|Year : 1997 | Volume
| Issue : 12 | Page : 465-469
Bacteriological analysis of various environmental sources in a rural hospital
BS Nagoba1, SR Deshmukh1, RA Husain2, AV Gomashe3, BJ Wadher3
1 Microbiology Deptt, MIMSR Medical College. Latur- 413 531., India
2 Microbiologist, Zulekha Hospital, Sharjah, United Arab Emirates
3 Medical Microbiology Research Lab, Microbiology Deptt, Nagpur University, Nagpur, India
B S Nagoba
Microbiology Deptt, MIMSR Medical College. Latur- 413 531.
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Nagoba B S, Deshmukh S R, Husain R A, Gomashe A V, Wadher B J. Bacteriological analysis of various environmental sources in a rural hospital. Indian J Med Sci 1997;51:465-9
|How to cite this URL:|
Nagoba B S, Deshmukh S R, Husain R A, Gomashe A V, Wadher B J. Bacteriological analysis of various environmental sources in a rural hospital. Indian J Med Sci [serial online] 1997 [cited 2015 Dec 1];51:465-9. Available from: http://www.indianjmedsci.org/text.asp?1997/51/12/465/11484
Nosocomial infections are difficult to treat because of multiple drug resistance. Any bacterium, on occasion, can cause nosocomial, infection, but those bacteria which are able to survive in hospital environment for long periods and develop resistance to antibiotic and disinfectants are particularly important. Regular practice of environmental survey and suitable control measures can reduce the rate of nosocomial infections. The detailed knowledge regarding the organism and its source helps in management of nosocomial infection, avoid further morbidity, reduce hospital stay and treatment costs. The present study was undertaken to findout the distribution of bacteria in a newly constructed rural hospital, their sources and antibiogram.
| ¤ Material and Methods|| |
Two hundred five specimens were collected from different wards, operation theatres, out patient departments, dressing room etc. of a newly constructed rural hospital during the period October 1995 to July 1996 and processed for isolation of bacteria using blood agar and MacConkey's agar. All positive cultures were identified following standard techniques.  The sensitivity pattern of isolated organism was determined by KirbyBauer disc diffuiosn method .  For isolation of bacteria from air, a blood agar plate was exposed to air for 10 minutes and then incubated. Each different type of colony grown on blood agar was studied and identified, following standard techniques and antibiotic sensitivity was determined.
| ¤ Results|| |
Out of 205 specimens 105 (51.7%) were found positive. Isolation was monobacterial in 73 specimens (35.6%) polybacterial in 33 (16%). The rate of isolation of bacteria was highest in discarding jar fluid (84.6%) followed by air (73%), basin swabs (70.5%), hand wash bowl solution (64.2%), cheatle forceps (64%) and thermometer fluid (53.8%). The isolation rate was less than 50% with other specimens processed [Table 1].
The highest monobacterial isolation was seen with specimen obtained from discarding jar (61.5%) while highest polybacterial isolation was seen in air (46.1%) [Table 1]. The most common organism isolated among the monobacterial as well as polybacterial isolates was Pseudomonas aeruginosa. Other bacterial isolated among the monobacterial isolates were Bacillus subtilis, Kiebsiella pneumaniae, Proteus Spp. Escherichia More Details coil and others in the decreasing order of frequency [Table 2]. Among the polybacterial isolates, other bacteria isolated were B. subtilis, E. call, Staphylococcus citrus, taph., Staph. aureus, Staph. Epidermidis and others in the decreasing order of frequency [Table 2]. Ciprofloxacin (72.88%) was found to be the most effective antibacterial agent against different bacterial isolates from hospital. environment. Next to ciprofloxacin, norfloxacin (61.01%) and gentamicin (60.16%) were other effective antibacterial agents. Erythromycin (64%) was found to be effective against Gram positive cocci. The large number of isolates were resistant to ampicillin, bactrim, carbenicillin and amoxycillin [Table 3]. Considering Bs subtilis as a common contaminant its sensitivity pattern was not determined.
| ¤ Discussion|| |
Majority of the nosocomial infections are exogenous in which the source of infection is hospital ecosystem. Even though various effective measures of cleanlines and hygiene are taken, it is difficult to maintain environmental hygiene in a hospital. The incidence rate of 51.7% and distribution of bacteria in different sources of hospital indicates lack of proper hygienic condition in hospital environment. The isolation of different bacteria from various sources in hospital , and P. aeruginosa in particulars. , And their role in nosocomial infection has been suggested previously. It is clear from the results of present study that the prevalence of Gram negative bacteria such as P. aeruginosa, nlebsiella Species, E. coil etc. is increasing. This finding is in agreement with the earlier reports . , The predominance of P. aeruginosa in the present study fairly correlates with Thakur et al  but not in agreement with Hobbs et al. who reported predominance of Klebsiella in their study.  In this study majority of isolates were resistant to ampicillin, amoxycillin, co-trimoxazole, carbenicillin, tetracycline and even isolates resistant to gentamicin, norfloxacin, ciprofloxacin were observed. This finding correlates with the current view that antimicrobial resistance is increasing especially in hospital pathogens. This resistance is due to frequent exposure to disinfectant and antibacterial agent in hospital. The survival of bacteria in specimen such as cheatle forcep fluid, dettol, savlon, eye drops, thermometer fluid, tongue depressor fluid etc. and their resistance to various antibacterial agents suggest their role in causing nosocomial infection. From this study it is concluded that such type of surveys help in knowing the details regarding the bacterial isolates prevalent in the hospital environment, their source and antibiogram and play a significant role in planning to reduce the rate of nosocomial infections by setting up control policies as it has already been proved that the rate of nosocomial infection can be reduced by intensive infection surveillance and control programmes. 
| ¤ Summary|| |
Two hundred and five specimens from various sources of hospital ecosystem were processed for isolation of bacteria. 51.7% specimens were found positive and a total of 146 isolates were obtained. Isolation was monobacterial in 35.6% and polybacterial in 16.0%. Bacteria were recovered from discarding jar fluid (84.6%), air (73%), basin swabs (70.5%) hand wash bowl solution (64.2%), cheatle forceps (64%) and thermometer fluid (53.8%) etc. The most common bacteria isolated were P. aeruginosa, B.subtilis, Klebsiella Spp. and E. coil and ciprofloxacin (72.88%) was found to be the most effective antibacterial agent.
| ¤ References|| |
|1.||Colee JG, Duguid JP, F raser AG, Marmion BP. Mackie and McCartney Practical Medical Microbiology, pp 141, London, Churchill Livingstone, 1989. |
|2.||Bauer AN, Kirby WMM, Sherries JG. Antibiotic Sensitivity testing by standardized single disc method, Am J Clin Pathol 1966:45:493-496. |
|3.||Thakur A, Mishra B, Mandal A. Environmental surveillance and its role in post operative hospital; acquired infections. Indian J Med Microbiol 1990;8:72-77. |
|4.||Hobbs BC, Raj J. Nosocomial infection with practicular reference to Kiebsiella and Pseudomonas Indian J Med Microbiol 1989;7:69-76. |
|5.||Narang P. Detection of a source of infection by aeruginocine typing, Indian J Pathol Microbiol 1983:26: 41113. |
|6.||Narang P, Moghe KV. Pseudomonas aeruginosa isolation, antibiogram and aeruginoune types in a rural hospital Indian J Med Res 1982;75: 654-660. |
|7.||Haley RW, David H, Culver HW. The efficacy of infection surveillance and control programmes in preventing nosocomial infections in U.S. Hospitals Am J Epidemiol 1985;121: 182. |
[Table 1], [Table 2], [Table 3]