Examining Major Sources of Bacterial Contaminants, Distribution and Their Susceptibility to Antibiotics in Kitui County Referral Hospital

Abstract

Background: Bacterial contaminants are the major sources of nosocomial infections which causes hospital acquired infections among health care workers patients and visitors in health facilities. Nosocomial infections are acquired during provision of health care services. The buildings provide the space used to provide hospital care while the equipment entails the tools and machines used to run the operations of the hospital. The people could be patients, healthcare workers or visitors. Thus, patient environment in surgical and medical wards has a huge impact on health safety of patients. The study sought to determine antimicrobial susceptibility patterns of bacteria isolated in Kitui County Referral Hospital.

 Methods: This study was done by collection of 195 swabs samples in the patient care and treatment environment which involved the floors, beds, drugs trolleys, infusion stands, sinks, door handles, chairs, tables and bedside lockers of the medical and surgical wards. A total of 177 bacteria isolates contaminants were identified from both surgical and medical wards. The study was done through culturing of specimen in MacConkey, Sheep blood agar and chocolate blood agar media. The identification was done by gram staining technique and biochemical tests which included citrate utilization test, catalase, coagulase, indole, Methyl Red, Voges Proskauer and oxidase test.

 Results: The study found that the primary types of bacteria in hospital setting being Staphylococci aureus, Escherichia coli, Klebsiella oxytoca, and Pseudomonas aeruginosa. S. aureus had the highest prevalence at 43% while the least was Pseudomonas aeruginosa at 13%. Lockers were the major source of contaminants (28%) whereas the least contaminants’ source was infusion stand (5.5%). Antimicrobial susceptibility test showed that all the isolated bacteria were sensitive to Meropenem. P. aeruginosa showed high sensitivity to Meropenem (100%) but averaged 33.3 % against Piperacillin Tazobactam, Ampicillin -clavulanic acid, and Ciprofloxacin and no sensitivity (0%) on other drugs. E. coli was only susceptible to Tazobactam, Ciprofloxacin, and Ceftazidime (20%), Augmentin (40%), and Meropenem (80%). Similarly, K. oxytoca was (100%) susceptible to Meropenem and ranked second with the most sensitivity to drugs tested: Tazobactam, Cefixime, Gentamicin, Ciprofloxacin, Ceftazidime (50%), and Augmentin, Ampicillin (25%). Vancomycin, Oxacillin, Penicillin, and Levofloxacin had no activity on bacteria isolates. S. aureus showed sensitivity to most of the drugs tested: Clindamycin (5.55%), Tazobactam, Ciprofloxacin, Ampicillin (38.88%), Augmentin (66.66%), and Meropenem, Linezolid and Gentamicin (88.8%).

Conclusion: Hospital surfaces, including doors, were the primary source of contaminants. S. aureus was distributed mainly on doors, while lockers, beds, sinks, and drug trolleys were contaminated with all bacteria isolates.