Investigating potential sources of transmission of healthcare-associated infections in a regional hospital, Ghana

BACKGROUND: Recent research has shown that healthcare-associated infections (HAIs) are on the increase despite education. AIMS: The aims of this study were to isolate, quantify, and determine antibiotic susceptibility pattern of bacteria on formites at the Central Regional Hospital, Cape Coast, Ghana. SETTINGS AND DESIGN: Purposive sampling of likely areas of contamination and contact by patients and healthcare workers was undertaken. MATERIALS AND METHODS: A total of 100 swabs were taken from door handles, working surfaces, beds and taps from the various wards, consulting rooms, OPDs, laboratory, and surgical theatre. Serial dilution was used in quantifying bacteria, MacConkey and blood agars were used in isolation, and the Kirby Bauer method applied in antibiotic sensitivity testing. Statistical analysis: Data were statistically analyzed using Statview from SAS Version 5.0. The means were separated using double-tailed paired means comparison. RESULTS: Mean bacterial count ranges from least in wards (9.67 × 10(11)), working surfaces (1.64 × 10(12)), door handles (1.71 × 10(12)), and highest in taps (2.08 × 10(12)). Door handles had the highest isolation (23) and highest number of differential isolates were from working surfaces (7). Of the total bacterial isolates, 46.14% were pathogenic, with S. aureus being the highest (14.42%), while 53.86% were nonpathogenic made up of 45.2% of Bacillus spp. Gentamicin was 100% effective, while 6 of the total 12 antibiotics tested (50%) were 100% resistant in either gram-positive or gram-negative bacteria. CONCLUSION: There was a high potential of bacterial transmission from the studied surfaces requiring hospital management to monitor and enforce cleaning regimen to prevent HAIs.