EVALUATION OF POLLUTION SOURCES IN HEALTH CARE UNITS

Abstract

Active surveillance cultures (ASCs) are universal or targeted microbiological screening cultures for patients admitted to a hospital. Healthcare associated infections (HCAIs) are a major health problem worldwide. Inanimate surfaces and equipment contamination may play a role in cross-transmission of pathogens and subsequent patient colonization or infection. Bacteria contaminate inanimate surfaces and equipment of the patient zone and healthcare area, generating a reservoir of potential pathogens, including multidrug resistant species. Traditional terminal cleaning methods have limitations. Indeed patients who receive a bed from prior patient carrying bacteria are exposed to an increased risk of being colonized and potentially infected by the same bacterial species of the previous patient., even on dry surfaces, may play a role in reducing the efficacy of terminal cleaning procedures since it enables bacteria to survive in the environment for a long period and provides increased resistance to commonly used disinfectants. Aim: The objectives of the research can be summarized in the following points:  Apply Systematic knowledge collection, examination, and interpretation to emphasize link between environmental and microbiological pollution.  Develop an environmental infection-control guideline that reviews strategies for the prevention and reduction of environmentally-mediated infections, particularly among health-care workers and immune-compromised patients.  Monitor the size of the healthcare acquired infections (HAIs) problem in infectious diseases departments and identify the areas where prevention activities are needed.  Analysis of the pathogenic bacteria isolated from the patient's nose, skin and Throat.  Compare the results of each department with its previous ones, and compare groups of patients stratified for infection risk, in order to be able to identify areas where the qualityofcare can be improved.  Sensitize personnel to infection problems (microorganisms, antibiotic resistance, etc.) and set targets for prevention.  Trying to eliminate the infection, reduce morbidity, and prevent complications.  Set up recommendations to control and prevent healthcare associated infections.  Minimize HAIs and antimicrobial resistance in healthcare units and follow the national guidelines for patient safety. This cross-sectional study was conducted in the year 2017 in the period between one April and 30 September, on 66 healthcare personnel (HCP) and 460 patients within 24 hours of admission, age ranged from one day to 85 years old at regional hospital located at Cairo with 300 bed for intensive care and long-term care. The name of the hospital studied for this research will remain anonymous for privacy considerations. 1269 surveillance cultures (SC) were received at the microbiology department at a hospital in Cairo. The response rates of this study were 77.5% of patients and 50 % of HCP. The HCP and patients swabs' results showed that the two most infectious departments were Gynaecology and Obstetrics department (GOD), Intensive Care Unit (ICU) followed by Neonate Intensive Care Unit (NICU) then the least infectious department compared to the previous departments was Surgery departments (SD). The results of environmental swabs showed that 70% of gram positive bacteria including Methicillin Resistant Staphylococcus Aureus (Mrsa) were monitored on Surgery department beds. The prevalence of gram negative bacilli and gram positive cocci carriage is (53.7% of patients and HCP). Monitoring and eradication of Mrsa and Extended Spectrum Beta Lactamase (Esbl) producing bacteria from patients and HCP should be considered to prevent continuous spread between healthcare facilities and the community.