ANTIBIOTIC SENSITIVITY PATTERN OF STAPHYLOCOCCUS AUREUS FROM FOMITES IN THE FEDERAL MEDICAL CENTRE UMUAHIA

ABSTRACT

This study determines the possible roles of cross examination in the hospital environment. One hundred swabs were obtained from doctor’s stethoscope diaphragm, cell phones of health care workers (HCWS). Patient’s bed linen, pillow and door knobs at the Federal Medical Centre Umuahia from May 4th to May 11th 2016 using sterile cotton tipped applicators. Cultures from the swabs were screened for Staphylococcus aureus. The results showed that 18.18% of the doctors stethoscopes, 22.73% of the doctors cellphones of the pillows and 13.64% of the bedlinens were contaminated with Staphylococcus aureus. Less than 97.73 of the isolated strains of Staphylococcus aureus were sensitive to Ciprofloxacin and 95.45% to Levofloxacin and 93.18% to Norfloxacin, while 81.82% were sensitive to Gentamycin. 68.18% to Erythromycin, 63.64% to Rifampin. 54.55% to Amoxacillin , while 40% were sensitive to chloramphenicol and Streptomycin, and 27.27% to Ampiclox. Staphylococcus aureus was sensitive to some of the antibiotics used than the others. The isolates were sensitive to most of the antibiotics to different degree except Ampiclox. The risk of having population of Staphylococcus aureus strains with high multi drug resistance is high in the study area. There is need to address indiscriminate use of antibiotics and other risk behaviour related to hygiene measure of the health care workers.

TABLE OF CONTENTS

Certification                                                                                                       i

Dedication                                                                                                          ii

Acknowledgement                                                                                              iii

Table of content                                                                                                  iv

List of Table                                                                                                       v

Abstract                                                                                                              vii

CHAPTER ONE

1.1       INTRODUCTION                                                                                                    1

1.2       Aim of Study                                                                                                              2

1.3       Objectives of Study                                                                                                   2

CHAPTER TWO

LITERATURE REVIEW

2.0       Nosocomial Infections                                                                                              3

2.1       Staphylococcus Aureus                                                                                            5

2.2       Staphylococcus Genus                                                                                              8

2.3       Pathogenesis of Staphylococcus aureus Infection                                                  9

2.4       Fomites                                                                                                                      11

CHAPTER THREE

MATERIALS AND METHODS

3.0       Hospital settings                                                                                                        12

3.1       Sample Collection                                                                                                     12

3.2       Media Preparation                                                                                                   12

3.2.1    Macconkey Agar                                                                                                       12

3.2.2    Nutrient Agar                                                                                                            13

3.2.3    Culture                                                                                                                       13

3.3       Isolation and characterization                                                                                14       

3.4       Gram Staining                                                                                                           14

3.5       Biochemical Test (Reactions)                                                                                  15       

3.5.1    Catalase Test                                                                                                             15

3.5.2    Coagulase Test                                                                                                          16

3.6       Antibiotic Susceptibility test                                                                                    16       

CHAPTER FOUR

4.0  RESULTS                                                                                                                  17

CHAPTER FIVE

SUMMARY, CONCLUSION AND RECOMMENDATION

5.0       DISCUSSION                                                                                                            22

5.1  Conclusion                                                                                                                 24

5.2  Recommendation                                                                                                                  25

REFERENCES

LIST OF TABLES

Table 1:  The bacterial isolates obtained from different hospital wards            18      

Table 2  Percentage occurrence at Staphylococcus aureus                                      19

Table 3. Antibiotic sensitivity patterns among clinical isolates of

  Staphylococcus aureus obtained from the hospital fomites.                               20

CHAPTER ONE

1.1       INTRODUCTION

Despite remarkable advances in medical research and treatment during the 20^th century, infectious diseases remain among the leading cause of death worldwide (NIAID, 2010). Of these, nosocomial infections comprise about 5 to 10% (Emmerson et al., 2004).

It has been estimated that one third of all nosocomial infections may be preventable and are frequently caused by organisms acquired within the hospital environment. (Hughes, 1988). In the United Kingdom, two national prevalence studies have shown that approximately 10% of patients in hospitals are admitted within infection and a further 10% acquire infection while receiving care (Plowan et al.,2000). Recommendations for infection control practices in hospitals are well documented and updated on a regular basis (Garne, 1996).

Staphylococcus aureus is considered as normal flora (Tolan, 2007). Some studies have evaluated staphylococcus aureus in contamination of various items such as stethoscopes (Cohen and Matalon, 1997) contamination of computer devices (Devine et al., 2001) and in all phone and television sets (Stacey et al., 1998). Door handles of hospital r

ooms that are frequently entered by staff maybe secondary rooms may occur by inadequate compliance with hand hygiene regulation by staff such as cleaners and patients family members (Oie et al., 2002). The new guidelines published by the Infection Control Nurses Association (ICNA) emphasized the primary role of hand decontamination in the prevention of transmission of infection.

The transmission of organism from artificially contaminated “Donor” fabrics to clean “Recipient” fabrics via hand contact has also been reported (Marple and Tower, 1979). The results indicated that the number of organisms was greater if the donor fabric’ or the hands were wet upon contact (Marple and Tower, 1979). Overall, only 0.06% of the organizations obtained from the contaminated donor fabrics were transferred to recipient fabric through hand contact. Organism are transferred to various types of surfaces in much larger number (i.e <10⁴) from wet hands than from hands that are thoroughly dried (Patric et al., 1997). Abraham and Jacob (2005) found that a significant percentage of all phones were contaminated with multi-drug resistant Aeinetobaster sp. and that cross contamination between hands, cellphones and patients occurred in which 10% cases were implicated for contamination of hands and cellphones.

1.2       Aim of Study

To determine the extent of contamination with common medical equipment associated with infection in the hospital environment.

1.3       Objectives of Study

1.     To isolate and identify Staphylococcus aureus present in formites in the hospital.

2.     To know the group of antibiotics with the best antibacterial activity against Staphylococcus aureus.

3.     To determine the antibiotics susceptibility pattern of Staphylococcus aureus against the group of antibiotics

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