The role of medical equipment in the spread of nosocomial infections: a cross-sectional study in four tertiary public health facilities in Uganda.
The role of medical equipment in the spread of nosocomial infections: a cross-sectional study in four tertiary public health facilities in Uganda.
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DOI：
10.1186/s12889-020-09662-w
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发表时间：
2020-10-16
影响因子：
4.5
通讯作者：
Joloba ML
中科院分区：
文献类型：
--
作者：
Ssekitoleko RT;Oshabaheebwa S;Munabi IG;Tusabe MS;Namayega C;Ngabirano BA;Matovu B;Mugaga J;Reichert WM;Joloba ML
由于医院中的许多医疗设备与医护人员、患者、技术人员、清洁工以及有时护理人员直接接触，因此必须密切关注它们携带潜在有害病原体的能力。本研究的目的是评估医疗设备可能在乌干达四个公共卫生设施的医院获得性感染中发挥的作用。2017年12月至2018年1月在乌干达的四个公共卫生设施进行了一项横断面研究。新生儿科、影像科或手术室的每件设备均在三个不同点进行擦拭：与患者接触的位置、与用户接触的位置以及患者或用户不太可能接触的远程位置。使用标准微生物学方法分析拭子的细菌生长。随机选择17个细菌分离株，并检测其对常用抗生素的敏感性/耐药性。收集的数据在STATA版本14中进行分析。共对65台设备的192个位置进行了擦拭，其中60.4%的位置检测呈阳性（116/192）。近十分之九的设备（57/65）在至少一个位置检测出污染阳性，三分之二的设备（67.7%）在两个或更多位置检测出污染阳性。116个污染点中，芽孢杆菌阳性率为52.6%，凝固酶阴性杆菌阳性率为14.7%，大肠杆菌阳性率为12.9%（15/116）。大肠杆菌，而所有其他细菌物种的合并患病率为19.8%。有趣的是，55%的远程位置受到污染，而66%的用户接触位置和60%的患者接触位置受到污染。此外，5/17份样本对至少三类测试抗生素具有耐药性，包括青霉素、甘氨酰环素、四环素、甲氧苄啶磺胺甲恶唑和尿抗感染药。这些结果为加强乌干达公共卫生设施医疗设备使用的整体消毒/灭菌实践提供了强有力的支持。还需要进一步的研究，以直接联系到在类似环境中确定的细菌分离株和患者中记录的感染病例。
With many medical equipment in hospitals coming in direct contact with healthcare workers, patients, technicians, cleaners and sometimes care givers, it is important to pay close attention to their capacity in harboring potentially harmful pathogens. The goal of this study was to assess the role that medical equipment may potentially play in hospital acquired infections in four public health facilities in Uganda. A cross-sectional study was conducted from December 2017 to January 2018 in four public health facilities in Uganda. Each piece of equipment from the neonatal department, imaging department or operating theatre were swabbed at three distinct points: a location in contact with the patient, a location in contact with the user, and a remote location unlikely to be contacted by either the patient or the user. The swabs were analyzed for bacterial growth using standard microbiological methods. Seventeen bacterial isolates were randomly selected and tested for susceptibility/resistance to common antibiotics. The data collected analyzed in STATA version 14. A total of 192 locations on 65 equipment were swabbed, with 60.4% of these locations testing positive (116/192). Nearly nine of ten equipment (57/65) tested positive for contamination in at least one location, and two out of three equipment (67.7%) tested positive in two or more locations. Of the 116 contaminated locations 52.6% were positive for Bacillus Species, 14.7% were positive for coagulase negative staphylococcus, 12.9% (15/116) were positive for E. coli, while all other bacterial species had a pooled prevalence of 19.8%. Interestingly, 55% of the remote locations were contaminated compared to 66% of the user contacted locations and 60% of the patient contacted locations. Further, 5/17 samples were resistant to at least three of the classes of antibiotics tested including penicillin, glycylcycline, tetracycline, trimethoprim sulfamethoxazole and urinary anti-infectives. These results provides strong support for strengthening overall disinfection/sterilization practices around medical equipment use in public health facilities in Uganda. There’s also need for further research to make a direct link to the bacterial isolates identified and cases of infections recorded among patients in similar settings.
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影响因子：
4.3
作者：
Fiore M;Maraolo AE;Gentile I;Borgia G;Leone S;Sansone P;Passavanti MB;Aurilio C;Pace MC
通讯作者：
Pace MC
影响因子：
6.9
作者：
Loveday, H. P.;Lynam, S.;Wilson, J.
通讯作者：
Wilson, J.
影响因子：
4.5
作者：
Atif, Mohamed Lamine;Sadaoui, Fetta;Boubechou, Nora
通讯作者：
Boubechou, Nora
影响因子：
3
作者：
Brook, I
通讯作者：
Brook, I
影响因子：
2.5
作者：
Emmerling, Dane;Dahinten, Alexander;Malkin, Robert A.
通讯作者：
Malkin, Robert A.