Abstract
Background Hospital-acquired infections have remained a serious cause of mortality, morbidity, and extended hospitalization. Bacterial contamination of inanimate surfaces of the hospital environment and equipment is considered a major contributing factor to the development of several nosocomial infections worldwide. The hospital environment and many devices are an important reservoir of many clinically important bacterial agents including multidrug-resistant pathogens. Therefore, this systematic review and meta-analysis are aimed at investigating bacterial pathogens and their antimicrobial resistance patterns of inanimate surfaces and equipment in Ethiopia. Methods An exhaustive literature search was carried out using the major electronic databases including PubMed, Web of Science, MEDLINE, EMBASE, CINAHL, Google Scholar, Cochrane Library, Scopus, and Wiley online library to identify potentially relevant studies without date restriction. Original articles which address the research question were identified, screened, and included using the PRISMA flow diagram. Data extraction was prepared in Microsoft Excel, and data quality was assessed by using 9-point Joanna Briggs Institute critical appraisal tools. Then, data were exported to STATA 16.0 software for analyses of pooled estimation of outcome measures. Estimation of outcome measures at a 95% confidence interval was performed using DerSimonian-Laird's random-effects model. Finally, results were presented via text, figures, and tables. Results A total of 18 studies with 3058 bacterial isolates recovered from 3423 swab specimens were included for systematic review and meta-analysis. The pooled prevalence of bacterial contamination of inanimate surfaces and equipment was found 70% (95% CI: 59, 82). Among the Gram-negative bacterial species, the prevalence of ampicillin-resistant K. pneumoniae was the highest 80% (95% CI: 78, 92) followed by Citrobacter species 78% (95% CI: 57, 83). Conclusion This study has shown a high prevalence of bacterial contamination of inanimate surfaces and equipment in Ethiopia.
Highlights
Hospital-acquired infections (HAIs) are causing the major cause of mortality, morbidity, increased medical costs for treatment, and extended hospitalization
The high prevalence in this study may be associated with a lack of routine practice including disinfecting, cleaning, decontaminating, and sterilizing of inanimate environmental surfaces like medical wards (MW), pediatric wards (PW), orthopaedic wards (OPW), surgical wards (SW), gynecologic wards (GW), emergency wards (EW), intensive care unit (ICU), and neonatal intensive care unit (NICU) as well as medical equipment like a stethoscope, thermometer, sphygmomanometer, ultrasound machine, X-ray machines, magnetic resonance imaging (MRI), and many other Healthcare workers ICU (HCW) fomites
The alarming increase in AMR among the Gramnegative bacterial species demands the use of antimicrobial surfaces to reduce microbial contamination of highly touched healthcare surfaces
Summary
Hospital-acquired infections (HAIs) are causing the major cause of mortality, morbidity, increased medical costs for treatment, and extended hospitalization. Bacterial contamination of inanimate surfaces and equipment is problematic to overcome as it can serve as a reservoir for an unlimited period through a gradual cross-transmission of pathogens and subsequent contact with patients and HCWs at a time of disease management [8]. It can be caused by a range of bacterial (both Gram-positive and Gram-negative isolates) and fungal species [9,10,11,12].
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