Incidence of Microbial Pattern Pre and Post Infection Control Training at Newly Established Teaching Centre; Experience from Pakistan
Authors: Anwar Nida , Mahar Uzma , Fatima Naveena , Shamsi Tahir 
Published: November 2023

Abstract

Introduction
Healthcare associated infection (HAI) is global health problem and main reasons behind these infections are suboptimal infection control practices along with excessive antibiotics consumption [1]. On the other hand, environmental factors including inadequate ventilation, bed spacing, contaminated water supply, environmental surfaces and improper disposal of waste are other concerns. The HAI risk can be minimized by implementation of infection prevention and control program, which is comprised of activities directed to dig out problems and applying various techniques to bring about a change in healthcare workers attitude in order to improve infection control practices [2].In the last decade infection prevention and control at hospital has been significantly improved globally. Measures such as hand hygiene, environmental cleaning, culture based screening are implemented in order to minimize hospital stay, morbidity and mortality.

Objective
The study was conducted to compare the difference in infection control at our hospital before and after taking measurement at our newly established centre.

Material and Method
It was an analytical cross-sectional study carried out at our new campus. The study was conducted from February 2018 to January 2019.Ethical approval was taken from research committee prior to the study and informed consent was taken from the patients and staff. The study was fabricated in two phases i.e. initial and later six months of hospital establishment. Based on the results obtained in the initial six months, we assigned an infection control team, along with facilitation of training sessions for our staff. Culture samples were taken from patients, patient’s rooms, patient’s wards, accessories inside the patient’s room, from counters and corridors. Blood cultures were performed using the BACTEC blood culture system. Organisms were identified according to routine bacteriological procedures and disc diffusion method was used for interpreting antibiotic susceptibility. Data were included cultures reports taken from the laboratory. For statistical analysis, SPSS version 23.0 was used. Descriptive statistics was applied for categorical variables and Chi square test was used to observe the association with significance level as p=&lt;0.05.

Results
A total of 1151 cultures were sent including patients, staff and environmental cultures. Out of which 681 (59%) were sent in initial phase and 470 (41%) were sent in later phase. The number of samples sent in initial and later phase and its distribution is depicted in Table 1. The growth of organisms was observed in initial and later phase from the samples and it was found out that there was increased rate of fungal growth in environment cultures in initial and later phase. In majority of the patient’s samples, no bacterial growth was reported in initial and later phase. (Table 2)Overall, absence of any organisms was found to be statistically same in both phases. However, bacterial and fungal growth reduced in later than the initial phase and the reduction in fungal growth was statistically significant as shown in Table 3 The samples taken from the patients and environment in initial and later phase were compared and are depicted in table 4. The growth of organism from the environment, accessories inside the patient’s room, nursing counter, and patients was found statistically non-significant.

Conclusion
Our study revealed that the number of organisms isolated in initial phase was greater than the later phase but the reduction was not significant. Bringing about a change in healthcare workers attitude is always a big challenge. Constant reinforcement is impending for compliance of healthcare professionals towards infection control and prevention.

Referernces
1) Shelanah A. Fernando GT, Thomas G. Healthcare-acquired infections: prevention strategies. Int J Gen Med 2017; 47:1341-51.
2) Lee MH, Lee GA, Lee SH, Park YH. Effectiveness and core components of infection prevention and control programmes in long-term care facilities: a systematic review. J Hosp Infect 2019; 102: 377-393