THE CONTRIBUTORY ROLE OF FOMITES IN THE TRANSMISSION OF NOSOCOMIAL INFECTIONS AT THE STATE SPECIALIST HOSPITAL, AKURE

Abstract

Nosocomial infections are infections contracted during the cause of hospital treatments, which are secondary to the patients’ original condition. Prevalence of nosocomial infections within a period of 12 months was investigated in five wards of the State Specialist Hospital, Akure, using patients’ medical files and diagnosis index. Male surgical ward, Female surgical ward, Children ward, Intensive Care Unit and Accident and Emergency ward were sampled for the prevalence of nosocomial infections. Surfaces of nine fomites were swabbed; drip stands, door knobs, fan switches, bed rails, bed linens, pillow cases, light-plug-ins, and sink knobs for microbial contamination. Microbes isolated from the 225 swabs samples were identified using standard microbiological methods. An overall prevalence of 11.9% nosocomial infections was recorded across the sampled wards. Intensive Care Unit (37.5%) and Children ward (7.6%) recorded the highest and lowest prevalence respectively. Prevalence of nosocomial infections in the sampled wards was not significantly different at (P>0.05). Gram positive bacteria (6) were more frequently isolated than Gram negative bacteria (5). Staphylococcus aureus (23.08%) was the most predominant, while Proteus mirabilis (4.81%) was the least isolated. Overall occurrences of bacteria isolates in the sampled wards were not significantly different at (Pvalue >0.05). The highest occurring fungus was Aspergillus niger. (43.8%). Correlation was positive between infections rate and microbial contamination of fomites surfaces across the sampled wards. The door knobs (22.76%) recorded highest microbial contamination; while light-plug-ins (4.88%) and pillow case (4.88%) were the least contaminated fomites. The highest bacterial colony count of 9.6×106 cfu/ml which is higher than the infectious dose of 106cfu/ml was recorded on the door knob of Female Surgical ward while pillow case shows insignificant count across most wards. Escherichia coli, Enterobacter aerogenes, Klebsiella pneumonia, and Proteus mirabilis 4 demonstrated multiple resistant to most of the antibiotics. All Gram positive isolate shows 100% resistance to Ampiclox and Zannicef. 50% of the Staphylococcus aureus isolated were found to be resistant to Methicillin. The Female surgical wards recorded the highest number of Methicillin-resistant Staphylococcus aureus (MRSA) strains 4 (16.7%). In conclusion, the isolation of microorganism from fomites surfaces in this research work shows that fomites serve as route of transmission of infections within healthcare facilities as they provide anchorage for multi-drug resistant microorganisms borne by patients and staff.