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BACKGROUND: The environmental matrices (water, air, and surfaces) play a vital role as reservoirs of Legionella spp. and Pseudomonas aeruginosa (Pseudomonas spp.). Hence, hospital environment control procedures are effective measures for reducing nosocomial infections. AIMS: This study was carried out to explore the profiles of microorganisms in air culture at various wards/units of a tertiary care hospital in Nepal. METHODS: A descriptive cross-sectional study was carried out at various wards/units of a tertiary care hospital in Nepal between January and September 2015 to explore the microbiological burden in inanimate objects. Each week one ward or unit was selected for the study. Bed, tap, the entire room, trolley, computer, phone, rack handles, table, chair, door, stethoscope, oxygen mask, gown, cupboard handles, and wash basins were selected for air culture testing. Ten different wards/units and 77 locations/pieces of equipment were selected for air culture by employing a simple random sampling technique. Information about the organisms was entered into the Statistical Package for the Social Sciences (SPSS) Version 22 (IBM: Armonk, NY) and descriptive analyses were carried out. RESULTS: Staphylococcus aureus (S. aureus), Micrococcus, coagulase negative staphylococcus (CONS), Bacillus, Pseudomonas aeruginosa, yeast, and Acinetobacter were the most commonly detected organisms. In the postoperative ward, S. aureus was the most frequently detected microorganism. Micrococcus was detected in four out of 10 locations. In the x-ray unit, S. aureus was detected in three out of four locations. CONCLUSION: S. aureus, Micrococcus, CONS, Bacillus, Pseudomonas, yeast, and Acinetobacter were the most common organisms detected.
RESUMEN
BACKGROUND: Healthcare waste is produced from various therapeutic procedures performed in hospitals, such as chemotherapy, dialysis, surgery, delivery, resection of gangrenous organs, autopsy, biopsy, injections, etc. These result in the production of non-hazardous waste (75-95%) and hazardous waste (10-25%), such as sharps, infectious, chemical, pharmaceutical, radioactive waste, and pressurized containers (e.g., inhaler cans). Improper healthcare waste management may lead to the transmission of hepatitis B, Staphylococcus aureus and Pseudomonas aeruginosa. METHODS: This evaluation of waste management practices was carried out at gynaecology, obstetrics, paediatrics, medicine and orthopaedics wards at Government of Nepal Civil Service Hospital, Kathmandu from February 12 to October 15, 2013, with the permission from healthcare waste management committee at the hospital. The Individualized Rapid Assessment tool (IRAT), developed by the United Nations Development Program Global Environment Facility project, was used to collect pre-interventional and post-interventional performance scores concerning waste management. The healthcare waste management committee was formed of representing various departments. The study included responses from focal nurses and physicians from the gynaecology, obstetrics, paediatrics, medicine and orthopaedics wards, and waste handlers during the study period. Data included average scores from 40 responders. Scores were based on compliance with the IRAT. RESULTS: The waste management policy and standard operating procedure were developed after interventions, and they were consistent with the national and international laws and regulations. The committee developed a plan for recycling or waste minimization. Health professionals, such as doctors, nurses and waste handlers, were trained on waste management practices. The programs included segregation, collection, handling, transportation, treatment and disposal of waste, as well as occupational health and safety issues. The committee developed a plan for treatment and disposal of chemical and pharmaceutical waste. Pretest and posttest evaluation scores were 26% and 86% respectively. CONCLUSIONS: During the pre-intervention period, the hospital had no HCWM Committee, policy, standard operating procedure or proper color coding system for waste segregation, collection, transportation and storage and the specific well-trained waste handlers. Doctors, nurses and waste handlers were trained on HCWM practices, after interventions. Significant improvements were observed between the pre- and post-intervention periods.