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. 2018 Feb 6;18(1):68.
doi: 10.1186/s12879-018-2980-5.

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

Ivan Sserwadda  1   2 , Mathew Lukenge  3 , Bashir Mwambi  3 , Gerald Mboowa  4 , Apollo Walusimbi  3 , Farouk Segujja  3   5
Affiliations

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

Ivan Sserwadda et al. BMC Infect Dis. .

Abstract

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.

Keywords: Antimicrobial susceptibility; Gram-negative; Gram-positive; Nosocomial infections.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval for the study was attained from the research and ethics committee of International Health Sciences University, Institute of Allied Health Sciences, Kampala, Uganda. Prior to sample collection, written approval was also granted by the Kawolo General Hospital administration, Buikwe and the International Health Sciences University, microbiology laboratory where this work was carried out.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Frequency of the bacteria isolated from the swabs with bacterial growth
Fig. 2
Fig. 2
Gram-positive antimicrobial susceptibility pattern
Fig. 3
Fig. 3
Gram-negative isolate antimicrobial susceptibility pattern
See this image and copyright information in PMC

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