Abstract
Nosocomial infections or hospital-acquired infections are infections that potentially occur in the patients under medical care. These infections are often caused by multidrug-resistant pathogens acquired via improper antibiotic use, not following infection control and prevention procedures. The main objective of this study was to investigate the contribution of medical wards contamination to wound infection and antibiotics susceptibility patterns at Ruhengeri Referral Hospital, Musanze district, Rwanda. This was a cross-sectional study where a total of 61 samples including air sampling to evaluate the contamination by airborne bacteria, working surface, equipment, and patients' surgical wounds swabs were collected in intensive care unit (ICU), pediatrics, and surgery departments. Culture, Gram stain, and biochemical tests were performed for microbiological isolation and identification. Antibiotic susceptibility testing was performed using the Kirby–Bauer disc diffusion method. Statistical Package for Social Science (SPSS) version 22 was used for data analysis. Gram-negative bacteria were frequently from surgery, pediatric, and ICU with 68.8%, 63.9%, and 31.1%, respectively, while Gram-positive isolates were 37.7% in surgery, 32.9% in pediatric, and 18.0% in ICU. There was a statistically significant association with E. coli and swabbed materials and surgical wound sites (x2 = 10.0253, P value = 0.018). All bacterial contaminants were sensitive to clindamycin and erythromycin. Pseudomonas aeruginosa, E. coli, and S. aureus were resistant to nitrofurantoin. Hospital environment could be a contributing factor to surgical wound site infections. Hospitals should apply preventive measures in the hospital environment surrounding wound surgery patients to prevent wound infections during hospital stay.
Highlights
Nosocomial infections, known as healthcare-associated infections (HAI), are infections acquired during the process of receiving healthcare that was not present during the time of admission [1]
Swab samples were taken from surface and patients who had developed wound infection and samples of airborne contamination within three different units: surgery, intensive care unit, and pediatric. e collected samples were analyzed in INES-Ruhengeri Clinical Microbiology Laboratory
Both Gram-positive and Gram-negative bacteria could be isolated in the hospital wards
Summary
Nosocomial infections, known as healthcare-associated infections (HAI), are infections acquired during the process of receiving healthcare that was not present during the time of admission [1]. Infections caused by multidrug-resistant (MDR) bacteria are a worrying healthcare problem and a daily challenge for the clinician dealing with critically ill patients [2]. They are often caused by breaches of infection control practice and procedures, unclean and nonsterile environmental surfaces, and ill employees who can provide opportunity for these pathogens for surviving to cause infections. According to the CDC report, the most common pathogens from medical wards contamination causing nosocomial infections are Staphylococcus aureus, International Journal of Microbiology. According to estimate report of CDC, in the United States, approximately 1.7 million of hospital-acquired infections from all types of microorganisms including bacteria and fungi combined contribute to 99,000 deaths each year [11]. E aim of this study was to determine contribution of medical wards contamination to wound infection among patients attending Ruhengeri Referral Hospital. e clinics and hospitals in Rwanda are crowded, creating atmosphere for hospital-acquired infections, and yet, few studies have been conducted related to medical wards contamination
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