Infection prevention practice, microbial load, and associated factors at Jimma Medical Center, Southwestern Ethiopia

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.