Abstract:
Surgical site infection (SSI) stands in the second position accounting one-third of total health
care associated infection (HAI). One of the risk factor for SSI is bacterial contamination of
indoor air and environmental surfaces in Operating rooms (ORs) and surgical wards (SWs).
Different measures are undergoing to reduce these contaminations so as to reduce the risk of SSI
of which determining the degree of bacterial contamination and antibiotic susceptibility pattern
of the isolates in the environment is one measure. These will help to evaluate the bacterial load
of the environments, select appropriate antibiotics as well as to revises and design appropriate
hospital infection prevention protocols. Thus, the aim of this study was to determine the degree
of bacterial contamination and antibiotic susceptibility pattern of isolates in ORs and SWs of
Jimma University Specialized Hospital (JUSH). Laboratory based cross sectional study was
conducted taking 252 environmental (108 indoor air and 144 housekeeping surface) samples
using purposive sampling technique. The settle plate and sample rinse methods were used for the
collection of air and housekeeping surface samples respectively. Then samples were processed
with standard bacteriological techniques from October to January 2009/2010 and the data was
analyzed using SPSS version 16 for descriptive statistics. The mean indoor air aerobic colony
count (ACC) of most SWs and ORs of JUSH were beyond acceptable range being Critical Zone
of ORs exceptionally with highest count. Similarly, the mean ACC in housekeeping surfaces
(Floor and Table top surfaces) of both ORs and SWs were also higher when compaired with the
recommended standard level. Staphylococcus aureus was a predominant isolate 44.4% and 33%
from both indoor air and housekeeping surfaces respectively. Among potential pathogenic Gram
negative bacteria identified from housekeeping surfaces of ORs and SWs, Klebsiella spp and
Escherichia coli were frequently isolated with a rate of 11% each followed by Citrobacter spp
(7%) and P. aeruginosa (6.3%). Regarding to the antimicrobial susceptibility pattern of isolates,
S. aureus showed 100% (70 isolates tested) resistance to methicillin and 82.3% (96 isolates
tested) to ampicillin. Similarly, more than 87% of Klebsiella spp and E. coli were resistant for
ampicillin and cephalothin. Unexpectedly, multidrug resistant Enterobacteriaceae for the
antibiotics tested was seen in more than 90 % of isolates. Since, the indoor air and housekeeping
surface of ORs and SWs of JUSH revealed high degree of aerobic bacterial load being most of
the isolates are a potential pathogens and multi drug resistant; an appropriate measures on the
infection prevention system need to be implemented to reduce the risk of SSIs.
