OCCURANCE OF HOSPITAL ACQUIRED CONTAMINANTS ON INANIMATE OBJECTS IN GYNECOLOGY WARD IN SPECIALIST HOSPITAL, YOLA.

The World Health Organization (WHO) considers an establishment to be a hospital if it is permanently staffed at least one physician, can offer inpatient accommodation, and can provide active medical and nursing care (WHO, 2017). Hospital environments are places that need more attention because of the influx of people coming for medical checkup and other services in the environment. Patients and hospital staff get in contact with this environment every day and some of these patients may have little or no knowledge about the bacteriology of the hospital air and various surfaces that are potential source of infections. A hospital-acquired infection (HAI), also known as a nosocomial infection, is an infection that is acquired in a hospital or other healthcare facility. Such an infection can be acquired by susceptible patients in hospital, nursing home, rehabilitation facility, outpatient clinic, or other clinical settings by various means. Healthcare staff can spread infection, in addition to contaminated equipment, bed linens, or air droplets. The infection can originate from the outside environment, another infected patient, staff that may be infected, or in some cases, the source of the infection cannot be determined. In some cases, the microorganism originates from the patient’s own skin microbiota, becoming opportunistic after surgery or other procedures that compromise the protective skin barrier. Although the patient may have contracted the infection from their own skin, the infection is still considered nosocomial since it develops in the healthcare setting (Srikant et al., 2008). The main source of microorganism’s human beings as they are discharged through human activities like coughing, sneezing, laughing, and even talking (Klevens et al., 2007). Quantification of airborne microbial pathogens causing infections is a difficult matter and the hospital air quality assurances have no particular widely accepted standard. As many critical patients are treated in hospital, they may emit various microbes from their disease prospects like flu, tuberculosis, sepsis, burn injury, sample collecting areas and inward patient diagnosis department (Pallabi, 2018). Pathological microbes can transmit themselves from an infected patient to susceptible person via air and can initiate infection (Pallabi, 2018). Common air contaminants can affect hospitalized patients, with conditions like chemotherapy and transplantation recipient (Pallabi, 2018). Routine air quality assurance in hospital-based environment is required for providing a healthy environment to clinicians, patient’s relatives, the hospital staffs and daily wage workers; otherwise all the non-infected people have a chance to carry airborne microbial infection. Notably, hospital floors are often heavily contaminated (Shanom et al., 2015) but are not considered an important source for pathogen dissemination because they are rarely touched. However, floors are frequently contacted by objects that are subsequently touched by hands (eg, shoes, socks, slippers). In addition, it is not uncommon for high-touch objects such as call buttons and blood pressure cuffs to be in contact with the floor (authors’ unpublished observations). Therefore, we hypothesized that floors might be an underappreciated reservoir for pathogen transmission (Shanom et al., 2015). Nosocomial transmission of pathogens such as Clostridium difficile, methicillin-resistant Staphylococcus aureus, and Norovirus (Donskey, 2013) is done through floor. Efforts to improve disinfection usually focus primarily on surfaces that are frequently touched by the hands of healthcare workers or patients (eg, bed rails and call buttons) Bacteria from air can cause infection on patients with compromised immunity, especially when the patients come close a very close range (that is, neglecting physical distancing) to another individual who is a carrier of bacteria that are potential hospital acquired pathogens. So, exchange of gas due to respiration during conversation or exchange of pleasantry will pave way to inhale potential pathogen breathe out by another person at closed range (Anusree et al., 2015). Moreover, hospital environment and its air are inseparable from health care worker and patients, bacteriological assessments of the environment such as indoor air quality cannot be underestimated when it comes to human health. The bacteria that live in troposphere, stratosphere and even ionosphere are capable of causing indoor air pollution (Awosika, Olajubu, and Amusa, 2012; Tambekar, Gulhane, and Bhokare, 2007). Favorable temperature and poor air ventilation of indoors coupled with poorly designed structure gives an ample opportunity for microbial growth. It has been observed that Bacillus, Clostridium and Staphylococci are the most common bacteria isolated from indoor surfaces (Hayleeyesus and Manaye, 2014). Tambekar, Gulhane, and Bhokare (2007) report showed that bacteria can survive in both indoors and outdoors and the maternity and children hospitals. The most common type of HAI in children are bloodstream infections, pneumonia (ventilator-associated VAP), urinary tract infections (UTI), skin and surgical site infections. Organisms such as gram-negative bacilli, coagulase-negative staphylococci, coagulase-positive staphylococci, pseudomonas spp, and streptococcus are the main causes of HAI (Becerra et al., 2015) 1.2 Statement of the Problem Infections acquired from hospital are a significant health problem globally, and the majority of them, namely 60%, are attributed to drug-resistant pathogens (WHO, 2016). Although hands are considered the primary vector for the transfer of microbes in the hospital setting, contamination of indoor air and surfaces with pathogens may lead to the spread of nosocomial infections among immune-compromised or other groups of susceptible patients (Park et al., 2013). Airborne pathogens, which mainly originate from patients through cough droplets or skin squamae (Park et al., 2013), can colonize the air throughout patient care settings, and their survival depends on various environmental conditions (Saltriti et al., 2007). 1.3 Justification of the study HAI remain a major problem in the health care centers across the world and leads to high mortality. These infections cause death, failure of surgeries, rejection of transplanted organs, failure of chemotherapies and increasing costs for patients and health centers, a longer stay in the hospital and mental and emotional stress. Surveillance of pathogens in healthcare settings is important not only for academic/epidemiologic purposes but also for the health and safety of patients and healthcare workers. Implementation of control measures can significantly reduce the risk of dissemination of pathogens and the consequent incidence of hospital-acquired infections. Also routine assessment and determination of the quality of the air and surfaces in the hospital environment will help reduce nosocomial infections. 1.4 Aim and Objectives Aim The aim of this study is to assess the occurrence of bacteria in pediatric ward in specialist hospital, Yola. Objectives The objectives are: I. Isolation and Identification of bacteria contaminants II. Isolation and identification of fungal contaminants III. To determine the antibacterial and antifungal susceptibility pattern of the isolated bacteria and fungi.