BACTERIAL CONTAMINATION OF DOOR HANDLES OF SOME HEALTHCARE FACILITIES IN UMUAHIA, ABIA STATE.

                                                            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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