CHARACTERIZATION OF BACTERIA ASSOCIATED WITH WRISTWATCHES WORN BY HEALTHCARE WORKERS

ABSTRACT

The introduction of the work is the  characterization of bacteria associated with wristwatches worn by healthcare workers. Bacterial contamination is a situation which occurs when bacteria ends up in a location where they are not suppose to be. A cross-sectional study was conducted on 50 samples, in which 18 were male, 32 were female. They were also samples based on the type of wristwatches in which 30 were chain watch, 19 were lather watch and 1 was rubber watch. The wristwatches were sampled using pour plate method and direct streak plate method.  The media used were macConkey agar, nutrient agar and blood agar. Isolation and identification of bacteria was done by standard microbiological techniques. The (5) different bacteria isolated were S. aureus (14%), E. coli (2%), Strept. Spp. (38%), K. pneumoniae (4%), P. aeruginosa (6%). S.aureus and Strept spp.,were mostly isolated from female chain wristwatches, K. pneumoniae from male leather wristwatches, E. colifrom male lather wristwatch, P. aeruginosafrom female chain watch. Wearing a wristwatch results in an increase of bacterial contamination on the wrist. Although it is higher among female nurses, it still serves as a potential source of infection among healthcare workers thus, it is recommended to disinfect wristwatches before starting any clinical procedures and proper hand washing after clinical procedures.

TABLE OF CONTENTS

Cover Page   

Title page                                                                                                                  i

Certification                                                                                                             ii

Declaration                                                                                                               iii

Dedication                                                                                                                iv

Acknowledgement                                                                                                    v

Table of Content                                                                                                       vi

List of Table                                                                                                             vii

Abstract                                                                                                                    viii

CHAPTER ONE:  INTRODUCTION

1.0      Introduction                                                                                                   1

1.2      Aim and Objective of the Study                                                                    3

1.3      Objective                                                                                                       3

CHAPTER TWO:  LITERATURE REVIEW

2.0       Literature Review                                                                                           4

2.1       General Incidence of Pathogenic Organism in Wristwatch Sample.                       4

2.2       Bacterial Contamination Associated with Wristwatches.                              4

2.2.1    Staphylococcus aureus:                                                                                  4

2.2.2    Methicillin-Resistant Staphylococcus aureus                                                 5

2.2.3    Streptococcus Species                                                                                    6

2.2.4    Pseudomonas aeruginosa                                                                               7

2.2.5    Micrococci                                                                                                      7

2.2.6    Klebsiella pneumoniae.                                                                                  8

2.2.7    Mycobacterium abscessus                                                                              9

CHAPTER THREE: MATERIALS AND METHODS

3.0       Materials and Methods                                                                                   10

3.1       Study Area                                                                                                      10

3.2       Collection of Samples                                                                                    10

3.3       Preparation of Culture Media                                                                         10

3.4       Sterilization                                                                                                    11

3.5       Bacteria Inoculation and lsolation                                                                  11

3.6       Characterization and Identification of Organism                                           11

3.7       Gram Stain.                                                                                                     11

3.8       Biochemical Test                                                                                            12

3.8.1    Coagulase Test                                                                                               12

3.8.2    Catalase test                                                                                                    12

3.8.3    Motility test                                                                                                    12

3.8.4    Citrate test                                                                                                       13

3.8.5    Indole test                                                                                                       13

3.8.6    Urease test                                                                                                      13

3.8.7    Oxidase test                                                                                                    14

3.8.8    Triple sugar iron test.                                                                                      14

CHAPTER FOUR: RESULT

4.0       Result                                                                                                              15

CHAPTER FIVE: DISCUSSION, CONCLUSION AND RECOMMENDATION

5.0         Discussion.                                                                                                    23

5.1         Conclusion                                                                                                    25

5.2         Recommendation                                                                                          25

REFERENCES                                                                                                         27

LIST OF TABLES

Table                 Title                                                               Page

1:                     Number of Samples Collected According to Gender and Profession                  16

2.                     Number of Positive Samples after Isolation of Different Types of                      17

Wristwatches. (%)

3.                     Distribution of Isolate in Various Types of Wristwatches(%)                    18

4.                     Degree of Contamination of Wristwatches Examined.                                    19

5.                     Identification and Characterization of the Bacterial Isolates.                       21

CHAPTER ONE

1.0           INTRODUCTION

Health care acquired infection (HCAI); are referred to as NOSOCOMIAL INFECTION, as an infection occurring in patient during the process of care in a hospital or other healthcare facility which was not present or incubating at the time of admission. Hospital acquired infection remains an important problem, the healthcare workers hands are frequently contaminated with potential pathogens, which increases with the risk of antimicrobial resistant organism transmission lie infection caused by multidrug resistant bacteria (MDR) are worrisome healthcare problems and a daily challenge for the clinician dealing with critically ill patients (Tenorio et al., 2001). They can act as vector for the spread of infection either directly or via transfer of microorganism contaminating the healthcare workers hands. Multidrug resistant bacteria have been reported as contaminating microorganism on surfaces of medical instrument, high contact communal surfaces and also inanimate objects, e.g. wristwatches, that are worn by healthcare workers which has been shown to increase the hand carriage of potential pathogen (Trick et al., (2005). It has been reported that both gram positive and gram-negative bacteria are able to survive up to months on dry inanimate surfaces with longer persistence under humid and lower temperature conditions (Reagan et al., (1991). Factors that may affect the transfer of microorganism from one surface to another and cross contamination rates are types of organisms, sources and destination surfaces, humidity level and sizes of inoculums (Pittet and Dharan, 1999).

Bacterial contamination is a situation which occurs when bacteria ends up in a location where they are not supposed to be. However, wristwatches have been shown to harbour bacterial pathogens which effect on the carriage of such bacteria on the hands has not been demonstrated. Accessories like wristwatches and rings can interfere with proper hand washing; they can cause tears to gloves, dirty yellowish colour to gloves especially chain watches and also interfere with active patients’ intervention. It can also be a problem in medical clinics, operation rooms and in others healthcare settings (Ducciet al., (1995) like; the healthcare workers who took off their rings and wristwatches just before a surgical procedure had higher bacterial counts on their hands than those who did not wear any accessories. Bacteria can be transferred from the patient or healthcare providers and they may end up on surgical instruments, medical equipments, door knobs and inanimate objects like wristwatches. Prevention of bacterial contamination can be challenging, keeping space clean and observing proper handling procedures in a big part of prevention. Simple steps like washing hands, dipping and wearing gloves to handle specimens, removal of materials like rings, wristwatches before attending to patients or surgical room followed by hand washing after touching those materials can cut down a great deal on the risk of passing bacteria from one place to another (Williams et al., (1999). It is also important to conduct regular testing to checks for bacterial contamination so that it can be identified before it makes someone sick or cause problem with experiment and test.

Hospital-acquired infections remain an important problem, which cause significant morbidity and economic costs (Pittet and Dharan, 1999). The health care workers’ (HCWs’) hands are frequently contaminated with potential pathogen which increases the risk of antimicrobial-resistant organism transmission. Items such as stethoscopes, tourniquets and white coats can become contaminated with microbes including Staphylococcus aureus and they can act as a vector for the spread of infections, either directly or via the health care workers (HCWs’) hands. Wearing wristwatches and rings has been shown to increase the hand carriage of potential pathogens (Williams et al, 1999).However, though wristwatches have been shown to harbour bacterial pathogens, their effect on the carriage of such bacteria on the hands has not been demonstrated. Recently, hospitals in the UK have been asked to implement a policy of ‘bare below the elbows’, which includes the banning of wristwatches (Pittet and Dharan, 1999). The WHO guideline (published in 2009) saysthat, “investigate the impact of wearing a watch on the efficacy of hand hygiene” is an open question, that requires more research and field tests. (WHO, 2009). Hautemaniere et al. 2010reportedthat wearing watches and bracelets were both risk factorsfor poor hand hygiene (odd ratio, OR2.03 and 1.95, respectively). This study was based on direct observation of 3067 HCW in France, using the fluorescent trial (Alp et al, 2006): Ramón-Cantón et al. 2011used similar study design, and observed 293 HCWin a Spanish hospital. They found “missed” areas on the wrist in 90% of those, who wore watch and 56% of those, who did not. The situation was quite the same for bracelets; there were missed area son the wrist in 93% of those, who wore bracelet, while 61% of those who did not. They reported that 36% of HCW wore watches and 13% wore one or more bracelets (Field, 1996) Both studies agreed that wearing watches has a negative impact on hand hygiene.

1.2     AIM AND OBJECTIVE OF THE STUDY

AIM: the aim of the study is to  characterize bacteria associated with wristwatches worn by healthcare workers.

1.3 OBJECTIVE:

Ø   To isolate bacteria from wristwatches worn by healthcare workers.

Ø   To identify and characterize bacteria from wristwatches of healthcare workers.

Ø  To determine the prevalence of each isolate.

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