Detection Of Potential Pathogenic And Drug Resistant Bacteria Isolated From Inanimate Hospital Environments In Operation Theaters And Intensive Care Units Of Tikur Anbessa Specialized Hospital And Alert Hospital In Addis Abab

Background: The role of hospital environments especially those of the operation theatersrn(OTs) and intensive care units (ICUs) in the transmission of hospital associated pathogensrnand multidrug resistant (MDR) bacterial strains like Extended-Spectrum β-Lactamasesrn(ESBLs), Methicillin-resistant S. aureus (MRSA) and Vancomycin resistant Enterococcirn(VRE) dissemination are critical and an essential element in the control of Health careassociatedrninfectionsrn(HAIs)rnandrnemergencern ofrnresistance genes.rnrnrnObjectives:rnrnThe current study aimed to detect potential pathogenic and drug resistantrnbacteria from inanimate hospital environments in OTs and ICUs of the selected hospitals.rnMethodology: A cross-sectional study was conducted on 280 hospital environmental samplesrnin two different hospitals from June to September, 2018 G.C: Tikur Anbessa SpecializedrnHospital (TASH) (n=187) and All Africa Leprosy Rehabilitation and Training Hospitalrn(ALERT) (n=93). Settle plate’s method (Passive air sampling following 1/1/1 schedule) wasrnused for air sample collection while swab method was used to collect samples from inanimaternsurfaces in the OTs and ICUs of the selected hospitals. A total of 257 environmental swabsrnand 23 air samples were collected from different sites of ICUs and OTs. All isolates/samplesrnwere identified by using routine bacterial culture, Gram staining and a panel of biochemicalrntests. For each identified bacteria antibiogram profiles were determined by the Kirby Bauerrndisk diffusion method based on the Clinical and Laboratory Standards Institute (CLSI)rnguidelines. Double disk synergy test was used to confirm ESBL production while ModifiedrnHodge test (MHT) was used to screen carbapenemases production. On the other hand,rnCefoxitin /oxacillin discs were used to screen MRSA.rnResults: Out of 280 swabs and settle plates, 227(81%) of samples were positive for bacterialrncontamination. A total of 282 bacteria were identified. Of these, the predominant bacteriarnidentified from the environmental samples from OTs and ICUs were S. aureus (27.5% vsrn9.6%), Coagulase negative Staphylococcus (CONS) (16% vs 2.8%) and Acinetobacter spprn(2.5% vs 14.5%) respectively. The bacterial load on air was found beyond the standard limits.rnThe most common bacterial contaminated sites were bed linens 37(13.1%), followed byrnenvironmental surfaces including (wall, floor, corridor and door knob) 35(12.4%) and bedsrn33(11.7%). Out of the 280 environmental samples 76(27.1%), 25(8.9%) and 7(2.5%) werernMRSA, ESBL and Carbapenemase producer bacteria respectively. Most the identified rnbacteria showed considerable resistance to antibacterial agents. Of the total 282 identifiedrnbacteria, 158(56%) of the isolates were resistant to at least 3 antibiotics and 58 multi-drugrnresistance phenotypes were exhibited by the MDR isolates.rnConclusion: Hospital environment especially those of the operation theaters and intensiverncare units are highly contaminated with potential pathogenic bacteria. Bacterial isolates werernhighly resistant to commonly used antibiotics with high multi-drug resistance percentage.rnTherefore, well-designed infection prevention and control strategies should be in place forrncombating health care-associated infections and the consequences.

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