Maternity and labor wards in public health facilities, which appear to be visibly clean, may not be free of bacterial contamination, a Gujarat-based study by researchers from the Indian Institute of Public Health Gandhinagar (IIPH-G ) and other public bodies. health institutes.
No less than 195 swab samples collected from various surfaces such as beds, mops, sink faucets, instruments, buckets, from maternity wards in 10 health care facilities in Gujarat – namely six centers of primary health centers (PHC) where at least 15 deliveries are carried out per month and four community health centers where at least 30 deliveries are carried out per month — were sampled from three key areas — labor wards, maternity wards and wards generals.
The result is concerning not only because 36 of the 195 swab samples (18.5%) show bacterial contamination in the selected sites, with the highest contamination observed in the labor rooms, followed by the maternity ward, then the general room, and higher contamination in items such as mops and beds, but also bacterial specimens showed high resistance against antibiotics.
The most prevalent bacterium found at contaminated sites with maximum antibiotic resistance was Pseudomonas aeruginosa, considered one of the most common gram-negative bacteria causing nosocomial infections, especially in hospitalized patients.
Pseudomonas aeruginosa is thought to be associated with puerperal sepsis, which is an infection of the genital tract occurring any time between the onset of rupture of membranes or labor and day 42 postpartum.
“The pathogen is responsible for serious infections, mainly in immunocompromised patients, causing bacteraemia, complicated intra-abdominal or urinary infections and ventilator-associated pneumonia. The presence of these microorganisms on high-touch surfaces such as faucets thus represents the source of transmission via multiple routes to patients and can result in life-threatening infections,” the study notes.
Acinobacter, which was the second most prevalent pathogen observed at sampled sites, was found in swab samples from the labor room bed and sink faucet. Although he remained sensitive to antibiotics, it is important to note that Acinetobacter species are responsible for healthcare-associated infections and “can cause severe pneumonia and infections of the urinary tract, bloodstream and certain other parts of the body”, with the survival rate of Acinetobacter species on surfaces in hospitals being relatively high, surviving in dry environments for weeks.
The mechanism of attack of this bacterium is through wounds and invasive devices, which poses a risk to new mothers and newborns by its very presence in healthcare facilities.
Other contaminating bacteria found at the sites sampled were E coli and Klebsiella species, of which E. Coli was found to be susceptible to antibiotics, but Klebsiella was found to be resistant to some antibiotics commonly used to treat urinary tract infections and respiratory infections .
As the study, published in the monthly journal “Healthcare” under MDPI on March 30, notes, “A recent study reports the predominance of Klebsiella pneumoniae and E. coli isolates in most patients with urinary tract infection ( UTI) in pregnant women… UTI during pregnancy is associated with complications for the mother and the fetus before and after delivery such as pyelonephritis (kidney infection), sepsis, septic shock, anemia, acute and chronic renal failure, premature delivery and fetal death Antimicrobial resistance is a major health concern in the treatment of urinary tract infections.
The study, supported by the Center for Environmental Health (CEH) of the Public Health Foundation of India (PHFI), was authored by researchers from the Department of Public Health Sciences at IIPH-G, Parul Institute of Public Health at Parul University in Vadodara and School of Epidemiology and Public Health at Datta Meghe Institute of Medical Sciences in Wardha.
The study is gaining importance because most research on nosocomial infections has been conducted in the context of intensive care units and operating theaters around the world, and there has been a lack of data specifically from theaters. work and maternity.
As the study notes, “Microbial safety priority for healthcare facilities should be more focused rather than the visual cleanliness proxy of hygiene considered so far. Microbiological monitoring should be an essential part of the infection control program and WASH (water, sanitation and hygiene) practices in healthcare facilities. Microbiological surveillance as well as monitoring of antimicrobial resistance patterns will help identify infection and resistance trends in advance. The increase in institutional birth rates in Gujarat means that it must be emphasized that the hospital environment cannot alter clinical outcomes unless the quality of care is more focused.