Introduction: Hand hygiene causes a significant reduction in the carriage of potential pathogen in the hand. Inadequate hand hygiene facilities is one of the factors affecting compliance with hand hygiene by health care workers. The objective of the study was to evaluate the availability and accessibility of hand hand hygiene facilities and supplies of hand hygiene agents in the inpatient wards of a tertiary hospital in Nigeria. Methods and Materials: The study was conducted in a federal tertiary hospital in Nigeria. A modified survey checklist that assessed the condition of hand hygiene sink and other facilities was adapted and pretested. Direct observations of existing hand hygiene facilities in all the inpatient wards were carried out by one of the authors. Results: Of the 28 sinks, 22 (78.6%) were accessible but 13 (46.4%) had blocked drain. All the taps were hand operated with only 4 (14.3%) working. Majority of the sinks (67.9%) had no soap and no sink had antiseptic solution. Only 8 (28.6%) sinks had hand drying material which was a cloth towel. No sink had hand hygiene instructions displayed on or close to it. Conclusion: There is gross inadequacy of hand hygiene facilities in Ido-Ekiti, Nigeria. There is an urgent need for health managers to give priority to provision of hand hygiene facilities at all levels of health care delivery. Infection Control Unit should be established and strengthened in each facility for effective implementation of infection control policies. [TAF Prev Med Bull 2012; 11(5.000): 571-576
Background: The most common means of transmission of Healthcare-Associated Infections (HAIs) is the contaminated hand of Healthcare Workers (HCWs), proper handwashing by HCWs is the best method of halting this transmission, however, there is poor adherence to the practice of the simple handwashing procedure in many health facilities. Aims: To assess the knowledge and practice of proper handwashing, to identify the factors impeding adherence to its good practice among HCWs and to identify the handwashing and hand drying facilities available to these HCWs. Study Design: This is a descriptive cross-sectional study. Place and Duration of Study: The study was carried out at Federal Teaching Hospital, Ido-Ekiti (FETHI), Southwestern Nigeria between July 2020 and December 2020. Methods: The study involved 328 randomly selected HCWs. Data was collected using pretested self administered questionnaires, entered into Microsoft Excel 2016 and analyzed by SPSS version 23. Results: Only 31.10% of respondents had good knowledge of handwashing while 80.18% had good practice of handwashing. Longer stay in service and being a doctor or nurse were associated with good knowledge and good practice of handwashing. Only 16.46% of respondents had previous training on handwashing within 3 years prior to this study. Previous training on handwashing was associated with good knowledge of handwashing (P=.001). Up to 68.60% of respondents used stored water and soap for handwashing. The most common hand drying facility reported in the study was common towel, no respondent ever used paper towel. The most common reason given for poor adherence to handwashing practices was the busy schedule. Conclusion: Hospital managers must prioritize the regular provision of handwashing and hand drying facilities for their centre, in addition to organizing regular hand hygiene training for HCWs, to improve their knowledge and practice of handwashing and thus reduce the rate of HAIs
Background: Bloodstream infections (BSIs) are a cause of significant morbidity and mortality requiring urgent antibiotic treatment. However, there is widespread antibiotic-resistance from the bacterial causes, necessitating regular surveillance for drug-resistant bacteria and their antibiograms.Objective: This study isolated and identified various bacterial causes of BSIs, determined their antibiotic susceptibility patterns, and determined the best empirical treatment for cases of BSI in the setting.Methods: A cross-sectional study was carried out at the Federal Teaching Hospital, Ido-Ekiti, Nigeria between June 2020 and February 2021 on 177 blood culture samples from cases of BSI. Identification of isolated bacteria and antibiotic susceptibility testing of the isolates were carried out following the standard protocol.Results: Culture positivity in this study was 19.2%. No significant difference was seen in culture positivity between male and female participants (p = 0.97). Gram-negative enteric bacteria were predominantly isolated (67.6%), including Escherichia coli (29.4%) and Klebsiella aerogenes (20.6%). Staphylococcus aureus was the most common Gram-positive bacterium isolated (23.5%). Three (37.5%) S. aureus isolates were methicillin-resistant. All isolates were sensitive to meropenem, and 97.1% were sensitive to imipenem; other sensitivity patterns were: ceftazidime (85.3%), ciprofloxacin (79.4%), ofloxacin (79.4%), and gentamicin (76.5%). There was low sensitivity to ampicillin (32.4%) and cotrimoxazole (38.2%). All Gram-positive isolates, including methicillin-resistant S. aureus, were sensitive to vancomycin.Conclusion: Regular surveillance of isolate sensitivity patterns, formulation of hospital antibiotic policies based on existing data and compliance with treatment guidelines will promote rational antibiotic use and reduce resistance among bacteria.
Background: Carriage of methicillin-resistant Staphylococcus aureus (MRSA) among Healthcare workers (HCWs) who serves as agent of pathogen transmission in hospital settings portends danger to critical care patients. Aim: To determine the carriage rate of MRSA among HCWs in the critical care units of the hospital, to identify the factors associated with carriage, and to determine the antibiotic resistance pattern of isolates. Study Design: A cross sectional descriptive study. Materials and Methods: A total of 135 randomly selected consenting HCWs from critical care units were studied. Data on demographic characteristics and infection control practices were obtained from participants with the aid of questionnaire. Swabs of the anterior nares and hands of participants were cultured on oxacillin-containing mannitol salt agar (MSA), S. aureus was identified using convectional criteria and MRSA was identified by cefoxitin disc diffusion technique. Antibiotic susceptibility testing was carried out on all isolated MRSA. Results: Carriage rate of MRSA was high (26.7%). Poor handwashing practices (P=.008) and presence of wound or skin infection (P=.003) were associated with higher isolation rate. None of the age, gender, profession and duration of unit stay of workers was associated with carriage rate of MRSA. Isolation rate was higher from the nose (18.5%) than the hands (8.1%). Isolates demonstrated high resistance to antibiotics: penicillin (100%), amoxicillin/clavulanate (66.7%), cefuroxime (61.1%), ceftriaxone (63.9%), erythromycin (55.6%). All isolates were sensitive to vancomycin. Conclusion: Carriage rate of MRSA among critical care unit staff was high in this study. There is urgent need for formulation of infection control policies and enforcement, to prevent MRSA spread among critical care patients.
Background: Methicillin-resistant Staphylococcus aureus (MRSA) colonized healthcare workers (HCWs) constitute massive threat to the well-being of hospitalized patients due to their ability to transmit this multidrug-resistant (MDR) bacteria strain in hospital settings. Aim: To determine the prevalence of MRSA carriage/colonization among HCWs, to identify risk-factors associated with colonization/carriage, and to determine the antibiotic resistance pattern of isolates. Study Design: A cross-sectional study. Materials and Methods: A total of 333 randomly selected consenting HCWs from most hospital care units were studied. Data on demographic characteristics and infection control practices were obtained from participants with the aid of questionnaire. Swabs of the anterior nares and hands of participants were cultured on oxacillin-containing mannitol salt agar (MSA), S. aureus was identified using convectional criteria and MRSA was identified by cefoxitin disc diffusion technique. Antibiotic susceptibility testing was carried out on all isolated MRSA. Results: The carriage rate of MRSA was high (21.3%). Isolation was significantly higher among; males compared to females (P=.035), staff of critical care units compared to other care units (P=.049), among doctors and nurses compared to other HCWs (P=.0031). Poor handwashing practices (P<.001), presence of wound or skin infection (P<.001) and recent antibiotic use (P=.006) were associated with higher isolation rate. Isolation rate was higher from the nose (15.0%) than from the hands (6.3%). Isolates demonstrated low resistance to clindamycin (16.9%) and ciprofloxacin (16.9%). No isolate was resistant to vancomycin. Conclusion: In this study; colonization of HCWs by MRSA was high, a male doctor or nurse from critical care unit, with poor handwashing practices, wound or skin infection, and recent antibiotic use had a higher risk of MRSA carriage/colonization. No MRSA isolated was resistant to vancomycin. Improved infection control policies and practices are needed to curtail this trend in hospital settings.
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