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Microbial contaminants isolated from items and work surfaces in the post- operative ward at Kawolo general hospital,
Ivan Sserwadda1,2, Mathew Lukenge3, Bashir Mwambi3
1Department of Medical Microbiology, International Health Sciences University, P.O. Box 7782, Kampala, Uganda. ivangunz23@gmail.com.
Background:
Nosocomial infections are a major setback in the healthcare delivery system especially in developing countries due to the limited resources. The roles played by medical care equipment and work surfaces in the transmission of such organisms have inevitably contributed to the elevated mortality, morbidity and antibiotic resistances.
Methods:
A total 138 samples were collected during the study from Kawolo general hospital. Swab samples were collected from various work surfaces and fomites which consisted of; beds, sink taps, infusion stands, switches, work tables and scissors. Cultures were done and the susceptibility patterns of the isolates were determined using Kirby Bauer disc diffusion method. Data was analyzed using Stata 13 and Microsoft Excel 2013 packages.
Results:
A total of 44.2% (61/138) of the collected swab specimens represented the overall bacterial contamination of the sampled articles. Staphylococcus aureus and Klebsiella pneumoniae accounted for the highest bacterial contaminants constituting of 75.4% (46/61) and 11.5% (7/61) respectively. Infusion stands and patient beds were found to have the highest bacterial contamination levels both constituting 19.67% (12/61). The highest degree of transmission of organisms to patients was found to be statistically significant for patient beds with OR: 20.1 and P-value 8X10- 4. Vancomycin, ceftriaxone and ciprofloxacin were the most effective antibiotics with 100%, 80% and 80% sensitivity patterns among the isolates respectively. Multi-drug resistant (MDR) Staphylococcus aureus accounted for 52% (24/46) with 4% (1/24) classified as a possible extensively drug resistant (XDR) whereas Gram negative isolates had 27% (4/15) MDR strains out of which 50%(2/4) were classified as possible pan-drug resistant (PDR).
Conclusion:
The high prevalence of bacterial contaminants in the hospital work environment is an indicator of poor or ineffective decontamination. The study findings reiterate the necessity to formulate drug usage policies and re-examine effectiveness of decontamination and sterilization practices within Kawolo general hospital. We also recommend installation of a sound Microbiology unit at the hospital to take on susceptibility testing to check on the empirical use of antibiotics as a way of reducing the rampant elevations in drug resistances.
Insights
Hospital surfaces like beds and infusion stands are heavily contaminated with bacteria, including drug-resistant strains like Staphylococcus aureus. This highlights poor hygiene practices and contributes to healthcare-associated infections and antibiotic resistance.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Nosocomial infections pose a significant challenge in healthcare, particularly in resource-limited settings.
- Medical equipment and surfaces are implicated in the transmission of pathogens, leading to increased morbidity, mortality, and antibiotic resistance.
Purpose of the Study:
- To assess bacterial contamination levels on hospital work surfaces and fomites.
- To determine the antibiotic susceptibility patterns of isolated bacteria.
- To identify high-risk items contributing to pathogen transmission and antibiotic resistance.
Main Methods:
- Collected 138 swab samples from various hospital items (beds, taps, stands, etc.) at Kawolo General Hospital.
- Performed bacterial cultures and antibiotic susceptibility testing using the Kirby Bauer disc diffusion method.
- Analyzed data using Stata 13 and Microsoft Excel 2013.
Main Results:
- 44.2% of samples showed bacterial contamination, with Staphylococcus aureus and Klebsiella pneumoniae being the most common.
- Infusion stands and patient beds had the highest contamination rates (19.67%). Patient beds showed a statistically significant association with organism transmission (OR: 20.1).
- High rates of multi-drug resistant (MDR) Staphylococcus aureus (52%) and MDR Gram-negative isolates (27%) were observed. Vancomycin, ceftriaxone, and ciprofloxacin were highly effective.
Conclusions:
- Elevated bacterial contamination indicates inadequate decontamination practices.
- There is a critical need to review and improve sterilization and disinfection protocols at Kawolo General Hospital.
- Establishing a microbiology unit for susceptibility testing is recommended to guide antibiotic use and combat rising drug resistance.
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