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ORIGINAL CONTRIBUTION
Year : 1997  |  Volume : 51  |  Issue : 12  |  Page : 465-469
 

Bacteriological analysis of various environmental sources in a rural hospital


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

Correspondence Address:
B S Nagoba
Microbiology Deptt, MIMSR Medical College. Latur- 413 531.
India
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PMID: 9715546

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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 2014 Dec 18];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 Top


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. [1] The sensitivity pattern of isolated organism was determined by Kirby­Bauer disc diffuiosn method . [2] 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 Top


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 Top


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 [3],[4] and P. aeruginosa in particulars. [5],[6] 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 . [3],[4] The predominance of P. aeruginosa in the present study fairly correlates with Thakur et al [3] but not in agreement with Hobbs et al. who reported predominance of Klebsiella in their study. [4] 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. [7]


 ¤ Summary Top


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 Top

1.Colee JG, Duguid JP, F raser AG, Marmion BP. Mackie and McCart­ney Practical Medical Microbiology, pp 141, London, Churchill Living­stone, 1989.  Back to cited text no. 1      
2.Bauer AN, Kirby WMM, Sherries JG. Antibiotic Sensitivity testing by standardized single disc method, Am J Clin Pathol 1966:45:493-496.  Back to cited text no. 2      
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.  Back to cited text no. 3      
4.Hobbs BC, Raj J. Nosocomial infec­tion with practicular reference to Kiebsiella and Pseudomonas Indian J Med Microbiol 1989;7:69-76.  Back to cited text no. 4      
5.Narang P. Detection of a source of infection by aeruginocine typing, Indian J Pathol Microbiol 1983:26: 41113.  Back to cited text no. 5      
6.Narang P, Moghe KV. Pseudomonas aeruginosa isolation, antibiogram and aeruginoune types in a rural hospital Indian J Med Res 1982;75: 654-660.  Back to cited text no. 6      
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.  Back to cited text no. 7      



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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