ISOLATION AND IDENTIFICATION OF BACTERIA ASSOCIATED WITH DOOR HANDLES OF WARDS, THEATRE, OFFICE AREAS AT FEDERAL MEDICAL CENTRE (FMC) UMUAHIA, ABIA STATE

ABSTRACT

The isolation and identification of bacteria from various door handles within the Federal Medical Centre, Umuahia, Abia State was carried out. A total of 15 samples were collected from the door handles of offices, wards and rooms of the hospital. The samples collected were inoculated into nutrient agar, mannitol salt agar and MacConkey agar. They were incubated at 37°C for 24 hours and the mean count of the bacteria isolated are ranged as follows: The total heterotrophic bacterial counts, 1.1 x 104cfu/cm2 to 9.0 x 104cfu/cm2, The Staphylococcus counts, 1.0 x 102cfu/cm2 to 6.0x102 cfu/cm2, coliform count, 2.1 x 102cfu/cm2 to 9.2 x 102cfu/cm2. The Bacteria isolated were Staphylococcusspecies, Bacillusspecies, Staphylococcus aureus,Escherichia coli,Klebsiellaspecies. The surfaces of the door handles were contaminated with bacteria of public health importance.

TABLE OF CONTENTS

Title Page i

Certification ii

Dedication iii

Acknowledgments iv

Table of Contents v

List of Tables ix

List of Figures                                                                                    x

Abstract xi

CHAPTER ONE: INTRODUCTION

1.1 Background studies 3

1.2  Aims and Objectives 3

CHAPTER TWO:  LITERATURE REVIEW

2.1 Bacteria Contaminants Associated with Hospital Door Handles 7

2.1.1 Klebsiellaspecies 8

2.1.2 Staphylococcus aureus 8

2.1.3 Escherichia coli 9

2.1.4 Bacillus subtilis 10

2.1.5 Pseudomonas aeruginosa 11

2.1.6 Streptococcus species 11

2.1.7 Proteus species 12

2.2 Nosocomial Infections 12

2.2.1 Sources of Nosocomial Infections 13

2.2.2 Types of Nosocomial Infections 14

2.2.3 Prevention and Control of Nosocomial Infections 15

2.3 The Effectiveness of Hand Hygiene and Hand Decontamination in

Reducing the Risk of Nosocomial Infections. 16

CHAPTER THREE:  MATERIALS AND METHODS

3.1 Collection of Samples 18

3.2 Preparation of Culture Media 18

3.3 Bacterial Inoculation and Isolation 19

3.4 Characterization And Identification of Isolates 19

3.5 Gram Staining 19

3.6 Biochemical Tests 20

3.6.1 Catalase Test 20

3.6.2 Indole Test 20

3.6.3 Citrate Test 21

3.6.4 Coagulase Test 21

3.6.5 Methyl Red 21

3.6.6 Sugar Fermentation 22

CHAPTER FOUR: RESULTS

CHAPTER FIVE: DISCUSSION, CONCLUSION AND RECOMMENDATION

5.1 Discussion 27

5.2 Conclusion 28

5.3 Recommendations 29

REFRENCES 30

APPENDIX

LIST OF TABLES

Table                               Title    Page

1 Mean Count of Bacterial Isolates         25

2 Bacterial Isolates and Percentage Occurrence         26

CHAPTER ONE

1.0 INTRODUCTION

Microorganisms are found everywhere and constitute the major part of every ecosystem in the environment. They live either freely or as parasite. In some cases, they live as transient contaminants in fomites or hands where they constitute a major health hazards as source of community and hospital acquired infections (Pittetet al., 1999).

The increasing incidents of epidemic outbreaks of certain diseases depend on their rates ofspread from one community to the other and have become a major public health concern. These infection risks are made possible through human to human interactions and human to fomites interactions daily.

The human hands are the chief organ of physical manipulation of the environment. The hands enable one to do all sort of things. They serve equally as a means through which microorganisms propagates from one person to another and from place to place. In as much as, it is nearly impossible for the hand to be free of microorganisms.The presence of pathogenic bacteria may lead to chronic or acute illness, human hands can harbor these pathogenic organisms which can be collected from doors handles through day to day activities that include door opening and closing in public places like hospital, classrooms, office areas, toilets, etc. and as such leaves and picks some of these organisms on these door handles. Besides the day to day interaction of people which constitute in one way of spreading disease, the major source of and spread of community acquired infections are fomites (Willeyet al., 2011).Fomites when in constant contact with humans or natural habitats of pathogenic organism constitute a major source of spread of infectious diseases (Osterholmet al., 1995). Human’s hand usually harbors microorganisms both as part of the body normal flora as well as transient microbes contracted from the environment (Dodrillet al., 2011). One of the most important microorganisms found on the human hand is the Staphylococcus species. The dominant resident microbes are Staphylococcus epidermidiswhich is found on almost every hand. It’s been estimated that the population of Staphylococcus epidermidisfar out numbers Staphylococcus aureuson healthy hands. Others are members of Corynebacteriaand Micrococcusspp. and certain members of Enterobacteriaceaefamily. Pathogens that may be present on the hand as transient types include Escherichia coli, Salmonella typhi, Shigellaspp, Clostridium perfringens, Giardia lamblia, Norwalk virus and Hepatitis A virus, Pseudomonas aeruginosa, Staphylococcus aureus, Proteus mirabilis, Citrobacteriumfreundii, Enterobacterspp, Streptococcus spp, Klebsiella spp.

Hospital environment has activities that involve the use of door handles frequently at the various rooms such as wards, theatre rooms, toilets, rest rooms, offices etc. These activities and interactions involve staff of the hospital which include doctors, nurses, cleaners, sales people, custodians, the visitors, patients, delivery personnel and anyone else who has contact with the hospital. These often lead to infections known as Nosocomial infections. These infections also known as Hospital acquired infections result from pathogens acquired by patients while in a hospital or other clinical care facility (Willeyet al., 2011) and pathogens acquired by nurses, physicians, aides, visitors, sales people delivery personnel, custodians and anyone else who has contact with the hospital.

The nosocomial pathogens that cause diseases come from either endogenous or exogenous sources (Willeyet al.,2011). Endogenous sources are the organisms from patients’microbiota; exogenous sources are microbiota other than the patients’microbiota. Endogenous pathogens are either brought into the hospital by the patient or are acquired through contact with people in the hospital area.

However, the risk of disease transmission through fomites is determined by; the frequency of site contamination and exposure; level of pathogen excreted by the host; likelihood of transfer of the infectious agent to a susceptible individual; virulence of organism; immune competence of the persons in contact; the practice of control measure such as disinfectant use and personal hygiene. (Reynolds, 2005).

1.1 Background studies

Hand contact surfaces in hospitals including door handles are heavily contaminated with microbes. These fomites are found to be important in transmission of pathogens of various sources, facial, gastrointestinal tract, respiratory tracts, skin, wounds, and surgical sources in hospital environment.

1.3  Aims and Objectives

i. To evaluate the presence or absence of pathogenic bacteria from different door handles of hospital wards, theatre rooms, conveniences, and offices.

To  isolate and identify the bacteria associated with door handles of hospital wards, theatre rooms, conveniences, and offices.

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