Abstract:
Background: Healthcare-associated infections (HAIs) are the "most frequent adverse events" in the
delivery of healthcare worldwide. Most of these infections are linked to resistant pathogens
harboured by hospital fomites and could persist for a long period of time thereby predisposing patients to HAI. Therefore the aim of this study was to determine the role of hospital surfaces (HS)
and theatre environment (TE) in the transmission of drug-resistant pathogens.
Materials and Methods: A descriptive cross-sectional study design was employed using a sample
of 42 swabs collected from indoor hospital surfaces and settle plate method for the theatre
environment. Isolates were cultured under favourable growth conditions and identified using colonal
morphology, microscopic appearance on gram stain and biochemical methods. Anti-microbial
susceptibility testing was performed using the Kerby-Bour disc diffusion method. Results were
analysed using SPSS version 16.0 software package and findings presented in tables, charts and
graphs.
Results: All plates contained growth either bacterial or fungal (bacteria 66% and fungi 34%),
majority isolates included Klebsiella (35%) and aspergillus spp. (26.19%) among bacteria and fungi
respectively. Other pathogens isolated included Bacillus, Staphylococcus and Pseudomonas among
bacteria and Rodothorula and Cladosporium among fungi. All isolates on settle plates displayed
varying numbers of colony forming units ranging from 1.6*102 to 4.2*104 CFU/m3. Enterococcus
showed the highest resistance to anti-microbial agents, though the general trend of pathogens
tested showed the existence of resistance to the commonly used antibiotics. There was rising
resistance to the beta-lactam class of antibiotics whereas vancomycin, linezolid, refampin and
cefoxitin showed high susceptibility to the antibiotics. There was a 60% MDR and 2.38% ESBL
specifically with pseudomonas.
Conclusion and Recommendations: There was a high level of bacterial and fungal colonisation
on hospital surfaces and theatre environment with a correspondingly high level of resistance to
antimicrobial agents in Ngora Freda Carr Hospital.
