Aims:A cross sectional study was conducted to determine the degree of microbial contamination of environmental surfaces and health-care workers (HCWs) in two multi-bed ICUs at a tertiaryreferral hospital in Bulawayo, Zimbabwe. Place and Duration of Study: Methodology: In total 64 surfaces were swabbed in two ICUs; inclusive of 6 hand swabs obtained from on-duty nurses. Fungal and bacterial isolates were identified using standard microbiological methods. Bacterial antibiogram profiles were determined by the Kirby-Bauer disc diffusion method. Mbanga et al.; JAMMR, 27(2): 1-15, 2018; Article no.JAMMR.42764 2 PCR was used to determine the presence of Extended Spectrum Beta Lactamase (ESBL) genes in isolated Enterobacteriaceae and the presence of the mecA gene in Staphylococcus aureus isolates. Results: Out of the 58 fomites and medical devices swabbed 50 (86.21%) were positive for bacterial contamination, with coagulase negative Staphylococci (CoNS) (20.31%) and Klebsiella species (20.31%) being the most prevalent environmental isolates. All 6 (100%) hand swabs obtained from the HCWs were positive for microbial contamination. A total of 51 (75%) of the 68 bacterial isolates were resistant to at least 3 antibiotics and 39 multi-drug resistance patterns were exhibited by the MDR isolates. Combinations of the ESBL genes blaCTX-M, blaTEM and blaSHV were detected in Escherichia coli, Klebsiella spp and Pseudomonas aeruginosa isolates. Methicillin-resistant Staphylococcus isolates (MRSA) were detected using phenotypic and molecular methods. Conclusion: ICU inanimate surfaces and medical equipment in the adult and paediatric ICUs of the referral hospital were heavily contaminated with MDR bacteria that could predispose critically ill patients to acquire nosocomial infections. Original Research Article

Background and objectives Infection prevention and control is a set of practices, protocols, and procedures that are put in place to prevent infections that are associated with health care service provision settings. It is an element of quality of care and safety in health care service delivery; health worker occupational health and safety practices; medical waste management; and is also concerned with clinical and public health surveillance and action. Healthcare facilities are ideal settings for the transmission of infections to patients (who are more susceptible), healthcare workers, their families and communities. Healthcare associated infections lead to prolonged hospital stay, increased cost of care and death. Therefore, the objective of this study was to assess infection prevention and control practices in various types and levels of health facilities in Nyandarua County, Kenya. Methodology A cross-sectional descriptive study was conducted in 47 health facilities that were sampled from a total of 153, using cluster sampling technique. The facilities were drawn from public, private and faith based organizations distributed across 5 sub-counties of Nyandarua County, Kenya. Data collection method was purely quantitative using a structured questionnaire. Descriptive analysis was done using SPSS version 17. Results 42/47 of the facilities were observing safe injection practices. Only 8/ 26 of the public health facilities had all their workers immunized against hepatitis B despite procurement, supply and distribution of adequate vaccine doses for the entire health workforce. Poor medical waste management practices where 37/47, 15/47 and 28/47 were segregating waste, had colour coded bins and had functional incinerators respectively. Only 28/47of the sampled facilities were decontaminating patient reusable equipment/instruments appropriately. Electricity, gas, charcoal and firewood were fuels used for autoclaving. About 33/47 and 30/47 of the sampled facilities had running water and soap/hand disinfectant respectively. Conclusions The findings revealed several gaps in the implementation of the national IPC policy especially in healthcare worker occupational health and safety, reprocessing of patient reusable equipment/instruments, medical waste management and hand hygiene practices. These findings will assist the department of health in designing interventions for strengthening and improving IPC practices, to mobilize and allocate resources for IPC activities, improve infrastructure and supplies