Multidrug Resistant Bacterial Pathogens in the Indoor Air and Floors of Surgical Wards in a University Hospital

Year 2018, Volume: 08 Issue: 03, 108 - 112, 15.09.2018

Ahmed Olowo-okere Yke Ibrahim M. Babandina Bo Olayinka

https://doi.org/10.5799/jmid.458460

Cited By: 1

Abstract

Objective: The hospital environment is a major source of
nosocomial pathogens. These pathogens could contaminate and colonize surgical
wounds leading to infections. This study evaluated the bacteriological quality
of air and floors of surgical wards of a University Teaching Hospital in Abuja,
Nigeria.

Methods: Bacteriological
quality of air and floor of surgical wards of the hospital was evaluated using
passive air sampling and swabbing methods respectively. The isolates were
characterized using rapid test kits and antibiotic susceptibility was
determined by the modified Kirby-Bauer disc diffusion method.

Results: A
total of 121 bacterial isolates comprising eleven species were isolated. In the
air and floor of all the surgical wards, Staphylococcus
spp. (>42%) was the most prevalent Gram-positive bacterium followed by
Bacillus subtilis (20.4%). Among the Gram-negative bacterial isolates, Pseudomonas aeruginosa (13.0%) and Proteus mirabilis (9.0%) were the most
prevalent in the air and floor, with occasional detection of Acinetobacter baumannii and other
members of the Enterobacteriaceae
family. The bacterial isolates exhibited diverse degrees of susceptibility to
the commonly prescribed antibiotics. The isolated bacteria were mostly
sensitive to fluoroquinolones.

Conclusion: This study documented the diverse environmental
microbiota of the surgical wards of the hospital. The high resistance of the
isolated bacteria to the commonly prescribed antibiotics in the hospital
highlighted the need for improved infection control and patient safety
protocols in the hospital so as to mitigate the spread of nosocomial infections
in the surgical wards of the hospital. J
Microbiol Infect Dis 2018; 8(3):108-113

Keywords

Microbial quality, Hospital environment, Indoor air, Antibiotics, Multidrug resistance

References

• 1. Reichman DE, Greenberg JA. Reducing Surgical Site Infections : A Review. Rev Obstet Gyneacology 2009; 2:212-221. 2. Gottrup F, Melling A, Hollander DA. An Overview of Surgical Site Infections: Aetiology, Incidence and Risk Factors. EWMA J 2005; 5:11-15. 3. Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg 2017; 152: 784-791. 4. Badri RM. Identification and Characterization of Bacteria Air Pathogens from Homes in Some Areas of the Baghdad City Material and Method : 2014; 2:384-388. 5. Nwankwo E. Isolation of pathogenic bacteria from fomites in the operating rooms of a specialist hospital in Kano, North-western Nigeria. Pak J Pharm Sci 2012; 12:90-96. 6. Poggio JL. Perioperative Strategies to Prevent Surgical-Site Infection. Clin Colon Rectal Surg 2013; 26:168-73. 7. Nwankwo EO, Ibeh I, Enabulele OI. Incidence and risk factors of surgical site infection in a tertiary health institution in Kano, Northwestern Nigeria. Int J Infect Control 2012; 8:8-13. 8. Atata RF, Ibrahim YKE, Olurinola PF, Giwa A, Akanbi Il AA, Sani AA. Clinical bacterial isolates from hospital environment as agents of surgical wound nosocomial infections. J Pharm Bioresour 2010; 7:146-55. 9. Onwubiko NE, Akande AO. Microbial Contamination In The Operating Theatre Of a Tertiary Health Institution In Kano, Northwestern Nigeria. Niger J Microbiol 1999;27:2671-2679. 10. Akanbi II AA, Kareem T, Adedoja A, et al. Bacterial contamination of medical doctors’ white coats as contributing factor to hospital acquired infections. Int J Biol Chem Sci 2017; 11:185-194. 11. Nwankwo EO, Akande AO. Contaminated operating theatre foot wear : a potential source of healthcare associated infections in a northern Nigerian hospital. Int J Infect Control 2014; 11:6-11. 12. Famurewa O, David OM. Cell phone: A medium of transmission of bacterial pathogens. World Rural Obs 2009; 1:69-72. 13. Pathak A, Mahadik K, Swami MB, et al. Incidence and risk factors for surgical site infections in obstetric and gynecological surgeries from a teaching hospital in rural India. Antimicrob Resist Infect Control 2017; 6:66. doi:10.1186/s13756-017-0223-y. 14. Napoli C, Marcotrigiano V, Montagna MT. Air sampling procedures to evaluate microbial contamination : a comparison between active and passive methods in operating theatres. BMC Public Health 2012; 12:1. doi:10.1186/1471-2458-12-594. 15. CLSI. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fifth Informational Supplement. 2015. 16. Cabo Verde S, Almeida SM, Matos J, et al. Microbiological assessment of indoor air quality at different hospital sites. Res Microbiol 2015; 166:557-563. 17. Obi C, Muhammad UK, Manga SB, Atata RF, Hauwa T. Assessment of commonly used Hospital Disinfectants on Bacteria isolated from the Operating Theatre. J Biosci Biotechnol Discov 2016; 1:59-65. 18. Shuaibu AS, Ibrahim YKE, Olayinka BO, et al. Phenotypic resistance of nosocomial bacterial isolates to some routinely used disinfectants. World J Pharm Med Res 2017; 3:52-56. 19. Nurain AM, Bilal NE, Ibrahim ME. The frequency and antimicrobial resistance patterns of nosocomial pathogens recovered from cancer patients and hospital environments. Asian Pac J Trop Biomed 2015; 5:1055-1059. 20. Nwankwo OE, Ejike N, Onyinyechi NP. Microbial contamination of air and protective wears in the operating theatre and surgical wards of two tertiary hospitals in Kano, Northwestern Nigeria. Int J Infect Control 2014; 11:1-9. doi:10.3396/IJIC.v11i3.020.15. 21. Monteiro A, Verde SC. Bacterial Bioburden in Hospital Environment. In: Viegas C., Viegas S., Gomes A., Täubel M., Sabino R. (eds) Exposure to Microbiological Agents in Indoor and Occupational Environments. Springer, Cham, 2017; p:321-328. doi:10.1007/978-3-319-61688-9. 22. Kolmos HJ. Health Care Associated Infections : Sources and Routes of Transmission Microorganisms : Health care. Infect. Control, INTECH Open Access Publisher; 2012, p. 20–5. https://www.intechopen.com/books/infection-control-updates/sources-and-routes-of-infection 23. Manyahi J. Bacteriological Spectrum Of Post Operative Wound Infections And Their Antibiogram In A Tertiary Hospital, Dar Es Salaam, Tanzania. Muhimbili University of Health and Allied Sciences Muhimbili, 2012, http://ihi.eprints.org/1510/ 24. Affifi M. Detection of Extended spectrum betalactamase producing Klebsiella pneumonia and Escherichia coli of environmental surfaces at upper Egypt. Int J Biol Chem 2013;7:58–68. doi:10.1186/s12879-015-1005-x. 25. Atata RF, Ibrahim YKE, Giwa A, Akanbi AA. Antibiotics resistance profile of bacterial isolates from surgical site and hospital environment in a University teaching hospital in Nigeria. J Med Med Sci 2013;4:181-187. 26. Hailemariam M, Birhaneselase M, Azerefege E. Bacterial load and antibiotic susceptibility pattern of isolates in operating rooms at Hawassa University Referral Hospital, southern Ethiopia. J Microbiol Antimicrob 2016; 8:1-6. doi:10.5897/JMA2015.0349.