ABSTRACT
The
transmission of infection via fomites constitutes a major threat to public
health especially in the developing countries. This study was carried out to
investigate the microbial carriage and antibiotics pattern of bacteria on the
door handles of campus shuttle operating in the Federal University of
Technology Akure. Samples were randomly collected from a total of one hundred
and fifty (150) door handles following standard laboratory techniques.
Enumeration of the bacterial counts was carried out using pour plating
technique while the bacteria isolates were identified using cultural,
morphological and biochemical characteristics. The results show that the drivers’ door handles, front passengers’
door handles and back passengers’ door handles had overall mean aerobic
bacterial counts of 195.56 ± 2.05 (x104cfu/ml), 228.08 ± 1.56 (104cfu/ml)
and 176.92 ± 2.70 (x104cfu/ml) respectively. Bacteria isolated
and identified were Enterobacter
aerogenes (17.1%), Escherichia coli (12.4%),
Klebsiella pneumoniae (10.1%), Proteus spp. (4.7%), Pseudomonas aeruginosa (4.7%), Salmonella
enteritidis (2.3%), Staphylococcus aureus (17.1), Staphyloccoccus epidermidis (22.5) and Streptococcus pneumoniae (9.3%) while
the fungal isolates were Aspergillus
fumigatus (29.3%), Aspergillus niger
(19.5%), Candida spp. (6.1%), Fusarium spp. (14.6%), Mucor spp. (9%), Penicillium spp. (15.9%), and Rhizopus
spp. (3.7%). The antibiotics pattern of the bacteria indicated that all the
bacteria isolated were susceptible to pefloxacin (19.25 ± 4.031-26.33 ±
4.041mm) and gentamycin (15.00 ± 2.685-25.00 ± 3.916mm) while all were
resistant to amoxicillin (3.67 ± 0.082-13.75 ± 2.217mm) except Enterobacter aerogenes. These campus
shuttles aside their usage as a means of transportation could also serve as a
means of transmission of both pathogenic and non-pathogenic microorganisms
which pose public health risks. Personal hygiene and sanitation such as hand
washing and the use of antimicrobial wipe to clean the hands could serve as a
means of reducing the incidence of microbial transmission to drivers and
passengers.
TABLE OF CONTENTS
Content Page
Title I
Certification II
Dedication III
Acknowledgements IV
Table
of contents V
List
of tables IX
List
of plate X
Abstract XI
CHAPTER ONE
1.0 Introduction 1
1.1 The
objectives of the study 4
1.2 Justification 4
CHAPTER TWO
2.0
Literature review 5
2.1 Background 5
2.2 Roles of different surfaces in the
transmission of pathogens 8
Content Page
2.2.1 Mobile
phones 8
2.2.2 Tooth
brushes 9
2.2.3 Toilet door handles 10
2.2.4 Currency and coins 10
2.3 Factors that favours transmission of
infection to humans from fomites 11
2.3.1 Individual susceptibility 11
2.3.2 Environmental factors 11
2.4 Possible preventive measures against
transmission of infection via fomites 11
2.5 Antimicrobial activities of antibiotics 12
2.6 Antibiotics resistance 13
CHAPTER THREE
3.0 Materials and methods 15
3.1 Ethical clearance 15
3.2 Sample collection 15
3.3 Media preparation and isolation of
microorganism 15
3.3.1 Nutrient agar 15
3.3.2 Potato dextrose agar 16
3.3.3 Eosin methylene blue agar 16
Content Page
3.3.4 Blood agar 16
3.3.5 Salmonella shigella agar 17
3.4 Total viable count 17
3.5 Purification of bacterial isolates 18
3.6 Cultural and morphological identification
of bacteria 18
3.7 Identification and biochemical
characterization of bacterial isolates 19
3.7.1 Gram staining 19
3.7.2 Indole test 19
3.7.3 Citrate test 20
3.7.4 Oxidase test 20
3.7.5 Urease test 21
3.7.6 Catalase test 21
3.7.7 Coagulase test 21
3.8 Identification and characterization of
fungal isolates 22
3.8.1 Isolation of pure fungal isolates 22
3.9 Antibiotics sensitivity test 22
CHAPTER FOUR
4.0 Results 25
Content Page
4.1 Total bacterial load 25
4.2 Frequency of bacterial isolates
associated with shuttle door handles 25
4.3 Identity of the bacterial isolates 33
4.4 Frequency of fungal isolates associated
with the shuttle door handles 36
4.5 Antibiotics susceptibility pattern of
bacterial from the door handles 41
CHAPTER FIVE
5.0 Discussion 48
CHAPTER SIX
6.0 Conclusion 54
6.1 Contribution to knowledge 54
6.2 Recommendation 54
References 56
LIST OF TABLES
Table Title Page
1. Total viable count of bacteria on the
door handles 26
2. Frequency of total bacteria isolated
from the shuttle door handles 27
3. Frequency of the bacterial species
isolated from the entire door handles 28
4. Frequency of bacterial species from the
drivers’ door handles 30
5. Frequency of bacterial species from the
front passengers’ door handles 31
6. Frequency of bacterial species from the
back passengers’ door handles 32
7. Biochemical characteristics of
bacterial isolate 34
8. Morphological characteristics of
bacterial isolate 35
9. Frequency of fungal isolates obtained
from the entire door handles 37
10. Frequency of fungal species on the entire door handles 38
11. Frequency of fungal species on the
drivers’ door handles 39
12. Frequency of fungal species on the front
passengers’ door handles 40
13. Frequency of fungal species on the back
passengers’ door handles 43
14. Morphological characteristics of fungal
species 44
15a. Zones of inhibition of the bacterial
isolates measured in millimeter 45
15b. Zones of inhibition of the bacterial
isolates measured in millimeter 46
LIST OF PLATE
Plate Title Page
1. Antibiotics pattern of Streptococcus pneumoniae 47
CHAPTER ONE
1.0 Introduction
The
spread of infectious disease through hand contact has been an area of major public
health concern because of the frequent contact of the hand with fomites which
are potential carriers of pathogenic organisms may lead to an alarming rate of
outbreaks of infections transmitted by the fomites. Worldwide annually there
are 1.7 million deaths from diarrhoeal diseases and 1.5 million deaths from
respiratory infections (Pruss-Ustun and Covahan, 2006), these are examples of
diseases which could be contracted by humans via fomites. According to (Itah,
2004), Gram positive Staphylococcus
aureus, and Gram negative bacteria such as Escherichia coli, Klebsiella species, Pseudomonas species, were found to contaminate various contact
surfaces including chairs, tables, windows, door handles and many other common
household fixtures. The presence of these pathogenic bacteria on environmental
surfaces poses a potential risk to vulnerable, immune-compromised individuals
(Pruss-Ustun and Covahan, 2006).
It
has been shown that hard, non-porous surfaces such as door handles have the
highest bacterial transfer rates to hands (Rusin et al., 2002). In recent past, a lot of effort has been invested in
emphasized hand hygiene through hand wipes and hand sanitizers (Hota, 2004). Hand
wipes with higher ethanol content are more effective in not only antimicrobial
activities but also remover of endospores via mechanical action (Stout et al., 2010). Even though people are
commonly aware of such practices, the possibility of inaccessibility or lack of
use of these practices do exist. According to Hansen and Knochel (2010) up to
60% 0f adults do not wash their hands when appropriate. People believe that
microbes are only present in research laboratories, hospitals or clinics and
thus they have a misleading feeling of security in other places or while
touching other surfaces such as door handles (Stout et al., 2010). Lack of knowledge of the roles of micro-habitat such
as door handles in dissemination of microorganisms is a threat to public health.
In fact 80% of infections are spread through hand contact with hands or other
objects (Reynold and Hurst, 2005).
Reynold and Hurst (2005) used an invisible fluorescent tracer for
artificial contamination of public surfaces. They found that contamination from
outside surfaces was transferred to 86% of exposed individual’s and 82% tracked
the tracer to their home or personal belongings hours later. The viability of
Gram positive and Gram negative organism under various environment conditions
have been described (Noskin et al.,
1995). Some microbes are infectious at very low doses and can survive for hours
to weeks on nonporous surfaces, such as countertops, telephone and door handles
(Reynold and Hurst, 2005). Enterococci have been found to survive
in dry conditions and on various fabrics utilized in the health care
environment. Infectious doses of pathogen may be transferred to the mouth after
handling everyday contaminated objects such as the door handles. Door handles
are contaminated with various types of microorganisms including varying species
of bacteria and fungi and this may be a source of nocosomial infections in
hospitals. Scientific information about the occurrence of microorganisms on
various objects outside the health care facilities is very little and needs to
be enriched in order to educate people on the necessity of improving the habit
of hand washing to reduce microbial transmission.
In
the past 60 years, antibiotics have been critical in achieving a dramatic rise
in life expectancy and significant improvements in public health (El-Astal,
2005). However, disease-causing microbes have become increasingly resistant to
the antibiotics commonly in use (El-Astal, 2005). It has been clearly shown
that the use of antimicrobials leads to selection of resistant strains both in
the individual and in the community, and overuse or inappropriate use only
increases this risk (Reynold and Hurst, 2005). History suggests that microbes
will never run out of ways of developing resistance, but we may run out of
effective antimicrobials (Reynold and Hurst, 2005). The Gram negative enteric
bacilli are common causes of a wide variety of infections involving diverse
anatomic sites in both healthy and compromised hosts (El-Astal, 2005). In
general, among adults, the incidence of infection due to these agents increases
with age. Thus, as the mean age of the population increases, so will the number
of these infections (Reynold and Hurst, 2005). Drug resistance is a serious
medical problem. Progressive increase in resistance to commonly used
antibiotics with many gram-negative bacilli being multidrug-resistant has been
noticed (Reynold and Hurst, 2005). The emergence of antibiotic resistance in
the management of infections is a serious public health issue, particularly in
the developing world where apart from high level of poverty and ignorance,
there is also high prevalence of fake and spurious drugs of questionable
quality in circulation (El-Astal, 2005). This has led to a significant increase
in morbidity.
There
also appears to be a significant lack of studies highlighting the
susceptibility patterns of locally prevalent microorganisms (El-Astal, 2005). Knowledge of etiological agents of infections
and their sensitivities to available drugs is of immense value to the rational
selection and use of antimicrobial agents and to the development of appropriate
prescribing policies (El-Astal, 2005). Microbial transmission via several
surfaces such as automated teller machines, mobile phones, door handles and
currency has been extensively studied but the role of commercial buses door
handles in the dissemination of pathogenic microorganisms have not been
properly investigated. Therefore this research project will be centered on the
role of commercial buses door handle in the transmission of pathogenic
microorganism to human via hand contact and the antibiotics pattern of the
potential isolates.
1.1 The
objectives of the study
The
aim and objectives of this research are to:
(a)
assess the role of campus shuttle door handles in dissemination of pathogenic
microorganisms; and
(b)
determine the antibiotics susceptibility and resistance pattern of the
potential isolates.
1.2 Justification
Over
the years, different researches has been conducted to examine the role of
various surfaces, such as tables, computer key boards and mobile phones on the
carriage and dissemination of pathogenic infection, but the role of door
handles of commercial shuttle buses as a route of microbial transmission has
not been reported. Hence the need to assess the carriage and transmission of
microorganism by shuttle door handles. The knowledge of this is expected to
broaden our understanding of the microbial carriage of the door handles and
their antibiotics pattern. This will help the University management to
implement public health preventive and control measure to forestall future
outbreak of infection that may result from this pathogenic microorganisms associated
with the shuttle door handles.
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