affiliation: Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome 00168, Italy.
authors.forename: Maria Giovanna
authors.initials: MG
authors.lastname: Ficarra
authors.affiliation: Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome 00168, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Carovillano
authors.affiliation: Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome 00168, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Ricciardi
authors.affiliation: Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome 00168, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Laurenti
mesh_terms: D020680:Bronchoscopes; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D004866:Equipment Contamination / Q000706:statistics & numerical data*; D006090:Gram-Negative Bacteria / Q000145:classification / Q000254:growth & development*; D006761:Hospitals; D006435:Renal Dialysis; D014871:Water Microbiology; D014881:Water Supply / Q000706:statistics & numerical data*
keywords: Antibiotic resistance; Non-fermentative gram-negative bacteria; Pseudomonas aeruginosa; Ralstonia pickettii; Stenotrophomonas maltophilia; Water source