Abstract
Hygiene practices has been a matter of concern in the healthcare system in South Africa and across the world. The patient environment in healthcare settings has continually proven to be a reservoir of potentially harmful and even lethal multi-drug resistant organisms (MDROs). Hand hygiene is the primary element of infection control activities that should be performed in order to reduce cross-contamination. Lack of proper hand hygiene leads to contamination of surfaces by healthcare workers, patients and visitors. Nevertheless, recent studies indicate that on average only 30-50% of healthcare professionals comply with hand washing protocols. To this end, no study has been conducted at the Homeopathic Health Training Centre (HHTC), at the University of Johannesburg, South Africa. Therefore, this study provides an initiative to investigate surface hygiene in the HHTC; to determine if there are any pathogens that could possibly lead to nosocomial infections. This is necessary since nosocomial infections can worsen the patients’ presenting complaints or even act as an obstacle to cure. This study was an exploratory study with a quantitative research design using objective (microbial enrichment) data to evaluate the surface hygiene in the HHTC. Seven (7) consulting rooms in the HHTC at the University of Johannesburg (UJ) Doornfontein campus that are frequently used by practitioners and their patients were assessed. Samples were collected from the surface areas of vinyl beds (n=21), wooden tables (n=21), steel cupboards (n=14) and steel cabinets (n=21), within each room. Therefore, the total number of surfaces sampled was n=77. Surface samples were taken using bioMerieux CountTact range. The samples were obtained by briefly depressing the 65mm vii irradiated CT3P agar contact plates for 10 seconds under 500g pressure with the Count-Tact® applicator over the three standardized areas for the tables, beds and steel cupboards and two standardized areas for the steel lockers. One sample of each set was incubated for up to 3 days (for bacteria) and the other incubated for up to 5 days (for fungi). The samples were taken after the clinic’s normal hours of operation so that none of the patients, students, or clinicians were aware of the study and thus could not change their normal habits. Colonies per plate (25cm) were counted and the results in colony forming unit (CFU) per cm were reported. Bacteria isolates were identified via the VITEK instrument and the fungal isolate were sent to the University of Free State for identification through sequencing. The result of the surface sampling demonstrated that all of the surfaces sampled at the HHTC contained microorganisms, with the highest bacterial counts on tables and fungal counts on beds. The results also highlighted that the surfaces are indeed a potential reservoir of bacteria such as; Staphylococcus haemolyticus, Staphylococcus lentus, Bacillus spp., Kocuria spp., Micrococcus luteus, Sphingomonas paucimobilis and Gardnerella vaginalis, as well as fungi such as; Aspergillus spp., Fusarium spp., Cladosporium spp. and Penicillium. These findings are consistent with the studies done at the Chiropractic UJ Clinic. Although most of the microorganisms isolated on the surfaces were harmless skin bacteria and/or environmental fungi, they are opportunistic which pose a direct threat to the patients, practitioners and possibly the community. Disinfection protocols must therefore address removal of microorganisms from these surfaces to prevent potential horizontal transmission or nosocomial acquisition.
M.Tech. (Homoeophathy)