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Microbial contaminants isolated from items and work surfaces in the post- operative ward at Kawolo general hospital, Uganda

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 mort...

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Autores principales: Sserwadda, Ivan, Lukenge, Mathew, Mwambi, Bashir, Mboowa, Gerald, Walusimbi, Apollo, Segujja, Farouk
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5801902/
https://www.ncbi.nlm.nih.gov/pubmed/29409447
http://dx.doi.org/10.1186/s12879-018-2980-5
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author Sserwadda, Ivan
Lukenge, Mathew
Mwambi, Bashir
Mboowa, Gerald
Walusimbi, Apollo
Segujja, Farouk
author_facet Sserwadda, Ivan
Lukenge, Mathew
Mwambi, Bashir
Mboowa, Gerald
Walusimbi, Apollo
Segujja, Farouk
author_sort Sserwadda, Ivan
collection PubMed
description 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.
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spelling pubmed-58019022018-02-14 Microbial contaminants isolated from items and work surfaces in the post- operative ward at Kawolo general hospital, Uganda Sserwadda, Ivan Lukenge, Mathew Mwambi, Bashir Mboowa, Gerald Walusimbi, Apollo Segujja, Farouk BMC Infect Dis Research Article 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. BioMed Central 2018-02-06 /pmc/articles/PMC5801902/ /pubmed/29409447 http://dx.doi.org/10.1186/s12879-018-2980-5 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Sserwadda, Ivan
Lukenge, Mathew
Mwambi, Bashir
Mboowa, Gerald
Walusimbi, Apollo
Segujja, Farouk
Microbial contaminants isolated from items and work surfaces in the post- operative ward at Kawolo general hospital, Uganda
title Microbial contaminants isolated from items and work surfaces in the post- operative ward at Kawolo general hospital, Uganda
title_full Microbial contaminants isolated from items and work surfaces in the post- operative ward at Kawolo general hospital, Uganda
title_fullStr Microbial contaminants isolated from items and work surfaces in the post- operative ward at Kawolo general hospital, Uganda
title_full_unstemmed Microbial contaminants isolated from items and work surfaces in the post- operative ward at Kawolo general hospital, Uganda
title_short Microbial contaminants isolated from items and work surfaces in the post- operative ward at Kawolo general hospital, Uganda
title_sort microbial contaminants isolated from items and work surfaces in the post- operative ward at kawolo general hospital, uganda
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5801902/
https://www.ncbi.nlm.nih.gov/pubmed/29409447
http://dx.doi.org/10.1186/s12879-018-2980-5
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