Contribution of Medical Wards Contamination to Wound Infection among Patients Attending Ruhengeri Referral Hospital

Abstract

Nosocomial infections or hospital-acquired infections are infections that potentially occur in the patients under medical care. These infections are often caused by multidrug-resistant pathogens acquired via improper antibiotic use, not following infection control and prevention procedures. The main objective of this study was to investigate the contribution of medical wards contamination to wound infection and antibiotics susceptibility patterns at Ruhengeri Referral Hospital, Musanze district, Rwanda. This was a cross-sectional study where a total of 61 samples including air sampling to evaluate the contamination by airborne bacteria, working surface, equipment, and patients’ surgical wounds swabs were collected in intensive care unit (ICU), pediatrics, and surgery departments. Culture, Gram stain, and biochemical tests were performed for microbiological isolation and identification. Antibiotic susceptibility testing was performed using the Kirby–Bauer disc diffusion method. Statistical Package for Social Science (SPSS) version 22 was used for data analysis. Gram-negative bacteria were frequently from surgery, pediatric, and ICU with 68.8%, 63.9%, and 31.1%, respectively, while Gram-positive isolates were 37.7% in surgery, 32.9% in pediatric, and 18.0% in ICU. There was a statistically significant association with E. coli and swabbed materials and surgical wound sites (x2 = 10.0253, P value = 0.018). All bacterial contaminants were sensitive to clindamycin and erythromycin. Pseudomonas aeruginosa, E. coli, and S. aureus were resistant to nitrofurantoin. Hospital environment could be a contributing factor to surgical wound site infections. Hospitals should apply preventive measures in the hospital environment surrounding wound surgery patients to prevent wound infections during hospital stay.

Colonisation of extended spectrum β-lactamase- and carbapenemase-producing bacteria on hospital surfaces from low-/middle-income countries

“…16 . We also found contamination of medical equipment and/or ward furniture/surfaces, as detected in other African based studies reporting on HAIs 32,[37][38][39] .…”

Colonisation of hospital surfaces from low- and middle-income countries by extended spectrum β-lactamase- and carbapenemase-producing bacteria

“…Bacteria carrying ARGs appeared to be found most frequently on surfaces near the sink drain, which was concordant with the work by Firesbhat et al in Ethiopia 16 . We also found contamination of medical equipment and/or ward furniture/ surfaces, as detected in other African-based studies reporting on HAIs 24,[36][37][38] .…”

Prevalence and Types of Bacterial Contaminants in a Tertiary Hospital in Kenya

“…The most prevalent genus in terms of frequency levels in the facility was as follows: Acinetobacter 19 (41.3%) followed by Enterobacter 6 (13.0%) which were predominantly surface contaminants and also gram-positive Staphylococcus 6 (13.0%) mainly found on humans. Studies in Morocco and Rwanda had similar ndings on the isolates though had a variable frequency of distribution [9,14]. Whereas the high contamination level with Acinetobacter species may be justi ed by the community being mainly agricultural -wince Acinetobacter is a soil inhabitant -the main concern is the fact that Acinetobacter baumanii is notorious in causing hospital associated pneumonia, septicemia, meningitis, UTIs and other infections, similar to Kleibsiella [32,33].…”

“…These infections are potentially acquired from hospital surfaces, equipment and healthcare workers during hospitalization [7,8]. Bacteria account for 90% of HAIs [9,10].…”