Assessment of possible healthcare associated infection pathogens at a military hospital, Lagos State, Nigeria, November, 2015

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Introduction : healthcare associated infection (HCAI) are infections among patients in hospital setting that become manifest only after 48hrs of hospital stay, which are caused by pathogens acquired in healthcare settings. Usually, HCAI are infections of urinary tract, surgical wounds, and the lower respiratory tract. They are a major cause of death and increased morbidity in hospitalized patients. In November, 2015, we assessed the prevalence of possible nosocomial pathogens at a military hospital in Lagos State, Nigeria. Methods : hospital areas such as theatre, treatment room, nurses’ station, male surgical ward, vital signs room, accident and emergency room, labour room, and post-natal ward were randomly sampled for the survey. We collected swabs specimens from specific sites such as table tops, faucets, door handles, beddings and equipment using sterile swab sticks. The swabs were inoculated on nutrient, chocolate and McConkey agar plates and incubated at 37⁰C for 24hrs. We characterized isolates by Gram reaction and biochemical methods. Results : out of the 83 sites cultured, 31(37.3%) yielded significant growth. Organisms isolated include Staphylococcus epidermidis (32.2%), Staphylococcus aureus (22.6%), Escherichia coli (12.9%), Klebsiella pneumoniae (9.7%), Streptococcus pyrogenes (9.7%), Aspergillus spp. (9.7%) and Proteus mirabilis (3.2%) were isolated. These isolates were from sterile and non-sterile sites, fomites and hospital equipment. Non-sterile sites were less likely to have microbial growth when compared with sterile sites; (Odds ratio: 0.78, CI: 0.20 - 3.03). However, this association was not statistically significant. Conclusion : possible pathogens for HCAI were isolated from vital sections of the hospital. Organisms isolated pose risk to sterile procedures and patients care with attendant burden on their recovery. We educated the hospital community on the importance of hand washing with soap and recommended adherence to regular sterilization and disinfection procedures of relevant sites where patient care is administered towards reduction of healthcare associated pathogens.