Thesis:

Prevalence of bacterial contaminants and their antibiotic susceptibility profiles at kitui county referral hospital, kenya.

The study determines the prevalence of bacterial contaminants, major sources and their antibiotics susceptibility profiles in Kitui County Referral hospital, Kenya. Bacterial contaminants are the major sources of Nosocomial infections which causes hospital acquired infections among health care workers, patients and visitors in the health facilities. Nosocomial infections are acquired during provision of health care services within the health facility set up. The buildings provide the space used to provide hospital care while the equipment entails the tools and machines used to run the operations of the hospital. Thus, environment in Surgical and medical wards have a huge impact on the health safety of the patients. This study was done by collection of 195 swabs samples in the patient care and treatment environment which involved floors, beds, drugs trolleys, infusion stands, sinks, door handles, chairs, tables and bedside lockers of medical and surgical wards. The study was done through culturing of specimen in MacConkey, Sheep blood agar and chocolate blood agar media. The identification was done by gram staining technique and biochemical tests; Citrate utilization test, Catalase, Coagulase, Indole, Methyl Red, Voges Proskauer and Oxidase test. A total of 177 bacteria isolates contaminants were identified from both surgical and medical wards. The study found that the primary types of bacteria in hospital setting being Staphylococci aureus, Escherichia coli, Klebsiella oxytoca, and Pseudomonas aeruginosa. S. aureus had the highest prevalence at 43%, Escherichia coli 30%., Klebsiella 14% and Pseudomonas aeruginosa was the least 13%. Proportion of contaminants on sources were; lockers 28%, bed 15 %, sink 16%, floor 9%, table 7.5 %, chair 7%, drug trolley 6%, infusion stand 5.5%, and doors 6%. The study found that hospital surfaces, including doors, tables, lockers, chairs, sinks, trolleys, and beds were the primary source of contaminants. S. aureus was distributed mainly on doors, while lockers, beds, sinks, and drug trolleys were contaminated with all bacteria isolates. Similarly, floors were contaminated with S. aureus, P. aeruginosa, and E. coli. Chairs and infusion stands were contaminated with S. aureus and E. coli. Tables had S. aureus, E. coli, and K. oxytoca contaminants. S. aureus, P. aeruginosa, E. Coli, and K. oxytoca were the predominant bacteria isolate from surgical and medical ward surfaces and equipment. Of all the four isolates, S. aureus was the most prevalent in medical and surgical wards (51%). Antimicrobial susceptibility test showed that all the isolated bacteria were sensitive to Meropenem. P. aeruginosa showed high sensitivity to Meropenem (100%) but averaged 33.3 % against Piperacillin Tazobactam, Ampicillin -clavulanic acid, and Ciprofloxacin. E. coli was only susceptible to Tazobactam, Ciprofloxacin, and Ceftazidime (20%), Augmentin (40%), and Meropenem (80%). Similarly, K. oxytoca was (100%) susceptible to Meropenem and ranked second with the most sensitivity to drugs tested. Vancomycin, Oxacillin, Penicillin, and Levofloxacin had no activity on bacteria isolates. Similarly, S. aureus showed sensitivity to most of the drugs tested. The study recommends inclusion of infection prevention and control measures to enhance safety against Nosocomial infections. Further, molecular techniques are recommended for further studies.