Browsing by Author "Sserwadda, Ivan"

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    Microbial Contaminants Isolated From Items And Work Surfaces In The Post- Operative Ward At Kawolo General Hospital, Uganda.
    (International Health Sciences University., 2015-12) Sserwadda, Ivan
    Introduction: Medical care equipment and hospital work surfaces play a major role in the accommodation of pathogenic bacteria. As such, they act as modes of transmission of these organisms among patients giving rise to nosocomial infections. Consequences of such infections include morbidity and mortality of the patients and increased antibiotic resistances amongst others. Objective: This research was aimed at determining the microbial contaminants present on medical items and work surfaces in the post-operative surgical ward at Kawolo general hospital and their susceptibility patterns to antibiotics. Methodology: A cross sectional and laboratory based study was conducted for the research. Sterile swabs were used to collect samples from medical equipment including scissors, infusion stands, beds and work surfaces which were composed of tables, sinks and taps. The samples were processed and the antimicrobial susceptibility patterns of the identified isolates were assessed and further classified as MDR, XDR and PDR. Results: Out of the total 138 swabs that were collected and processed, the overall prevalence of bacterial contaminants was 44.2% (61/138). The Gram positive organisms constituted of 75.4% (46/61) while the Gram negative organisms accounted for 24.6% (15/61). All the Gram positive organisms isolated were Staphylococcus aureus, while the Gram negative bacteria isolated had Klebsiella pneumoniae with 7(11.5%), Proteus vulgaris, Enterobacter species and Serratia merscescans representing 5(8.2%), 2(3.3%) and 1(1.6%) respectively. The items that had the highest level of bacterial contaminants that were isolated were infusion stands and patient beds from which 12 swabs (19.67%) had isolates followed by tables and sinks represented by 10 (16.39%), scissors with 9 (14.75%) and light switches with 8 (13.11%). Statistically, contaminated patient beds were the most likely medical care equipment that were capable of transmitting organisms to the patients with OR: 20.1 and p value 0.0008. Antibiotic susceptibility patterns for Gram positive isolated revealed that vancomycin was the most effective antibiotic with 100% while ciprofloxacin and ceftriaxone were the most effective antibiotics for Gram negative isolates both with 80% sensitivity. MDR for Staphylococcus aureus accounted for 52% (24/46) with 4% (1/24) classified as a possible XDR. Gram negat ive isolates had 27% (4/15) MDR strains out of which 50 %( 2/4) were classified as possible PDR. Conclusion: The high prevalence of bacteria present on the medical equipment at Kawolo hospital is an indicator of ineffective decontamination. A microbiology unit should be put in place for routine isolation and susceptibility testing of bacteria before antibiotic treatment to combat increasing drug resistance trends together with an infection control surveillance system.
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    Microbial contaminants isolated from itemsand work surfaces in the post- operativeward at Kawolo general hospital, Uganda
    (Bio Med Central, 2018-02-06) Sserwadda, Ivan; Lukenge, Mathew; Mwambi, Bashir; Mboowa, Gerald; Walusimbi, Apollo; Segujja, Farouk
    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 of 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, worktables 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 pneumonia 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-value8X10−4.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 orineffective decontamination. The study findings reiterate the necessity to formulate drug usage policies and re-examine the effectiveness of decontamination and sterilization practices within Kawolo general hospital. We also recommend the 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 resistance.