CHAPTER FIVE - MEDICAL LABORATORY TECHNOLOGIST



REPUBLIC OF CAMEROON REPUBLIQUE DU CAMEROUN

Peace-Work-Fatherland Paix-Travail-Patrie

MINISTRY OF PUBLIC MINISTERE DE LA SANTE

HEALTH PUBLIQUE

CATHOLIC SCHOOL OF HEALTH SCIENCES SHISONG

DEPARTMENT OF MEDICAL LABORATORY TECHNOLOGY

BACTERIOLOGICAL ANALYSIS OF HOSPITAL EQUIPMENT/INSTRUMENTS AND MATERIALS FOR NOSOCOMIAL INFECTIONS AT THE ST. ELIZABETH’S GENERAL HOSPITAL AND CARDIAC CENTRE SHISONG

A Dissertation Submitted In Partial Fulfilment of the Requirements for the Award of a Diploma in Medical Laboratory Technology

Presented by

Nicoline Afungndang

Supervisor:

Mr. Chem Elvis Nzelamonyuy

B.Sc (Hons) Microbiology

Shisong,

July, 2011

DECLARATION

This is to declare that this dissertation was carried out and written by me and that it is an authentic record of my work. No part of this dissertation has been submitted in any form elsewhere for the award of a Diploma, Certificate or Degree.

______________ ______________

Nicoline Afungndang Date

CERTIFICATION

This is to certify that the dissertation “BACTERIOLOGICAL ANALYSIS OF HOSPITAL EQUIPMENT/INSTRUMENTS AND MATERIALS FOR NOSOCOMIAL INFECTIONS AT THE SAINT ELIZABETH’S CATHOLIC GENERAL HOSPITAL AND CARDIAC CENTRE SHISONG” is an authentic record of work conducted by Nicoline Afungndang under my supervision at the Catholic School of Health Sciences Shisong as part of the requirements for the award of a Diploma in Medical Laboratory Technology.

________________ _______________

Mr. Chem Elvis Nzelamonyuy Date

Supervisor

_______________ ______________

Mr. Nulah Gabriel Date

Principal

DEDICATION

This piece of work is dedicated to;

➢ God Almighty whose loving kindness and tender mercies have made me what I am today.

➢ My parents Mr./Mrs Nwatum Maboh who were determined to make me know how to read and write.

AKNOWLEDGEMENTS

My profound gratitudes go to the following who made valuable contributions to the realization of this project;

Special thanks go to my Supervisor Mr. Chem Elvis Nzelamonyuy who sacrificed his time and energy to go through this work making all the necessary corrections and amendments and final editing of this work. May God replenish his efforts.

Many thanks go the matron of the Saint Elizabeth’s Catholic General Hospital for permitting me carry out this study in her institution.

The Director of the Catholic School of Health Sciences Shisong Mr. Nulah Gabriel and his vice Mr. Ndiyung Donatus who gave me the authorization to carry on this work and the great work they are doing to see that this institution maintains its qualities.

Immense thanks go to my teachers both in the laboratory and nursing sections especially Sr. Lilian Limunga Che, Mr. Shey Godfrey and Mr. Tekwe Sylvanus for the knowledge they gave me which enabled me to put down this write - up.

Great thanks go to the workers of the hospital laboratory for teaching, correcting and moulding me up ensuring that I become a good laboratory technician in future.

I would also thank the ward charges and nurses in the various wards for their maximum cooperation during the time of specimen collection in the wards.

Special thanks go to my sisters Grace Ngekwi, Alice Ngefah, Stella Sefeh, Mercy Ntumnyui and brother Amos Maboh for their enormous support, advice and encouragement through out my stay here in Shisong.

To all my friends and classmates who understood the meaning of being assistable and charitable, I say thank you.

ABSTRACT

This study aims to determine which equipment/instruments and materials in the hospital environment contributes to the introduction of bacteria associated with nosocomial infections, identify which bacteria pathogen is the most prevalent in nosocomial infections, to propose simple measures hospital administration can employ to reduce nosocomial infections and to evaluate the level of sterilization of hospital equipment/instruments that are used directly on patients during nursing care.

It was a prospective hospital based research carried out in the laboratory from 1st December 2010 to 30th June 2011. Swab specimens collected from surgical instruments like forceps, kidney dishes, gauze just to name a few, door knobs, sink trap, sink handles, toilet surfaces from the various wards of the hospital were analyzed for bacterial contamination.

A total of 138 samples were collected and analyzed and bacteria growth gave a prevalence of 34.1%. Sink traps, toilet surfaces and door knobs showed the highest prevalence of 18.11%, 10.9% and 5.8% respectively. Staphylococcus aureus was the most prevalent isolate (50.7%) followed by Escherichia coli (5.8%) and least prevalent was Serratia species (1.4%).

It was then concluded that nosocomial infections were common among the instruments/equipment and materials in the hospital and strict measures of infection control/prevention should be practiced in all the wards to break the link between patients and nosocomial pathogens.

TABLE OF CONTENTS

Page Numbers

Title page……………………………………………………. i

Declaration………………………………………………….. ii

Certification…………………………………………………. iii

Dedications………………………………………………….. iv

Acknowledgments…………………………………………… v

Abstract………………………………………………………. vi

Table of contents………………………………………….….. vii

List of Tables…………………………………………………. ix

List of Figures………………………………………………… x

List of abbreviations………………………………………….. xi

CHAPTER ONE

1. Introduction……………………………………….….. 1

1. Background Information………………………….….. 2

2. Statement of the Problem…………………………….. 3

3. Purpose…………………………………………….…. 5

1.3.1 Goal…………………………………………………… 5

1.3.2 Objectives…………………………………………….. 5

4. Significance of the Study……………………………… 6

5. Research Question and Hypotheses…………………… 6

CHAPTER TWO

2. Introduction to Nosocomial Infections……………….. 7

1. Types of Nosocomial Infections…………………………. 7

2. Laboratory Diagnosis of Nosocomial Infections……… 16

3. Factors Influencing the Development of NS………….. 20

4. Sources of Nosocomial Infections…………………….. 23

5. Prevention and Control of Nosocomial infections………. 24

2.6 Definition of Terms…………………………………… 28

CHAPTER THREE

3. Introduction…………………………………………… 30

1. Research Type and Time Line………………………… 30

2. Study Area…………………………………………….. 30

3. Ethical consideration………………………………….. 31

4. Materials and Reagents…………………………….…. 31

5. Sample Collection and Examination…….……………. 33

6. Biochemical tests done on Isolates……………………. 35

7. Preparation of Reagents……………………………….. 38

8. Quality Control………………………………………… 44

9. Limitations and Delimitations…………………………. 44

CHAPTER FOUR

4. Introduction……………………………………………. 45

1. Analysis………………………………………………… 46

CHAPTER FIVE

5. Discussion……………………………………………. 54

1. Conclusion……………………………………………. 55

2. Recommendations……………………………………. 56

References……………………………………………. 57

Appendix I…………………………………………… 59

Appendix II…………………………………………… 60

LIST OF TABLES

TABLES Page Numbers

I Overall percentage of bacterial isolated…………….…… 46

II Prevalence according to departments……………….…… 46

III Department versus bacteria species isolated……...…… 48

IV Prevalence according to materials……………...……… 49

V Materials analysed versus bacteria species isolated……. 51

VI Prevalence of individual bacteria isolates………………….52

LIST OF FIGURES

FIGURES Page Numbers

1. Percentage of Nosocomial infections by site……… 8

2. Prevalence according to department………………. 47

3. Prevalence according to materials………………… 49

4. Prevalence of individual bacterial isolated………… 52

LIST OF ABBREVIATIONS

PICU:- Pediatric Intensive Care Unit

NICU:- Neonatal Intensive Care Unit

WHO:- World Health Organisation

ICU:- Intensive Care Unit

CDC:- Centre for Disease Control

BSI:- Blood Stream Infections

UTI:- Urinary Tract Infections

SSI:- Surgical Site Infections

MRSA:- Methicillin Resistant Staphylococcus aureus

CLED:- Cystine Lactose Electrolyte Deficient

GIT:- Gastro- Intestinal Tract

SECGH:- Saint Elizabeth’s Catholic General Hospital

BSI:- Blood Stream Infections

RTI:- Respiratory Tract Infections

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