Bacterial contamination and antibiogram of isolates from health care workers’ fomites at Felege Hiwot Referral Hospital, northwest Ethiopia

Abstract

Background: Health care workers’ 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 HCWs’ fomites in Ethiopia. This study determined the bacterial contamination and antibiogram of isolates from health care workers’ 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 workers’ 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 HCWs’ 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 workers’ 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