Contamination of microbial pathogens and their antimicrobial pattern in operating theatres of peri-urban eastern Uganda: a cross-sectional study

Abstract

BackgroundMicrobial contamination of hospital environment, especially in operating theatres (OT) and other specialized units has greatly contributed to continuous and multiple exposure to nosocomial infections by patients and the public.We purposed to assess microbial contamination of operating theatres and antibacterial sensitivity pattern of bacteria isolated from theatres of Mbale Regional Referral Hospital, Eastern Uganda.MethodsWe employed a laboratory based cross-sectional study design. Swabbing of different surfaces and settle plate establishment in 4 various operating theatres was carried out. A total of 109 samples were collected, 31 air samples and 78 swabs from four operating theatres. Samples were collected in the mornings after disinfection prior to start of daily operations. Antibacterial sensitivity testing of isolated bacterial pathogens was performed by Kirby Bauer disc diffusion method following standard operating procedure. Colony counts for the settle plates were carried out using a colony counter.ResultsAll the four theatres had their mean colony counts exceeding the acceptable limit of 5 cfu/dm2/h. Gynaecology theatre had up to 261 cfu/dm2/h and Ophthalmology operating theatre had approximately 43 cfu/dm2/h. A total of 14 different organisms were isolated with Pseudomonas spp. [23.9%]; Bacillus spp. [17.5%] and Aspergillus spp. [15.8%] being the most common contaminants respectively. Other isolates included Enterococcus spp., Rhizopus spp. and Coagulate Negative Staphylococcus isolates especially from settle plates. Most bacterial isolates showed considerable resistance to antibacterial agents. Pseudomonas spp. was resistant to chloramphenicol (53.6%) and cotrimoxazole (57.1%). Most of the bacterial pathogens were sensitive to imipenem [83.3%].ConclusionsThere is moderate contamination of operating theatres of Mbale Regional Referral Hospital. Common organisms were Pseudomonas, Bacillus, and Aspergillus spps. Resistance was observed against chloramphenicol and cotrimoxazole. More caution is necessary to carefully disinfect the operating theatres at Regional referral settings and similar tertiary health care centres with more emphasis on obstetrics and gynecology theatres. Diagnosis and care of patients at such clinical settings should consider the possibility of antibiotic resistance.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3374-4) contains supplementary material, which is available to authorized users.

Major Bacteria Species Surface Contaminants in Hospitals of Littoral Region, Cameroon

“…Elsewhere a study from Kawolo General Hospital in Uganda reported, S. aureus with the highest prevalence 46/61 (75.4%) [10]. On contrary our findings are different for some studies carry out in Cameroon (surveillance of nosocomial infections in YUTH) and Uganda (contamination of microbial pathogens in 4 operating theatre), where Klebsiella spp (27%), Pseudomonas spp (23.9) and Bacillus spp (17.5%) were found as common organisms respectively [6,11]. This difference can be due to the type and level of target hospital, units, type of specimen (hospital environment & hospitalized patients) and sample size.…”

“…Besides, our study recovered 33 different species, whereas more the Uganda study 14 different organisms were reported in Mbale Regional Referral Hospital. On the different surfaces and settle plate establishment in 4 various operating theatres were swabbed and cultured [11]. This difference can be explained by obvious fact like distinction in study area, sample size, target articles brief methodology.…”

“…It has been documented that, the hospital environment (equipment, materials and work surface) are considered as reservoir and play a role in the prolonged maintenance of NI and transmission [10]. In several studies, bacteria are the most predominant infectious agents (85%) [7,8,11]. Laxity in applying basic hygiene actions (individual or collective) has increased the incidence of this phenomenon over the last thirty years.…”

Post Caesarean Wound sepsis and associated factors among patients attending a rural regional referral hospital in Western Uganda: A cross-sectional study

“…In our study, coliforms showed high susceptibility to Imipenem followed by Staphylococcus aureus to Ciprofloxacin and this is comparable to a study done in Mbale Regional Referral Hospital, Eastern Uganda [37]. Furthermore, the study also showed that Staphylococcus aureus and other coliforms were resistant to Ciprofloxacin, Ceftriaxone, Gentamycin and Cotrimoxazole.…”

“…These findings are in agreement with findings in central Uganda in which Staphylococcus aureus and coliforms have been shown to be common pathogens in post-caesarean wound sepsis [19] . In addition, in Zanzibar, Staphylococcus aureus and E. coli were found to be common pathogens in sepsis [36], showing similarities in the common pathogens of Tanzania and Uganda, this may be attributed to the fact that Regional Referral Hospital, Eastern Uganda [37]. However findings are different from the study done in Muhimbili teaching Hospital [38], where the commonest organism isolated was Pseudomonas aeruginosa, this may be due to the difference in the standard of Hygiene (poor aseptic technique) as evidenced in this Hospital, since one nurse was responsible for cleaning and dressing 15 postoperative wounds hence putting patients at risk of cross infection.…”