Abstract
Nosocomial infections are of public health concern globally. Despite the use of a variety of method and techniques for cleaning and sterilization of environmental surfaces, they still play an important role in transmission of pathogens especially healthcare-associated pathogens including Methicillin Resistant Staphylococci (MRSA), Vancomycin Resistant Enterococci (VRE), and many others. In this study, 60 swab samples were collected from door handles from the six different hospitals (including wards, offices, and rest rooms). All samples were transported and processed within two hours of collection. The swabs were cultured on routine microbiological media and incubated for 24 hours before examination and bacterial identification. Antimicrobial susceptibility of the isolated bacteria was also performed according to standard guidelines. The results of this investigation has shown that most of the tested samples contained a variety of organisms like Staphylococcus aureus, E. coli, Streptococcus spp, klebsiella spp among others. These findings are of public health importance and should be considered by the hospital infection control committees in order to reduce the risks of spread of pathogens from doors handles in the hospitals.
TABLE OF CONTENTS
Cover
page
Title
page i
Certification ii
Dedication
iii
Acknowledgement iv
Table
of contents v
List
of tables vi
Abstract vii
CHAPTER ONE
1.0 INTRODUCTION 1
1.1 Aims 2
1.2 Objectives 2
CHAPTER TWO
2.0 LITERATURE REVIEW 3
2.1 Definition of door handles 3
2.1.1 Brief history of door handles 3
2.1.2 Bacterial contamination 4
2.2 Healthcare facilities 5
2.2.1 Previous studies 6
CHAPTER THREE
3.0 MATERIALS AND METHODS 12
3.1 Study area 12
3.2 Sample collection 12
3.3 Media and materials used 12
3.4 Microbiological analysis 13
3.4.1 Inoculation of samples 13
3.4.2 Isolation and identification of bacterial
isolates 13
3.5 Gram staining 13
3.6 Antimicrobial susceptibility test 14
3.7 Biochemical identification of the
isolates 15
3.7.1 Catalase test 15
3.7.2 Coagulase test 15
3.7.3 Oxidase test 15
3.7.4 Indole test 16
3.7.5 Citrate utilization test 16
3.7.6 Urease test 16
3.7.7 MR/VP test 16
3.7.8 Triple sugar iron test 17
CHAPTER FOUR
4.0 RESULTS 18
CHAPTER FIVE
5.1 DISCUSSIONS 25
5.2 CONCLUSION 26
5.3 RECOMMENDATION 26
REFERENCES
LIST OF TABLES
TABLE TITLE PAGE
4.1. Type of bacteria isolated
from various door handles 19
4.2. Bacterial count and types of microorganisms isolated 20
4.3. Differentiation
of isolates from study by Gram staining reaction 21
4.4. Morphology identification of isolates 22
4.5. Biochemical identification of isolates 23
4.6. Antibiotics
susceptibility of the bacterial isolates. 24
CHAPTER ONE
1.0 INTRODUCTION
Microorganisms are living things ordinarily
too small to be seen without magnification, in terms of numbers and range of
distribution, microbes are the dominant organisms on earth (Kathleen and
Arthur, 2002). A large and diverse group of microscopic organisms that exist as
single cells or cell clusters; it also includes viruses, which are microscopic
but not cellular (Jawetz et al., 2007).
Kathleen
and Arthur, 2002 emphasized that we live in the age of bacteria; they were the
first living organism and probably constitute the largest of the earth’s
biomass. Microbes can be found nearly everywhere, from in the deep in the
earth’s crust, to the polar ice and oceans, to the bodies of plants and
animals. Being mostly invisible, the actions of microorganisms are usually not
as obvious or familiar as those of larger plants and animals (Kathleen and
Arthur, 2002).
The
human body harbors several species of bacteria, viruses, fungi and protozoa.
The anatomic sites where bacteria are usually discovered include the skin (Staphylococci
and Bacteroides),
Oropharynx (Streptococci, Anaerobes),
large intestine (Enteric bacilli) and Vagina (lactobacilli),
(Beaugerie and Petit, 2004.).
These
microorganisms colonize part of the body without causing infection, these ones
are called Normal Body Flora, but can cause infection when found in another
site, for example culture of Staphylococcus from a blood sample may
represent skin contamination at the time of phlebotomy, the flora of
gastro-intestinal tract which are the enterobacteriaceae which are passed out
through excreta, is a serious source and reservoirs from which they are
transferred to the susceptible host who then becomes possible source of
infection, hence making the control of the infection easy.(Francesco, 2010)
Door
handles remain major reservoir source of human pathogens in health institution,
which in adverse situation may bring about outbreaks of infection example Staphylococcal
infection (Francesco, 2010).
The
occurrence of this may be attributed to the unhygienic use of the toilet
facilities, which results to the gross contamination of the place including
door-handle, which individuals are less likely to see as contaminated (Francesco,
2010).
These
articles once contaminated become vehicle for transmission of infection, such
that the user may succeed in picking this pathogens on his way out even after
he/she washed hands, the organism thus picked can introduce infection into such
individual either orally or topically or can be transferred to another person.
The people exposed to this risk factor are the workers, cleaners and patients etc.
who may be unfortunate to come down with the infection, which is in nature in
the course of being in contact with the door handles (Francesco, 2010).
1.1 Aim
of study
To
evaluate the bacterial contamination of door handles in a health facility
1.2 objectives
of the study
The
objectives of the study are as follows:
a. To
isolate and identify potentially pathogenic bacteria from door handles of
health care facilities.
b. To
determine the prevalence of each isolate.
c. To
perform antibiotic susceptibility pattern of the isolates.
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