Microbiological assessment of environmental surfaces in a healthcare facility

M Awanye Amaka; Amrasawore Believe

doi:10.30574/gscbps.2020.12.2.0236

Authors

M Awanye Amaka Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical Sciences, University of Port Harcourt, Nigeria.
Amrasawore Believe Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical Sciences, University of Port Harcourt, Nigeria.

DOI:

https://doi.org/10.30574/gscbps.2020.12.2.0236

Keywords:

Nosocomial Infections, Hospital-Acquired Infections, Inanimate Surfaces, Fomites, Antimicrobial Resistance

Abstract

Hospital-acquired infections (HAIs) are infections occurring within 48 hours of hospital admission, 3 days of hospital discharge or 30 days after a surgical procedure. HAIs are a major cause of death and disability within the hospital. Inanimate surfaces can serve as sources of HAIs and can significantly contribute to the spread of pathogens within hospitals. Swab samples were obtained from 53 inanimate surfaces such as air, bed pan, ward doorknob, nurses’ glove, sink, sink tap, cistern lever, toilet seat and wheel chairs located in the various wards of the Accident and Emergency Unit as well as Plastic and Burn unit of, University of Port Harcourt Teaching Hospital (UPTH). The samples obtained were screened for the presence of pathogenic microorganisms and their susceptibility to frequently prescribed antibiotics using disc diffusion method. Our findings showed highest level of contamination was the cistern lever (15 %), and the least was from nurses’ gloves (6 %). Microbial identification revealed the presence of 161 microorganisms comprising Pseudomonas aeruginosa (27 %), Staphylococcus spp. (22 %), Salmonella spp. (16 %), Klebsiella spp. (13 %), and Candida spp. (21 %). Interestingly, 83 % of isolated staphylococci were resistant to cefoxitin, 57 % of Pseudomonas spp. was resistant to levofloxacin, and both Klebsiella spp. and Salmonella spp. were most resistant to ceftriaxone (81 % and 77 % respectively). The observed high prevalence of pathogenic and antibiotic resistant microorganisms calls for implementation of regular surveillance and effective infection control measures within the hospital.

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References

WHO. (2002). Prevention of hospital-acquired infections: a practical guide / editors: G. Ducel, J. Fabry and L. Nicolle, 2nd. ed. Geneva, Switzerland : World Health Organization.

Barrasa-Villar JI, Aibar-Remon C, Prieto-Andres P, Mareca-Donate R and Moliner-Lahoz J. (2017). Impact on Morbidity, Mortality, and Length of Stay of Hospital-Acquired Infections by Resistant Microorganisms. Clin Infect Dis, 65(4), 644-52.

Alp E, Coruh A, Gunay GK, Yontar Y and Doganay M. (2012). Risk factors for nosocomial infection and mortality in burn patients: 10 years of experience at a university hospital. J Burn Care Res, 33(3), 379-85.

Chen KH, Chen LR and Wang YK. (2014). Contamination of medical charts: an important source of potential infection in hospitals. PLoS One, 9(2), e78512.

Shiferaw T, Beyene G, Kassa T and Sewunet T. (2013). Bacterial contamination, bacterial profile and antimicrobial susceptibility pattern of isolates from stethoscopes at Jimma University Specialized Hospital. Ann Clin Microbiol Antimicrob, 12, 39.

Worku T, Derseh D and Kumalo A. (2018). Bacterial Profile and Antimicrobial Susceptibility Pattern of the Isolates from Stethoscope, Thermometer, and Inanimate Surfaces of Mizan-Tepi University Teaching Hospital, Southwest Ethiopia. Int J Microbiol, 9824251.

Chaoui L, Mhand R, Mellouki F and Rhallabi N. (2019). Contamination of the Surfaces of a Health Care Environment by Multidrug-Resistant (MDR) Bacteria. Int J Microbiol, 3236526.

Darge A, Kahsay AG, Hailekiros H, Niguse S and Abdulkader M. (2019). Bacterial contamination and antimicrobial susceptibility patterns of intensive care units medical equipment and inanimate surfaces at Ayder Comprehensive Specialized Hospital, Mekelle, Northern Ethiopia. BMC Res Notes, 12(1), 621.

Singh S, Pandya Y, Patel R, Paliwal M, Wilson A and Trivedi S. (2010). Surveillance of device-associated infections at a teaching hospital in rural Gujarat--India. Indian J Med Microbiol, 28(4), 342-7.

Treakle AM, Thom KA, Furuno JP, Strauss SM, Harris AD and Perencevich EN. (2009). Bacterial contamination of health care workers' white coats. Am J Infect Control, 37(2), 101-5.

Cassini A, Hogberg LD, Plachouras D, Quattrocchi A, Hoxha A, Simonsen GS, et al. (2019). Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. Lancet Infect Dis, 19(1), 56-66.

Wang M, Wei H, Zhao Y, Shang L, Di L, Lyu C, et al. (2019). Analysis of multidrug-resistant bacteria in 3223 patients with hospital-acquired infections (HAI) from a tertiary general hospital in China. Bosn J Basic Med Sci, 19(1), 86-93.

CLSI. (2016). Performance Standards for Antimicrobial Susceptibility Testing. 26th ed. CLSI supplement M100S. Wayne, PA: Clinical and Laboratory Standards Institute.

Humphries RM, Ambler J, Mitchell SL, Castanheira M, Dingle T, Hindler JA, et al. (2018). CLSI Methods Development and Standardization Working Group Best Practices for Evaluation of Antimicrobial Susceptibility Tests. J Clin Microbiol, 56(4).

Biemer JJ. (1973). Antimicrobial susceptibility testing by the Kirby-Bauer disc diffusion method. Ann Clin Lab Sci, 3(2), 135-40.

Knowlton SD, Boles CL, Perencevich EN, Diekema DJ, Nonnenmann MW and Program CDCE. (2018). Bioaerosol concentrations generated from toilet flushing in a hospital-based patient care setting. Antimicrob Resist Infect Control, 7, 16.

Debnath T, Bhowmik S, Islam T and Hassan Chowdhury MM. (2018). Presence of Multidrug-Resistant Bacteria on Mobile Phones of Healthcare Workers Accelerates the Spread of Nosocomial Infection and Regarded as a Threat to Public Health in Bangladesh. J Microsc Ultrastruct, 6(3), 165-9.

Kramer A, Schwebke I and Kampf G. (2006). How long do nosocomial pathogens persist on inanimate surfaces? A systematic review. BMC Infect Dis, 6, 130.

Lai X, Wang M, Qin C, Tan L, Ran L, Chen D, et al. (2020). Coronavirus Disease 2019 (COVID-2019) Infection Among Health Care Workers and Implications for Prevention Measures in a Tertiary Hospital in Wuhan, China. JAMA Netw Open, 3(5), e209666.

WHO. (2020). Advice on the use of masks in the context of COVID-19: Interim guidance.

Wang X, Pan Z and Cheng Z. (2020). Association between 2019-nCoV transmission and N95 respirator use. J Hosp Infect, 105(1), 104-5.

Ziebuhr W. (2001). Staphylococcus aureus and Staphylococcus epidermidis: emerging pathogens in nosocomial infections. Contrib Microbiol, 8, 102-7.

Driscoll JA, Brody SL and Kollef MH. (2007). The epidemiology, pathogenesis and treatment of Pseudomonas aeruginosa infections. Drugs, 67(3), 351-68.

Almagor J, Temkin E, Benenson I, Fallach N, Carmeli Y and consortium D-A. (2018). The impact of antibiotic use on transmission of resistant bacteria in hospitals: Insights from an agent-based model. PLoS One, 13(5), e0197111.

Canton R, Horcajada JP, Oliver A, Garbajosa PR and Vila J. (2013). Inappropriate use of antibiotics in hospitals: the complex relationship between antibiotic use and antimicrobial resistance. Enferm Infecc Microbiol Clin, 31 Suppl 4, 3-11.

Friedman ND, Temkin E and Carmeli Y. (2016). The negative impact of antibiotic resistance. Clin Microbiol Infect, 22(5), 416-22.

Struelens MJ. (1998). The epidemiology of antimicrobial resistance in hospital acquired infections: problems and possible solutions. BMJ, 317(7159), 652-4.

Dancer SJ. (2014). Controlling hospital-acquired infection: focus on the role of the environment and new technologies for decontamination. Clin Microbiol Rev, 27(4), 665-90.

Nerandzic MM, Cadnum JL, Pultz MJ and Donskey CJ. (2010). Evaluation of an automated ultraviolet radiation device for decontamination of Clostridium difficile and other healthcare-associated pathogens in hospital rooms. BMC Infect Dis, 10, 197.

Noyce JO, Michels H and Keevil CW. (2006). Potential use of copper surfaces to reduce survival of epidemic meticillin-resistant Staphylococcus aureus in the healthcare environment. J Hosp Infect, 63(3), 289-97.

Stobie N, Duffy B, Colreavy J, McHale P, Hinder SJ and McCormack DE. (2010). Dual-action hygienic coatings: benefits of hydrophobicity and silver ion release for protection of environmental and clinical surfaces. J Colloid Interface Sci, 345(2), 286-92.