The degree of bacterial contamination of operating rooms And surgical wards environment and antibiotic Susceptibility pattern of isolates at jimma university Specialized hospital, south west ethiopia

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.