SURVEILLANCE OF NOSOCOMIAL PATHOGENS IN THE HOSPITAL WARD OF MICHAEL OKPARA UNIVERSITY OF AGRICULTURE UMUDIKE ABIA STATE

ABSTRACT

Nosocomial pathogens are hospital acquired pathogens.The infections caused by these Pathogens occurs within 48hours of hospital admission, they are serious threats to patients care.Swabs from beds, sinks, chairs and cupboards were collected from the hospital ward of Michael Okpara University of Agriculture Medical Centre Umudike.They were surveyed for contamination by nosocomial pathogens.The collected samples were cultured and analysed using Blood and Macconkey agar. The organisms isolated were subjected to antimicrobial test using disc diffusion method. About 85% of the collected samples had growth of Staphylococcus aureus,10% growth Escherichia coli and 5% growth Proteus specie.Some isolates were resistant to the antibiotics while most of them were sensitive. In the sensitivity of the isolates it was observed that Staphylococcus aureus were more sensitive to Ciproflox, Ceporex and Chloramphenicol. Escherichia coli were more sensitive to Augmentin and Streptomycin while Proteus Specie were more sensitive to Rimfapicin and Ampiclox.

TABLE OF CONTENTS

Certification                                                                                                  i

Dedication                                                                                                    ii

Acknowledgement                                                                                       iii

Table of content                                                                                                        iv

List of table                                                                                                            v

List of figure                                                                                                          vi

Abstract                                                                                                      vii

Chapter One

1.1                   Introduction                                                                                           1

1.2         Aim and Objective                                                                                                      2

Chapter Two

Review of Related Literature                                                                                                      3

2.1      Literature Review                                                                                                         3

2.2    Nosocomial pathogens and sites of infection                                                                                                       3

2.3    Causes of nosocomial infection                                                                                                       6

2.4    Nosocomial infection causing organism                                                                                                      6

2.5    Method of acquisition                                                                                                    6

2.6    Description of isolates                                                                                                        7

2.6.1     Escherichia coli    7

2.6.2    Proteus specie                                                                                                           8

2.6.3    Staphylococcus aureus                                                                                                          8

2.7   Emergence and spread of nosocomial pathogens                                                                                                     9
2. 8  Mechanism of antibiotics resistance                                                                                                     10
2.9  Infection and control                                                                                                        12

Chapter Three

Materials and method

3.1      Sample Collection                                                                               13

3.2     Preparation of sample                                                                          13

3.3      Preparation of media                                                                           13

3.4     Isolation of bacteria                                                                            13
3.5. Identification and characterization                                                      14

3.5.1    Coagulase Test                                                                                  14

3.5.2    Catalase Test                                                                                     14
3.5.3OxidaseTest                                                                                     14
3.5.4Motilitytest                                                                                       15

3.5.5    Gram Staining                                                                                   16

3.5.6    Citrate utilization test                                                                        16

3.6      Preparation of antibiotic disc                                                              16

3.7      Antibiotic sensitivity test                                                                    18

3.8      Measurement of Zone of inhibition                                                     18

Chapter Four

Result                                                                                                        19

Chapter Five

5.1    Discussion                                                                                           25

5.2    Conclusion                                                                                           26

5.3    Recommendation                                                                                 27
References

Appendix

LIST OF TABLES

Table          Title                                                                  Page

     1          Relative percentage of pathogens by Site of infection.                                                   5

     2         Gram negative susceptibility disc                                                                                                             16

     3         Biochemical characterization of isolate.                                                                                                        20

     4        Percentage of the isolates from different sites                                                                                                            21

     5        Antibiotics susceptibility test of the different isolates                                                                                                        25

LIST OF FIGURE

Fig 1 Frequency of occurrence of the bacteria on the sinks, beds, cupboards and chairs.                                                                                                        22

 CHAPTER ONE

1.1         INTRODUCTION

Nosocomial pathogens are hospital acquired pathogens. Although microbiologically contaminated surfaces can serves as reservoir for pathogens, these surfaces generally are directly associated with transmission of infection to either staff or patients. The transmission of micro organism from the environmental surfaces to patient and staff are largely through hand contact with surfaces (Jarvis, 2007).Although hand hygiene is important to minimize the impact of this transfer, cleaning and disinfecting environmental surfaces appropriately is fundamental in reducing their potential contribution to the incidence of healthcare and patients associated infections. Nosocomial infections occurs worldwide both in developed and developing - world. They are significantly burden to patients and public health. They are the major cause of death and increase hi morbidity hi hospitalized Patient (Ssteizor, et al., 2005).They may cause increase in functional disability and emotional stress and may lead to condition that reduce quality of life, not only do they affect the general health of patients, but also become a huge financial burden. The increased stay in hospital also contribute to the chance of infection. The organisms that cause most hospital acquired infection (pathogens) are common in the general population in which settings, they are relatively harmless. They may cause severe or mild form of disease more in hospitalized patients. Factors that increase a patient's susceptibility to the nosocomial pathogens include young or aged, decreased immune system, underlying disease, therapeutic and diagnostic interventions. Nosocomial infections have emerged as an important cause of morbidity and mortality in elderly patients leading to prolonged hospital stay, treatment failure and increased cost of healthcare. Extensive and inappropriate use of antimicrobial agents has invariably resulted in the development of antibiotics resistance, which in recent years has become a major problem world wide. The organisms that cause nosocomial infections are often drug resistant. (Ekrami, et al., 2010). Many strains of pneumococci, Staphylococcus, Enterococci, & tuberculosis are resistant to most or all antimicrobial agent which were once effective.

1.2      AIMS AND OBJECTIVE

This investigation was done to determine the following

·       The detect the extent of contamination of environmental surfaces by bacteria and their susceptibility to various antimicrobial agents.

·       To isolate and characterizes common aerobic pathogenic organisms in the hospital ward of Michael Okpara University of Agriculture Umudike.

·       To understand and determine the epidemiology of nosocomial pathogens in the hospital ward of Michael Okpara University of Agriculture Umudike.

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