Abstract
Background The hospital environment, especially surfaces and medical devices, is a source of contamination for patients. Objective This study carried out, to the best of our knowledge, for the first time at Taza Hospital in Morocco aimed to assess the microbiological quality of surfaces and medical devices in surgical departments and to evaluate the disinfection procedure in time and space. Methods Samples were taken by swabbing after cleaning the hospital surface or medical device, to isolate and identify germs which were inoculated on semiselective culture media then identified by standard biochemical and physiological tests, using the analytical profile index (API) galleries. Moreover, the association rules extraction model between sites on the one hand and germs on the other hand was used for sampling. Results The study showed that 83% of the samples have been contaminated after biocleaning. The most contaminated services have been men's and women's surgeries. 62% of isolated germs have been identified as Gram-positive bacteria, 29% as Gram-negative bacteria, and 9% as fungi. Concerning the association rules extraction model, a strong association between some contaminated sites and the presence of germ has been found, such as the association between wall and nightstand and door cuff, meaning that the wall and nightstand contamination is systematically linked to that of the door cuff. The disinfection procedure efficacy evaluation has enabled suggesting renewing it each 4 h. Conclusion Microbiological monitoring of surfaces is necessary at hospital level through the use of the association rule extraction model, which is very important to optimize the sampling, cleaning, and disinfection site scenarios of the most contaminated ones.
Highlights
Background. e hospital environment, especially surfaces and medical devices, is a source of contamination for patients
Samples were taken by swabbing after cleaning the hospital surface or medical device, to isolate and identify germs which were inoculated on semiselective culture media identified by standard biochemical and physiological tests, using the analytical profile index (API) galleries
Some complications can emerge in certain cases as nosocomial infections (NAI), which include any infectious event related to the individuals’ care. ese infections affect approximately 5% to 10% of patients in developed countries but the risk is 2 to 20 times higher in developing countries [1]. e presence and increase of these infections induce an extension in the length of stay of patients in hospital, overuse of antibiotics leading sometimes to the emergence of resistant microorganisms, increased costs and expenses, either for the patient or the hospital, and a high mortality rate [2]
Summary
Background. e hospital environment, especially surfaces and medical devices, is a source of contamination for patients. E hospital environment, especially surfaces and medical devices, is a source of contamination for patients. Microbiological monitoring of surfaces is necessary at hospital level through the use of the association rule extraction model, which is very important to optimize the sampling, cleaning, and disinfection site scenarios of the most contaminated ones. Among the main causes of these infections, the patient’s environment, the hospital rooms’ surfaces and Journal of Environmental and Public Health architecture, as well as the medical or accommodation equipments frequently used, presents a risk of germ’s transmission and contamination by germs in the hospital environment [3]. Several types of germs of nosocomial origin have been isolated from surfaces and have shown an innate ability to survive on high-contact surfaces, such as methicillin-resistant Staphylococcus aureus [11], Klebsiella pneumoniae [12], coagulasenegative Staphylococci [13], and Acinetobacter baumannii [14]. Among the most well-known nosocomial infections, surgical site infections (SSI) are ranked second to urinary tract infections [15]. ese SSIs develop from environment in the operating rooms during surgery through direct and multiple contacts between patients. e level of surface contamination in hospital wards differs according to the surface’s and/or room’s types, or the nature of hygiene in a specific unit [16]
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