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نوع مقاله : Research Paper

نویسندگان

1 دانشیار، گروه میکروب‌شناسی و ویروس‌شناسی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 دانشجوی دکتری باکتری شناسی، گروه میکروب شناسی و ویروس شناسی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

3 دانشجوی پزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

4 دانشیار، گروه بیماریهای عفونی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

5 استادیار، گروه پزشکی اجتماعی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

زمینه و هدف: عفونت‌های بیمارستانی همواره یکی از مشکلات عمده بهداشت و درمان می­باشد و روزبه‌روز بر اهمیت آن افزوده شده و چالشی برای نظام سلامت کشورها می­باشد. مطالعه حاضر با هدف بررسی میزان آلودگی در محیط و تجهیزات بیمارستان‌های قائم (عج) و امام رضا (ع) انجام شد.
مواد و روشها:این مطالعه مقطعی در دو بیمارستان دانشگاهی مشهد انجام شد. نمونه‌برداری به‌روش در دسترس از محیط و سطوح بخش‌های بالینی مختلف انجام گردید. تعداد و بازه نمونه‌برداری متغیر و بر اساس خط‌مشی کنترل عفونت هر بیمارستان در هر بخش تعیین شده بود. محل جمع‌آوری نمونه‌های محیطی شامل آب، سینک، تخت بیمار و انکوباتورها بود. نمونه­ها در محیط‌های کشت باکتری کشت داده شده و تعیین هویت گردید.
یافته‌ها: از 323 نمونه اخذ شده، 272 نمونه (84/2%) از بیمارستان قائم (عج) و 51 نمونه (15/8%) از بیمارستان امام رضا (ع) بود. 128مورد (47/1%) از نمونه‌های بیمارستان امام قائم و 17مورد (33/3%) از نمونه‌های بیمارستان امام رضا مثبت شدند (0/071=p). در مجموع بیشترین آلودگی مربوط به باسیلوس‌ها (16/7%)، استافیلوکوک اپیدرمیدیس (6/8%) و استافیلوکوک ساپروفیتیکوس (0/5%) بود. عوامل دیگر شامل استینوباکتر، انتروباکتر و سودوموناس بودند.
نتیجه‌گیری: گونه­ های باسیلوس به‌دلیل اسپور ماندگاری بالایی در محیط دارند و حذف آنها شاخصی از بهداشت محیط مناسب خواهد بود. وجود باکتری‌های بالقوه بیماری‌زا در محیط بیمارستان، اهمیت برنامه­ های کنترلی و نظارتی بهداشت محیطی را آشکار می­سازد.

کلیدواژه‌ها

عنوان مقاله [English]

Investigation of microbial contamination in air and interior surfaces of two teaching hospitals of Mashhad University of Medical Sciences

نویسندگان [English]

  • Masoud Yosefi 1
  • Faria Hasanzadeh 2
  • Adeleh Tabatabei Zadeh 3
  • Hamid Reza Naderi 4
  • Majid Khadem Rezaiyan 5

1 Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 PhD candidate of Microbiology, Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Medical Student, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Department of infectious diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

چکیده [English]

Abstract
Background and Aim: Nosocomial infections have always been one of the major health problems, and it is becoming increasingly important and a challenge for the health system of different countries. In this study, the contamination in the environment and equipment of two hospitals of Mashhad were studied.
Methods: This cross-sectional study was performed in two academic hospitals. The sampling method was convenient based on policy of infection control committee of each hospital. Environmental samples were collected from water, sink, patient bed and incubators. Samples were cultured in bacterial culture media and phenotypically identified. .
Results: Out of 323 samples, 272 (84.2%) were from Qaem Hospital and 51 (15.8%) from Imam Reza Hospital. Overall, 47.1% of samples of Imam Ghaem hospital (128 samples) and 33.3% of samples of Imam Reza hospital (17 samples) were positive (p = 0.071). Overall, the most prevalent organisms were Bacillus (54 samples, 16.7%) followed by Staphylococcus epidermidis (22 samples, 6.8%) and Staphylococcus saprophyticus (16 samples, 0.5%). Others were consisted of Acinetobacter, Enterobacter and pseudomonas spp.
Conclusion: Bacillus species have a high persistence in the environment due to Sporulation and their removal will be an indicator of proper environmental health. The presence of potentially pathogenic bacteria in the hospital environment reveals the importance of environmental health control and monitoring programs.
 

کلیدواژه‌ها [English]

  • nosocomial infection
  • hospital contamination
  • Mashhad
1.          Zazouli M-A, Yazdani-charati J, Ahanjan M, Eslamifar MJJoHitF. Bacterial contamination of environmental surfaces in two educational hospitals under the auspices of Mazandaran University of Medical Sciences. 2017;3(1).
2.          Mamishi S, Pourakbari B, Teymuri M, Babamahmoodi A, Mahmoudi SJOph, perspectives r. Management of hospital infection control in Iran: a need for implementation of multidisciplinary approach. 2014;5(4):179-86.
3.          Lobdell KW, Stamou S, Sanchez JA. Hospital-acquired infections. Surgical Clinics. 2012;92(1):65-77.
4.          com/d2qwn9m WHOJNht. Health care-associated infections fact sheet. 2016.
5.          Haque M, Sartelli M, McKimm J, Bakar MA. Health care-associated infections–an overview. Infection and drug resistance. 2018;11:2321.
6.          Pittet D, Allegranzi B, Boyce J, Control WHOWAfPSFGPSCCGoEJI, Epidemiology H. The World Health Organization guidelines on hand hygiene in health care and their consensus recommendations. 2009;30(7):611-22.
7.          Askarian M, Mahmoudi H, Assadian OJIjopm. Incidence of nosocomial infections in a big university affiliated hospital in Shiraz, Iran: A six-month experience. 2013;4(3):366.
8.          Ahoyo TA, Bankolé HS, Adéoti FM, Gbohoun AA, Assavèdo S, Amoussou-Guénou M, et al. Prevalence of nosocomial infections and anti-infective therapy in Benin: results of the first nationwide survey in 2012. 2014;3(1):17.
9.          Boyce JM. Environmental contamination makes an important contribution to hospital infection. Journal of hospital infection. 2007;65:50-4.
10.        Noroozi R, MohammadHadi MH, Zafarzadeh A, Salehi L, Abasi ZJJoEHE. Assessment of Microbial Contamination of Surfaces and Medical Equipment in Wards of the Panjom Azar Hospital of Gorgan in 2014. 2014;1(3):216-24.
11.        Lee M, Chiu C, Chow V, Lam R, Lai RJJoHI. Prevalence of hospital infection and antibiotic use at a university medical center in Hong Kong. 2007;65(4):341-7.
12.        Bijari B, Abbasi A, Hemati M, Karabi KJIJoMM. Nosocomial infections and related factors in southern khorasan hospitals. 2015;8(4):69-73.
13.        Tolabi T AF, Payamani SH. Evaluation of compliance of general principles of prevention of nosocomial infections in hospitals Khorramabad2004-2005. Scientific Journal of Lorestan University of Medical 2006;8:37-46.
14.        Perdelli F, Cristina M, Sartini M, Spagnolo A, Dallera M, Ottria G, et al. Fungal contamination in hospital environments. Infection Control & Hospital Epidemiology. 2006;27(1):44-7.
15.        Sattar SJJoHI. Microbicides and the environmental control of nosocomial viral infections. 2004;56:64-9.
16.        Weinstein RA, Hota B. Contamination, disinfection, and cross-colonization: are hospital surfaces reservoirs for nosocomial infection? Clinical infectious diseases. 2004;39(8):1182-9.
17.        Karami G, Emtiyazipoor Z, Rasuli Ravandi F, Khazei MJTJoUN, Faculty M. EVALUATING THE EFFECT OF HOSPITAL MEDICAL INSTRUMENTS ON THE NOSOCOMIAL INFECTION RISK. 2015;13(7):579-87.
18.        Vandijck DM, Labeau SO, Vogelaers DP, Blot SI. Prevention of nosocomial infections in intensive care patients. Nurs Crit Care.15(5):251-6.
19.        Fernstrom A, Goldblatt M. Aerobiology and its role in the transmission of infectious diseases. Journal of pathogens. 2013;2013.
20.        Best E, Parnell P, Couturier J, Barbut F, Le Bozec A, Arnoldo L, et al. Environmental contamination by bacteria in hospital washrooms according to hand-drying method: a multi-centre study. Journal of Hospital Infection. 2018;100(4):469-75.
21.        Chaoui L, Mhand R, Mellouki F, Rhallabi N. Contamination of the surfaces of a health care environment by multidrug-resistant (MDR) bacteria. International journal of microbiology. 2019;2019.
22.        Kim YA, Lee H, Lee K. Contamination of the hospital environmental by pathogenic bacteria and infection control. Korean Journal of Nosocomial Infection Control. 2015;20(1):1-6.
23.        Talon D. The role of the hospital environment in the epidemiology of multi-resistant bacteria. Journal of Hospital Infection. 1999;43(1):13-7.
24.        Park SH. Management of multi-drug resistant organisms in healthcare settings. Journal of the Korean Medical Association. 2018;61(1):26-35.
25.        Ghanizadeh G, Mirmohammadlou A, Esmaeili D. Survey of legionella water resources contamination in Iran and foreign countries: A Systematic Review. Iranian Journal of Medical Microbiology. 2016;9(4):1-15.
26.        Ahmadi E, Ghazvini K, Yekta-Roudi H, Najafpoor A, Ghaderifar S, Youssefi M. Factors Affecting Hospital Water System Contamination with Legionella pneumophilain Northeast of Iran. J Appl Environ Biol Sci. 2017;7(1):105-10.
27.        Rafla K, Tredget EE. Infection control in the burn unit. Burns. 2011;37(1):5-15.
28.        Hanberger H, Arman D, Gill H, Jindrák V, Kalenic S, Kurcz A, et al. Surveillance of microbial resistance in European Intensive Care Units: a first report from the Care-ICU programme for improved infection control. Intensive care medicine. 2009;35(1):91-100.
29.        Różańska A, Romaniszyn D, Chmielarczyk A, Bulanda M. Bacteria contamination of touch surfaces in Polish hospital wards. Medycyna pracy. 2017;68(4).
30.        Esfeden ZB, Moghanni M, Eslami R, Noori M, Ahmadi S, Naderi E. Study of bacterial contamination in different parts of the center Educational and therapeutic center in Qaen Shohada Hospital during the years 2011-2016. 2018.
31.        Young JM, Naqvi M, Richards LJAjoic. Microbial contamination of hospital bed handsets. 2005;33(3):170-4.
32.        YOUSEFI MR, HAIDAR BZ. Survey on microbial contamination of intensive care wards of hamadan hospitals. 2001.
33.        Glasset B, Herbin S, Granier SA, Cavalié L, Lafeuille E, Guérin C, et al. Bacillus cereus, a serious cause of nosocomial infections: epidemiologic and genetic survey. 2018;13(5):e0194346.
34.        Saito N, Kondo J, Haruki S, Itoga M, Yamamoto A, Kimura M, et al. Possible involvement of reusable towels in the high rate of Bacillus species-positive blood cultures in Japanese hospitals. 2016;22(2):96-101.
35.        Jalalpoor S, Abousaidi H. Survey Role and Important of Surfaces Structure and β-lactamase of Bacillus cereus in Drug Resistant. 2009.
36.        Organization WH. Prevention of hospital-acquired infections: a practical guide. Geneva, Switzerland: World Health Organization; 2002.