Microbial Contaminants Isolated From Items And Work Surfaces In The Post- Operative Ward At Kawolo General Hospital, Uganda.

Abstract

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.