Elema Teshome Bekele, Negeri Abebe Aseffa, Verstraete Lavuun, Desta Adey Feleke, Al-Mulla Taha, Goyol Kitka, Baye Kaleab
Center for Food Science and Nutrition, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Front Public Health. 2024 Dec 2;12:1478906. doi: 10.3389/fpubh.2024.1478906. eCollection 2024.
Inadequate water, sanitation and hygiene (WASH) in health facilities, and the low adherence to infection control protocols can increase the risk of hospital-acquired (nosocomial) infections (HAIs). The risk for HAIs can increase morbidity, and mortality, health care cost, but also contribute to increased microbial resistance.
The study aimed to assess WASH facilities and practices, and levels of nosocomial pathogens in selected health facilities in Oromia Region and Southern, Nations and Nationalities and Peoples (SNNPs) Region.
An observational cross-sectional study design was employed to assess the WASH facilities in health care in SNNPs (Bulle and Doyogena) and Oromia (Bidre) regions through interviews and direct observations ( = 26 facilities). Water and surface samples were collected from major hospitals and health centers. A total of 90 surface swabs and 14 water samples were collected identified, characterized and tested for antimicrobial susceptibility. Epi-info was used for data entry and the data was subsequently exported to Stata version 17 for data cleaning and analysis.
Water supply, toilet facilities, and waste management procedures were suboptimal (below the minimum standards of WHO). Only 11/26 of the health facilities had access to water at the time of the survey. The lowest hand-hygiene compliance was for Bidre (4%), followed by Doyogena (14%), and Bulle (36%). Over 70% of the identified bacteria were from four categories: spp., spp., and spp. These bacteria also found in high-risk locations including neonatal intensive care units, delivery and surgical rooms. Antimicrobial susceptibility detected in ≥50% of the isolates for penicillin, cefazolin, ampicillin, oxacillin, and cotrimoxazole, and ≥ 50% of the isolates displayed multi-drug resistance.
Investing in WASH infrastructures, promotion of handwashing practices, implementing infection prevention and control (IPC) measures and antibiotic stewardship is critical to ensure quality care in these settings. We recommend careful use of higher generation cephalosporins and fluoroquinolones.
卫生设施中供水、环境卫生和个人卫生（WASH）不足，以及对感染控制协议的低依从性会增加医院获得性（医院内）感染（HAIs）的风险。HAIs的风险会增加发病率、死亡率、医疗保健成本，还会导致微生物耐药性增加。
本研究旨在评估奥罗米亚地区以及南方各族州（SNNPs）选定卫生设施中的WASH设施及做法，以及医院内病原体水平。
采用观察性横断面研究设计，通过访谈和直接观察评估SNNPs（布勒和多约格纳）以及奥罗米亚（比德雷）地区医疗保健中的WASH设施（n = 26个设施）。从主要医院和卫生中心采集水和表面样本。共采集了90份表面拭子和14份水样，进行鉴定、表征并测试抗菌药敏性。使用Epi-info进行数据录入，随后将数据导出到Stata 17版本进行数据清理和分析。
供水、厕所设施和废物管理程序未达最佳标准（低于世界卫生组织的最低标准）。调查时，只有11/26的卫生设施能够获得水。手部卫生依从性最低的是比德雷（4%），其次是多约格纳（14%）和布勒（36%）。超过70%的已鉴定细菌来自四类：葡萄球菌属、肠杆菌属、假单胞菌属和不动杆菌属。这些细菌也在包括新生儿重症监护病房、产房和手术室等高风险地点被发现。≥50%的分离株对青霉素、头孢唑林、氨苄西林、苯唑西林和复方新诺明检测出抗菌药敏性，且≥50%的分离株表现出多重耐药性。
投资于WASH基础设施、推广洗手做法、实施感染预防与控制（IPC）措施以及抗生素管理对于确保这些环境中的优质护理至关重要。我们建议谨慎使用更高代的头孢菌素和氟喹诺酮类药物。
