Identification of Carbapenemase Gene in Sinks of the General Hospital in Makassar City, Indonesia

Abstract

Background: Carbapenem-resistant bacteria pose a significant threat to healthcare systems. Sinks can harbor germs and serve as a source of transmission. Objectives: This study aims to determine the presence of carbapenemase in sinks located in the emergency room (ER), intensive care unit (ICU), and inpatient rooms in general hospitals in Makassar city. Methods: This cross-sectional observational study examined 63 sink swab specimens from 19 general hospitals in Makassar, Indonesia. The specimens were cultured for gram-negative bacteria, and the resulting colonies were analyzed for bacterial strains and carbapenemase genes (blaKPC, blaNDM, blaVIM, blaIMP, and blaOXA) using PCR. Results: The study found that 52.6% of hospitals had sinks contaminated with carbapenemase, distributed as 15% in ERs, 21% in ICUs, and 29% in inpatient rooms. The identified carbapenemases were Ambler class B (Metallo-β-lactamase) and class D, with imipenem (IMP)-resistant Pseudomonas carbapenemase being the most common. Enterobacter sp. and Klebsiella sp. accounted for 37.1% of the gram-negative bacteria found in sinks. This combination exhibited the highest diversity of resistance genes, with all four carbapenemase genes (blaIMP, blaVIM, blaOXA, blaNDM) detected. Conclusions: Carbapenemase contamination is widespread in hospital sinks. Infection control strategies must be strengthened to reduce nosocomial transmission.