Abstract:
Background: Hospital environments are a source of healthcare-associated infections, which
are mostly caused due to bacteria and fungi. The burden of healthcare-associated infections in
low and middle-income countries is much higher and resulted in worse outcomes. It is
essential to evaluate the status of infection prevention and control practices and the level of
microbial load to design strategies and guidelines to avert the spread of infections related to
healthcare.
Objective: The aim of this study is to evaluate the infection prevention practice, microbial
load, and associated factors in selected wards at Jimma Medical Center.
Methods: A cross-sectional study was conducted in Jimma Medical Center from April 1 to
June 22, 2022. Infection Prevention and control assessment framework tool was used to
evaluate compliance with infection prevention and control practices. The settle plate method
with a 1/1/1 scheme was used for indoor air sampling and swab samples were taken from
inanimate surfaces and medical equipment. A total of 40 indoor air samples, 228 inanimate
surfaces, and medical equipment samples were taken from 10 rooms. Multiple linear
regression analysis was conducted to find the associated factors with the microbial load in the
study area.
Result: From the findings of our study, the infection prevention and control practice score
was 456 out of 800, which is an intermediate level. From the total sample, 181 (67.5%) were
positive for culture. The mean bacterial and fungal load ranged from 124.4 to 1,607 and 96
to 814.6 CFU/m3
, respectively. A higher indoor air microbial load was detected during the
morning time. Crowdedness [β = 2.748 (CI 95%: 1.057 – 4.44)], presence of waste material [β
= 1.747 (CI 95%: .213 – 3.282)], and Unclean room [β = 2.505 (CI 95%: .990 – 4.019)] have
a significant association with the microbial load.
Conclusion: The findings showed an intermediate level of infection prevention and control
compliance at Jimma Medical Center. Almost all wards had intermediate levels of indoor air
microbial load. The microbial load of inanimate surfaces and medical equipment was beyond
the standard limit which will have an impact on health. Crowdedness, the presence of waste
material, and unclean rooms were associated with the microbial load. Periodic infection
prevention and control training for workers, and microbial surveillance of the hospital
environment should be practiced.
