The Risk of Nosocomial Infection Transmission in the Paediatric Outpatient Clinic in a Developing Country

Abstract

Objective: As more care is provided for children in outpatient facilities, it is increasingly important to understand the potential for disease transmission and this is particularly so for nosocomial infections which are infections originating in hospitals. Knowledge of the profile of bacterial isolates of surfaces in outpatient facilities and their sensitivity patterns serves as a guide for prevention of nosocomial infection transmission.
 Material and Methods: This hospital-based cross-sectional study was conducted in the Children's Outpatient Clinic (CHOP) of Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria (ESUT-TH). Samples for culture were collected from equipment and hospital surfaces. Antimicrobial susceptibility testing was determined for each isolate by the Agar diffusion method using Standard Nutrient Agar 1 discs.
 Results: Out of 122 samples collected from various sites, bacterial growth was observed in 55 (45.0%) specimens. Staphylococcus aureus and Coagulase-negative Staphylococcus were the most common isolates cultured from 23 different locations. Among the Staphylococcus aureus isolates, 17.4% (4/23) were MRSA. Levofloxacin and Imipenem showed the best sensitivity pattern for Staphylococcus aureus
 Conclusion: Staphylococcus aureus, Coagulase-negative Staphylococcus were the commonest isolates.
 There is need to develop specific protocols that will ensure hand hygiene, judicious use of antimicrobials, active surveillance, and enhanced cleaning/disinfection of surfaces in outpatient clinics as essential components of prevention and control of nosocomial infections.

Examining outpatients’ hand hygiene behaviour and its relation to other infection prevention measures.

“…Inadequate compliance with infection prevention and control measures (e.g., hand hygiene behaviour, wearing masks, and cleaning surfaces) puts patients and healthcare workers (HCWs) at risk [8]. Some studies have shown high pathogenic contamination of HCWs' hands [3,7] and surfaces [8][9][10][11] in outpatient facilities. However, only little research has been conducted on compliance with infection prevention measures in outpatient settings, with most studies focusing on HCWs' hand hygiene behaviour [7,[12][13][14][15][16].…”