Bacterial contamination and antibiogram of isolates from health care workersâ€™ fomites at Felege Hiwot Referral Hospital, northwest Ethiopia
Background: Health care workersâ€™ fomites are highly predisposed to bacterial contamination in the health care setting and are potential sources of hospital-acquired infections. However, there is scarcity of data on the status of bacterial contamination and antibiogram of isolates from HCWsâ€™ fomites in Ethiopia. This study determined the bacterial contamination and antibiogram of isolates from health care workersâ€™ fomites at Felege Hiwot Referral Hospital, Ethiopia.
Methods: A cross-sectional study was conducted from February to April 2017 in different wards of the hospital. From 422 health care workersâ€™ fomites, surface samples were swabbed using a simple-rinse method. Data from participants were collected by face-to-face interviews using a structured questionnaire. Bacterial colonies were counted and species were identified using standard bacteriological techniques. Drug susceptibility testing was performed using a disk diffusion technique. Chi-square test was computed to ascertain the association between variables. Regression analysis was computed to identify the independent risk factors.
Results: Overall, 243 (57.6%) fomites were contaminated with aerobic bacteria. Working in medical (AOR=5.2, 95% CI=1.85-14.8) and gynecology (AOR=3.1, 95% CI=1.5-6.43) wards and intensive care units (AOR=16, 95% CI=2.1-17.9), and poor laundering of HCWsâ€™ uniforms (AOR=1.3, 95% CI=1.34-3.72), were significantly associated with bacterial contamination. Staphylococcus aureus (19.2%) was the predominant pathogen, followed by Klebsiella pneumoniae (6.4%). The proportion of K. pneumoniae (P<0.001) and E. coli (P=0.014) was significantly highest in mobile phones and white coats, respectively. S. aureus isolates were resistant to penicillin (82.7%) and co-trimoxazole (53.1%). K. pneumoniae isolates were 100% resistant to ampicillin. E. coli isolates were 87.5% resistant to co-trimoxazole. Overall, 204 (88.3%) of the isolates were multidrug-resistant. The overall multidrug-resistant rates among S. aureus, K. pneumoniae and E. coli isolates were 88.9%, 92.6% and 100%, respectively.
Conclusions: Bacterial contamination of health care workersâ€™ fomites is a major health care problem in the study area. Multidrug-resistant isolates are alarmingly high in pathogenic bacteria. Therefore, hospital HCWs need to implement proper handling of fomites to reduce contamination and the spread of drug-resistant pathogens. [Ethiop.J. Health Dev. 2019; 33(2):128-141]
Keywords: Health care workers, bacterial contamination, antibiogram, fomites, health-care associate infections, Ethiopia