dc.description.abstract | BACKGROUND
Nosocomial infections in newborn units pose a great challenge to health care systems. They
have been linked to contaminated surfaces and equipment in neonatal wards. The sources and
spread of the infections are mainly attributed to contamination of fomites within the hospital
environment.
OBJECTIVE
To investigate the bacterial contamination profile of surfaces and equipment in the newborn
unit (NBU) of Kenyatta National Hospital (KNH) and determine the antimicrobial
susceptibility pattern of selected potentially pathogenic bacteria, which include E. coli, S.
aureus, Coagulase-negative staphylococci (CoNS), K. pneumoniae, and P. aeruginosa.
METHODS
A cross-sectional study was conducted in the NBU of KNH. Samples from surfaces and
equipment were systematically collected from NBU until the required sample size was
obtained. All the steps of sample collection and inoculation were carried out using aseptic
techniques and transported to the Microbiology Laboratory of the University of Nairobi
(UON) within 1- 2 hours of collection for analysis. Samples were cultured on selective and
non-selective media. Phenotypic identification of the isolates was based on colonial
morphology, gram staining, and biochemical tests. Antimicrobial susceptibility testing for
selected bacteria was determined using the Kirby-Bauer disk method. Univariate and
bivariate analyses were done using IBM® SPSS® software version 21.0 and data were
presented in tables and graphs.
RESULTS
A total of 580 swabs were collected from surfaces and equipment in six different NBU
locations/rooms. Following inoculation on the culture plates, 273 (54%) swabs showed
growth. The majority of the positive bacterial cultures, 137/273 (50.2%), were coagulasenegative
staphylococcus (CoNS). Others were: Klebsiella pneumoniae, 119/273 (43.6%);
Escherichia coli 16/273 (5.9%), and Pseudomonas aeruginosa 1/273 (0.4%). Equipment and
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surfaces with abundant growth included cots 55/273 (20%), radiant warmers 51/273 (19%),
oxygen masks 46/273 (17%), incubators 16/273 (6%), desk surfaces 29/273 (11%), sinks
24/273 (9%), door handles 17/273 (6%) and taps 16/273 (6%). Most of the isolates were
highly susceptible to meropenem, amikacin, and imipenem (70-100%) but resistant to
penicillin, clindamycin, and vancomycin (45-100%).
CONCLUSION AND RECOMMENDATIONS
The study determined that newborn environmental surfaces and equipment at the Kenyatta
National Hospital were contaminated with potentially pathogenic bacteria including CoNS,
K. pneumoniae, and E. coli. The majority of the isolated bacteria were sensitive to
meropenem, imipenem, and amikacin. All bacteria isolated had high resistance to penicillin,
vancomycin, and clindamycin. The identified potentially pathogenic bacteria isolated from
the NBU could be the source of infections to preterm and sick term neonate infants.
Therefore, this study recommends improved compliance with infection control practices
(hand hygiene, sterilization, and disinfection of patient-care items, devices, and
environmental infection prevention and control) in the NBU at KNH. | en_US |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |