Research Article
HandColonizationwithGram-NegativeOrganismsofHealthcare
Workers Accessing the Cardiac Intensive Care Unit: A
Cross-Sectional Study at the Uganda Heart Institute
Lameck Ssemogerere ,
1,2,3
Cornelius Sendagire,
1,2,3
Ceaser Mbabazi,
2,3
Yvonne Namungoma,
2,3
Anna Noland Oketayot,
2,3
Judith Namuyonga,
2,3
Cephas Mijumbi,
2,3
Ritah Nkwine,
2,3
Moses Othin,
2,3
Michael Oketcho,
2,3
John Paul Magala,
1,2,3
Peter Lwabi,
2
Arthur Kwizera,
1,2,3
MartinW.D¨ unser,
4
and Christine Florence Najjuka
5
1
Department of Anaesthesia and Critical Care, Makerere University College of Health Science, Kampala, Uganda
2
Cardiac Critical Care Research Group-Uganda (CCCRG-Ug), Kampala, Uganda
3
Uganda Heart Institute, Kampala, Uganda
4
Department of Anaesthesiology and Intensive Care Medicine, Kepler University Hospital and Johannes Kepler University,
Linz, Austria
5
Department of Medical Microbiology, Makerere University College of Health Science, Kampala, Uganda
Correspondence should be addressed to Lameck Ssemogerere; lssemogerere@gmail.com
Received 11 April 2019; Accepted 5 September 2019; Published 9 October 2019
Academic Editor: Samuel A. Tisherman
Copyright © 2019 Lameck Ssemogerere et al. is is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Background. Hands of healthcare workers (HCWs) are vehicles for pathogens responsible for healthcare-associated infections
(HAIs). Following the identification of Gram-negative organisms (GNOs) in all cases of HAIs in the cardiac intensive care unit
(ICU), we sought to determine the burden of hand colonization with GNOs among healthcare workers who access the cardiac
ICU. Methods. We retrospectively reviewed results from surveillance cultures of fingertip imprints of HCWs who access the
cardiac ICU at the Uganda Heart Institute. We collected data on staff category, isolates, and susceptibility to antibiotics. We
analyzed the data using Microsoft Excel, and the results are summarized in proportions and percentages and presented in charts
and tables. Results. Fifty-six healthcare workers participated in the surveillance. 21 were ICU clinicians, 21 non-ICU clinicians, and
14 nonclinicians. GNOs were cultured in 19 (33.9%) HCWs, in which 8/19 (42.1%) were non-ICU clinicians, 6/19 (31.2%) ICU
clinicians, and 5/19 (26.3%) nonclinicians. 32 isolates were identified, of which 47%, 28%, and 25% were cultured from non-ICU
clinicians, nonclinicians, and ICU clinicians, respectively. Predominant isolates were Acinetobacter (34%), Citrobacter (21.9%),
and Pseudomonas (21.9%). Antimicrobial resistance ranged from 4% to 90%. 9/28 (32.1%) isolates, predominantly Acinetobacter
species (spp), were carbapenem resistant. 8/28 (28.6%) isolates, predominantly Citrobacter spp, were multidrug resistant. Re-
sistance to ciprofloxacin and cefepime was low at 3.6% and 4.4%, respectively. Conclusion. Gram-negative organisms, pre-
dominantly Acinetobacter, Citrobacter, and Pseudomonas spp, were prevalent on the hands of HCWs who access the cardiac ICU
irrespective of the staff category. Antimicrobial resistance was high, with multidrug resistance and carbapenem resistance
common among Citrobacter spp and Acinetobacter spp, respectively. Resistance to cefepime and ciprofloxacin was low.
Hindawi
Critical Care Research and Practice
Volume 2019, Article ID 6081954, 8 pages
https://doi.org/10.1155/2019/6081954