Surfaces and Air Bacteriology of Selected Wards at a Referral Hospital, Northwest Ethiopia: A Cross-Sectional Study

Abstract

Background The hospital environment is a source of medically important pathogens that are mostly multidrug resistant (MDR) and posing a major therapeutic challenge. The aim of this study was to assess the surface and air bacteriology of selected wards at Felege Hiwot Referral Hospital (FHRH), Northwest Ethiopia. Methods A cross-sectional study was carried out from 15th February to 30th April 2017. A total of 356 surface and air samples were collected from selected wards using 5% sheep blood agar (Oxoid, UK) and processed at FHRH microbiology laboratory following the standard bacteriological procedures. Pure isolates were tested against the recommended antibiotics using Kirby–Bauer disc diffusion methods, and the susceptibility profile was determined based on Clinical Laboratory Standards Institute (CLSI). Data were entered and analyzed using SPSS version 23 for Windows. Results Of the total 356 samples processed, 274 were from surfaces and 82 were from air. Among these, 141 (39.6%) showed bacterial growth, yielding a total of 190 isolates. Gram-positive isolates were predominant at 81.6% (n=155), while the gram negatives were at 18.4% (n=35). The main isolates were coagulase negative staphylococci (CoNs), 44%, followed by S. aureus, 37.4%, and Klebsiella species at 11.6%. The bacterial load on surfaces and air was found beyond the standard limits. Besides, the antimicrobial susceptibility profile of the isolates showed that about 75% of the identified isolates were found resistant for two and more antimicrobial agents tested. Conclusions This study showed high degree of bacterial load that is beyond the standard limits on both surfaces and air samples of the hospital. Furthermore, some 75% of the isolates were found multidrug resistant. Therefore, it is important to evaluate and strengthen the infection prevention practice of the hospital. Moreover, stakeholders should also reinforce actions to decrease the pressure of antimicrobial resistance in the studied area.

<p>Bacterial Profiles and Antimicrobial Susceptibility Pattern of Isolates from Inanimate Hospital Environments at Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia</p>

“…The results of our study showed substantial contamination of inanimate environments by varied groups of bacteria, including both Gram-positive (56.3%) and Gram-negative (43.7%). Similar reports were documented by several authors from other studies in Ethiopia and abroad such as Gondar, Ethiopia (60.5% vs 39.5%), 37 Northwest, Ethiopia (81.6% vs 18.4%), 16 Iran (60.7% vs 39.3%) 38 and Nigeria (52.2% vs 47.8%). 39 The dominance of GPB could be explained by the fact that these bacteria, being devoid of the lipid-dominant desiccation-prone outer membrane, have a natural ability to retain their viability on abiotic hospital environments for several days to months.…”

“…In the present study, out of 164 environmental samples from swabs, 141 (86%) were positive for bacterial contamination which has similarly been reported from studies like Zimbabwe (86.2%) 14 and Morocco (96.3%). 28 In contrast to our result, studies conducted from Gaza Strip (24.7%), 29 Sudan (29.7%), 30 Uganda (44.2%), 31 Nigeria (39.4%), 32 and Bahir Dar, Northwest Ethiopia (39.6%) 16 reported far lower surface contamination rates. Differences in hand hygiene, ventilation system, sterilization, and disinfection techniques could account for these discrepancies.…”

“… 54 Because these tested antimicrobials represent the antibiotics most frequently used in practice, serious problems can be encountered while prescribing those antibiotics. 3 One way of fighting such a rise of resistance should include establishing guidelines for prescribing antibiotics 16 based on locally generated antimicrobial resistance data such as the findings from this study.…”

“…Studies on the bacterial contamination of the ward of the hospital environments in Ethiopia reported high bacterial load and multidrug-resistant (MDR) strains. 9 , 10 , 15 , 16 However, few data exist on the bacterial contamination of the hospital environment in the studied hospital. Therefore, this study aimed to determine bacterial contamination, detect potential pathogenic bacteria, and to determine the antimicrobial susceptibility patterns from inanimate hospital environments in the environments of Operation Theaters (OTs) and Intensive Care Units (ICUs) at Tikur Anbessa Specialized Teaching Hospital in Addis Ababa, Ethiopia.…”

Antimicrobial activity of Ricinus comunis, Swietenia mahogani and Crusentia cujete ethanol extracts against multidrug resistant pathogens, recovered from a hospital environment

“…Recovery of microbial pathogens from fomites supports the earlier reports of isolating similar microbes from toilet door handles in various settings including; hospitals in India (Lincy et al, 2016), beds and door handles in Kiwoko Hospital in Uganda (Segujja et al, 2016) and hospital surface samples in Ethiopia (Getachew et al, 2018). Recovery of methicillin-resistant S. aureus from different surfaces including; glass, vinyl floor tile, countertop and stethoscopes have been documented by Williams and Davis, (2009).…”