The levels of indoor air microbial load in hospitals are very crucial to the health of patients and health care workers and are to be regularly monitored and maintained at an acceptable level. However, this problem remains overlooked, particularly in developing countries including Ethiopia. A hospital-based cross-sectional study is designed to determine the indoor air microbial load (settle plate technique), microbial isolates (standard microbiological techniques), bacterial susceptibility profiles (Kirby-Bauer disk diffusion technique), and associated factors, in different wards of the title Hospital, southern Ethiopia. An observational checklist was used to collect relevant information related to the associated factors; descriptive and inferential statistics were applied using Statistical Package for Social Sciences (SPSS); p-values ≤ 0.05 in the multivariable analysis were considered statistically significant. The total average bacterial and fungal load of the selected wards was 1914±1081.4 Colony Forming Units (CFU)/m3 (95% CI: 1718.5–2109.48 CFU/m3) and 1533.7±858.8 CFU/m3 (95% CI: 1378.5-1688CFU/m3) respectively. The highest mean bacterial (1914±1081.4 CFU/m3) and fungal (1533.7±858.8 CFU/m3) loads were found in the male surgical and female medical wards respectively. A total of 229 bacterial and 139 fungal isolates were obtained; Gram-positive bacteria were the predominant type, 130 (56.7%), particularly the isolates of Staphylococcus aureus, 46 (20.1%). The predominant fungal isolates were Aspergillus sp., 53(38%). Percentages of multidrug-resistant (MDR), extended-spectrum beta-lactamase (ESBL), and carbapenemase producers respectively were 48.5, 26.5, and 25%. High room crowd index [p = 0.003; Adjusted Odds Ratio (AOR) 12.5 (Confidence Interval (CI) 95%: 2.42–65)], presence of damp/wet materials [p = 0.025; AOR 7 (CI 95%: 1.3–37.4)], intense room traffic [p = 0.004; AOR 9.6 (CI 95%: 1.2–79.3)], inappropriate storage of food and drugs [p = 0.008; AOR 7.5 (CI 95%: 1.7–32)], and unclean environment [p = 0.03; AOR 5.8 (CI 95%: 1.2–28)] showed statistical significance concerning the indoor air microbial loads; most of the wards in Arba Minch General Hospital (AMGH) stand high and not in an acceptable level as per the WHO and the European Commission standards on indoor air microbial load. Periodic air surveillance and infection prevention control programs are required to reduce the transmission of these microbes to inpatients, visitors, and health care workers.

Background:The diminishing efficacy of antibiotics currently in use and the emergence of multidrug-resistant bacteria pose a grave threat to public health worldwide. Hence, new classes of antimicrobials are urgently required, and the search is continuing. Methods: Nine plants were chosen for the current work, which are collected from the highlands of Chencha, Ethiopia. Plant extracts containing secondary metabolites in various organic solvents were checked for antibacterial activity against type culture bacterial pathogens and MDR clinical isolates. The broth dilution technique was used to evaluate the minimum inhibitory and minimum bactericidal concentrations of highly active plant extracts, and time-kill kinetic and cytotoxic assays were performed using the most active plant extract. Results: Two plants (C. asiatica and S. marianum) were highly active against ATCC isolates. The EtOAc extract of C. asiatica produced the highest zone of inhibition ranging between 18.2±0.8-20.7±0.7 and 16.1±0.4-19.2±1.4 mm against Gram-positive and Gram-negative bacteria, respectively. The EtOH extract of S. marianum displayed zones of inhibition in the range of 19.9±1.4-20.5 ±0.7 mm against the type culture bacteria. The EtOAc extract of C. asiatica effectively curbed the growth of six MDR clinical isolates. The MIC values of C. asiatica against the Gram-negative bacteria tested were 2.5 mg/mL, whereas the corresponding MBC values were 5 mg/mL in each case. The MIC and MBC values were the lowest in the case of Gram-positive bacteria, ie, 0.65 and 1.25 mg/ mL, respectively. A time-kill assay showed the inhibition of MRSA at 4 × MIC and 8 × MIC within 2 hours of incubation. The 24 h LD 50 values of C. asiatica and S. marianum corresponding to Artemia salina were 3.05 and 2.75 mg/mL, respectively. Conclusion: Overall results substantiate the inclusion of C. asiatica and S. marianum as antibacterial agents in traditional medicines.