Appraisal and prospective analysis of bacteriological surveillance of operation theatres of Integral Institute of Medical Sciences & Research, Lucknow

Health care-associated infections are serious health hazard as it increases patient’s morbidity and mortality, length of hospital stay and the costs associated with hospital stay. At any given time, 7% hospitalized patients in developed and 10% in developing countries acquire at least one nosocomial infection. The environment in the hospital plays an important role in the occurrence of hospital acquired infection (WHO 2002, General Guidelines on Prevention and control of HAI).

AIMS AND OBJECTIVES-Purpose of our study was to find out prevalence rate of microorganisms and contamination rate of various sites in Operation Theatre and type of bacterial contamination for instituting effective preventive measures and thereby reducing the mortality and morbidity caused by Hospital acquired infection.

Materials & Methods

Samples were collected in a year period from july2018 to june 2019 and processed in Microbiology department of Integral Institute of Medical Sciences and Research, Lucknow (U.P.) India.

COLLECTION OF SAMPLES

All samples were taken just before proper sterilization and disinfection of the Operation thetares . ICUs and LRs before the entry of surgery and support team.All aseptic precautions were taken while collecting the samples.

Two sampling procedures were used in this study-

1. Settle plate method for air sampling and

2. Swab method for surface sampling.

. Samples were taken from floor , wall ,table and light of operation theatres. All samples were labeled properly and immediately transported to the Microbiology laboratory.

LABORATORY DIAGNOSIS:-

1) Culture-

Swabs taken from different sites were inoculated on Blood agar,

MacConkey agar or CLED agar and incubated at 37°C for 18-24h underaerobic condition. Further tests for their isolation and identification weredone by conventional methods(Mackie and McCartney Practical MedicalMicrobiology. 14th ed.).

2) Microscopy-Microscopic examination was done by making a smear from the colony and examining under oil immersion after the Gram staining.

3) Identification of isolates:-Identification of isolates were done on the basis of colony morphology, motility, catalase test, coagulase test, oxidase test and biochemical tests total of 2025 swab samples and 488 air samples were collected from eight Operation Theatres.

Among various Operation theatres, Septic OT showed highest non-permissible report (48%) followed by General surgery (42.3%), Orthopaedics OT (36.5%), and OBG (33.3%), ENT (27.5%) and EYE OT (23.5%) were least contaminated.

In surface sampling of various OTs, ASB (14.4%) was the most commonisolate followed by CoNS (4.6%), Micrococcus (4.4%) and S.aureus (4.1%) . S.aureus was found predominant pathogenic organism colonizing floors and walls while CoNS was predominant pathogen colonizing table and light.

Among the various surfaces of OTs, OT tables were found highly contaminated followed by wall.

The reason might be due to the frequent touching of OT table by staffwith/without wearing gloves or ignoring indications of glove removal and direct exposure of OT table with the patients. The tendency of people leaning against the wall might be one of the reasons of contaminating it.

In our study, bacterial count was high in Septic OT followed by bothsurgery, Orthopaedics and Obstetrics and gynaecology .

Some bacteria isolated from the environment could be derived from thepatient’s skin, which could play an important role in the development ofnosocomial infections