ESBL and CPO bacteria on hospital surfaces from Low- and Middle-Income Countries
Inanimate surfaces in hospital settings are among the most critical factors in the emergence and spread of nosocomial infections including neonatal sepsis, which is associated with increased mortality in low- and middle-income countries (LMICs). During the BARNARDS study (Burden of Antibiotic Resistance in Neonates from Developing Societies) we identified bacterial species carrying Antibiotic Resistance Genes (ARGs) colonising neonatal wards from Nigeria, Ethiopia, South Africa, Bangladesh, Pakistan, and Rwanda. We determined which hospital surfaces were at greater risk of colonisation with antimicrobial resistant bacteria, to help provide evidence and create awareness for the need for improved Infection Prevention and Control (IPC) guidelines.  The presence of four ß-lactamase genes was determined by PCR, confirming the presence of Extended-Spectrum ß-lactamases (ESBL; blaCTX-M-15) and carbapenemases (blaNDM, blaOXA-48-like and blaKPC). Species containing these genes were identified by Matrix-Assisted Laser Desorption/Ionization Time-Of-Flight Mass Spectrometry (MALDI-TOF MS) and further analysed by Whole Genome Sequencing (WGS) using a hybridisation of both Illumina MiSeq and MinION Oxford Nanopore Technologies. Statistical analysis was performed to study correlations between ARGs and different hospital surfaces.