INDOOR AIR MICROBIAL LOAD, ASSOCIATED FACTORS AND ANTIBIOTIC SUSCEPTIBILITY PATTERNS OF BACTERIA IN DIFFERENT WARDS OF ARBA MINCH GENERAL HOSPITAL, ARBA MINCH, SOUTHERN ETHIOPIA

Abstract

Background: The level of indoor air microbial load in hospitals is very crucial with regard to the health of patients and health care workers. If it is not regularly monitored and maintained in an acceptable level, it may result in the outbreak of infections. But this problem remains ignored, particularly in developing countries including Ethiopia. Studies done so far in this context are limited. Objective: The study is designed to determine the indoor air microbial load, associated factors, microbial isolates and bacterial susceptibility patterns in different wards of Arba Minch General Hospital, Arba Minch, southern Ethiopia, 2021. Methodology: A hospital-based cross sectional study was conducted from 1st February to 30th April 2021. A total of 120 settle plates each for bacteria and fungi were collected from 7 wards by the settle plate technique. Sheep blood agar and Sabouraud dextrose agar were respectively used for the isolation/enumeration of bacteria and fungi. The isolated microbes were further identified by standard microbiological techniques. Kirby-Bauer disc diffusion method was used to perform the antimicrobial susceptibility testing, as per the Clinical laboratory standard institute guidelines. Relevant information related to the associated factors of indoor air microbial load was collected by means of observational check lists. Descriptive statistics and multivariate logistic regression analysis were done by SPSS version 25. P-value <0.05 in multivariable analysis were considered as statistically significant. Finally, the results were displayed as texts and tables. Results: The total average bacterial and fungal load of the selected wards were 1914±1081.4 CFU/m3 (95% CI: 1718.5-2109.48 CFU/m3 ) and 1533.7±858.8 CFU/ m3 (95% CI: 1378.5-1688CFU/m3 ) respectively. The highest mean bacterial (1914±1081.4CFU/m3 ) and fungal (1533.7±858.8 CFU/m3 ) loads were found in male surgical and the female medical wards respectively. A total of 229 bacterial and 139 fungal isolates were obtained. Gram-positive bacteria were the predominant type, 130 (56.7%), particularly the isolates of Staphylococcus aureus 46 (20.1%), coagulase negative staphylococcus 40(17.5%), and Enterococcus sp., 22 (9.6%). The predominant fungal isolates were Aspergillus sp. 53(38%), Penicillium sp., 42(30.2%) and Candida albicans 28(20.1%). Percentages of multiple drug resistant, extended spectrum beta-lactamase and carbapenemase producers respectively were 48.5%, 26.5% and 25%. High room crowd index [p=0.003; AOR 12.5 (CI 95%: 2.42- 65)], presence of damp/wet materials [p=0.025; AOR 7 (CI 95%: 1.3- 37.4)], high room traffic [p=0.004; AOR 9.6 (CI 95%: 1.2- 79.3)], inappropriate storage of food and drugs [p=0.008; AOR 7.5 (CI 95%: 1.7- 32)], and unclean environment [p=0.03; AOR 5.8 (CI 95%: 1.2- 28)] showed statistical significance with regard to the indoor air microbial loads. Conclusions: Indoor air microbial load in AMGH is in a moderate level compared to other studies done in Ethiopia. As per the WHO and the European Commission standards on indoor air microbial load, most of the wards in AMGH stand at a high and not in an acceptable level. Therefore, a periodic air surveillance and infection prevention control programs are required to avoid the transmission of these microbes to the inpatients.