Multidrug-Resistant Bacteria on Surfaces, Equipment and Healthcare Workers’ Hands in the Neonatal and Surgical Units of the Saint-Louis Regional Hospital Center, Senegal: A Cross-Sectional Screening

Abstract

Background: Antimicrobial resistance is now recognised as a major global public health threat. Multidrug-resistant (MDR) bacteria can persist in the hospital environment, thereby contributing to their dissemination, which underscores the need for regular microbiological monitoring. Aim: This study aimed to determine the proportion of environmental and hand samples harbouring MDR bacteria and to describe the species and resistance profiles recovered in the neonatal and surgical units of the Saint-Louis Regional Hospital Center (CHR), Senegal. Methods: A cross-sectional, one-time, unannounced microbiological investigation was conducted in 2024 in the neonatal and surgical units of the Saint-Louis CHR. Thirty swab samples were collected from high-risk surfaces and equipment in both units, as well as from the hands of healthcare workers in the neonatal unit. After enrichment, samples were cultured on a ceftriaxone-supplemented chromogenic medium and on mannitol salt agar. Isolates were identified using conventional biochemical methods, and antimicrobial susceptibility was determined by the disk diffusion method according to CA-SFM/EUCAST 2024. MDR was defined as acquired non-susceptibility to at least one agent in three or more antimicrobial categories. Results: Overall, 8 of 30 samples (26.7%; 95% CI 14.2–44.4) yielded an MDR isolate. In the neonatal unit, 5 of 20 samples (25.0%; 95% CI 11.2–46.9) were MDR-positive: extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae (n = 4; two patient beds, one healthcare worker’s hand, one desk) and ESBL-producing Escherichia coli (n = 1; reconstituted infant formula). In the surgical unit, 3 of 10 samples (30.0%; 95% CI 10.8–60.3) were MDR-positive: carbapenem-resistant Acinetobacter spp. (suction device), ESBL-producing Enterobacter spp. (operating table) and methicillin-resistant Staphylococcus aureus (MRSA) (floor). Conclusion: MDR bacteria of infection-control importance were detected on near-patient surfaces, equipment and a healthcare worker’s hand in both units. These findings support the reinforcement of hand hygiene, environmental cleaning and safe infant-formula preparation, and call for repeated, larger environmental surveillance including molecular typing.