The Effect of Applying the International Guidelines for Clean Surgery on Infection Control of Patient's Close Intimate Environments

Authors

  • Ismaeil M. Abdulkahar University of Duhok
  • Haider N. Mohammed University of Duhok
  • Sabeeha A. Mansour Azadi Teaching Hospital, Health directorate of Duhok

DOI:

https://doi.org/10.25271/2017.5.2.358

Keywords:

Contamination, Operation theatres, International Guideline for Clean Surgery, Infection Control, Sterilization programme

Abstract

Surgical site infections are the most common cause of hospital acquired nosocomial infections. To evaluate the effects of applying and following the international standard guidelines for clean surgery on the final infection control in operation theatres, a comparative study was designed and carried out during the period from May 2014 to February 2015, at two operating theatres, the general surgical and the gynaecological theatre at Azadi teaching hospital – Duhok city – Kurdistan region. A total number of 492 samples (swabs and settles plate) were taken from different sites of intimate contact with the patients and were divided into two parts, pre (part I) and post (part II) samples. They were taken in a periodic day to day, and collected periodically three days of the week (Saturday -Monday- Wednesday) for a period of one month. Swabs were taken from different places were streaked on Blood and Mac-Conkey agar plates and incubated at 37°C under aerobic conditions for 24 hours. After incubation, the bacterial colonies were counted and diagnosed by Phoenix. The concentration of bacteria was expressed as colony forming units. The rates of bacterial contamination in places of close contact with patients of both theatres before the application of the WHO guidelines were as following: out of 348 samples collected from the surgical theatre in the first part; 105 (30.1%) showed significant growth in comparison to 32/144(22.2%) that showed significant growth from the gynaecological theatre, while all samples in part II from the surgical theatre showed no significant growth that 100%, in comparison to141/144(97.92%) in the gynaecological theatre in the second part after application of the WHO guidelines. As a conclusion there are 3 factors which have an effect on the result of surgical site infections namely patients, staff and environmental factors. The environmental factors have the greatest impact which are indirectly related to the degree of application of WHO standards of operation theaters.

Author Biographies

Ismaeil M. Abdulkahar, University of Duhok

Dept. of Medical Laboratories, College of Health Sciences, University of Duhok, Kurdistan Region, Iraq

Haider N. Mohammed, University of Duhok

Dept. of Anesthesia, College of Health Sciences, University of Duhok, Kurdistan Region, Iraq

Sabeeha A. Mansour, Azadi Teaching Hospital, Health directorate of Duhok

Dept. of Microbiology, Azadi Teaching Hospital, Health directorate of Duhok, Kurdistan Region, Iraq

References

Baillie, N.; Crawshaw, S.; Neary, R.; Smith, T.; Bee, C.; Clifford, E.; et al (2008). Prevention and Treatment of Surgical Site Infection NICE Clinical Guidelines. Health Guidance in UK. NICE quality standard, 49:22-5.
Bruce, J.; Russell, E.M.; Mollison, J.; Krukowski, Z.H. (2001). The measurement and monitoring of surgical adverse events. Health Technology Assessment, 5(22):1-194.
Department of Health Estates and Facilities (2013). Health Building Note 00-09: Infection control in the built environment, ENG. Department of Health (guidance): 11-29.
Desai, S. N.; Kikani, K. M.; Mehta, S. (2012). Microbilogical Surveillance of Operation Theaters & Intensive Care Units of Teaching Hospital in Surendranagar. Gujarat Medical Journal, 67(2):95-97.
Ensayef, l. S.; Al-Shalchi, S.; Sabbar, M. (2009). Microbial contamination in the operating theatre: a study in a hospital in Baghdad. Eastern Mediterranean Health Journal, 15(1): 219-23.
Ibraheem, H. H.; Wesam, A.Z.; Hindi, B. H.; ALamedi. S.; Shorok, A. A.; AL Ameer, D. etal (2009). Bactriological Study of Nosocomial Infections Caused by Aerobic Bacteria in Hilla General Hospital. Al Taqani, 22(4):1-5.
Javed, I.; Hafeez, R.; Zubair, M.; Anwar, M.S.; Husnain, S. (2008). Microbiological surveillance of operation theatres and ICUs of a tertiary hospital. Lahore Biomedica, 24(1): 102- 99.
Landrin, A.; Bissery, A.; Kac, G. (2005). Monitoring air sampling in operating theatres: can particle counting replace microbiological sampling. Journal of Hospital Infection, 61 (1):9- 27.
Lishman, G.; Robb, A.; Winter, C.; Matron, J, L. (2013). Infection Prevention and Control Practice in the Operating Department. Ratified by: Infection Prevention and Control Committee, 3(1):1-12.
Mangram, A.J.; Horan, T.C.; Pearson, M.L.; Silver, L.C.; Jarvis, W.R. (1999) Guidelines for prevention of surgical site infection. Hospital Infection Control Practices Advisory Committee, 20(4): 251-75.
Merican, M. I.; Abdullah, N. H.; Maskon, K.; Zain, R. M.; Sutris, J. M. et al(2009).Policies And Procedures On Infection Control. Quality Medical Care Section .Text in Medical Development Division, Ministry of Health Malaysia. 2nd edition: 81-168.
Napoli, C.; Marcotrigiano, V.; Montagna, M.T.(2012).Air sampling procedures to evaluate microbial contamination: A comparison between active and passive methods in operating theaters. BioMedical Central Puplic health, 12(594):1-6.
Newcastle upon Tyne NHS Hospitals Foundation Trust (2013). Infection Prevention and Control Practice in the Operating Department, version No.3.1.
Nwankwo, E. (2012).Isolation of pathogenic bacteria from fomites in the operating rooms of a specialist hospital in Kano, North-western Nigeria. Pan African Medical Journal, 12(90): 1307-90.
Okon, K. O.; Osundi, S.; Dibal, J.; Ngbale, T.; Bello, M.; Akuhwa, R.T. et al (2012). Bacterial contamination of operating theatre and other specialized care unit in a tertiary hospital in Northeastern Nigeria. African Journal of Microbiology Research, 6(13): 3092-6.
Operation Theatre Sterilization by Fumigation (2009). Infection Control; 15 comments. iNVISIBLE YET iNVINCIBLE . Published by Mas template.
Sehulster, l.; Raymond, Y.W.; Hughes, J.M.; Solomon, S.L. et al (editor) (2003). Guidelines for Environmental Infection Control in Health-Care Facilities. Centers for Disease Control and prevention “Morbidity and Mortality Weekly Report, 52 (10): 1- 48.
Singh, K.; Dar, F. A.; Kishor, K. (2013). Bacterial Contamination Operating Theatres of District Hospital Budgam in Kashmir Division. Innovative Journal of Medical and Health Science, 3(2): 62 - 3.
Suzuki, A.; Namba, Y.; Mastsuurat, M.; Horisawa, A. (1984). Bacterial contamination of floors and other surfaces in operating rooms: a five-year survey. Journal of hygiene .93(3): 559–566.
Tesfaye, T.; Berhe, Y.; Gebreselassie, K. (2015). Microbial contamination of operating Theatre at Ayder Referral Hospital, Northern Ethiopia. International Journal of Pharma Sciences and Research, 6 (10): 1264-67.
Vincent, J.R.; Bihari, D.J.; Suter, P.M. (1995).The prevalence of Nosocomial infection in intensive unit in Europe. Journal American medical association, 274(8): 639-644.
William, A.; Rutala, D.; David, J.; Weber, M.D. (2008). Guideline for Disinfection and Sterilization in Healthcare Facilities. Centers for Disease Control and prevention, 39(5): 702-709.
World Health Organization (WHO) (2009). Practical Guidelines for Infection Control in Health Care Facilities,Text :1-120.

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Published

2017-06-30

How to Cite

Abdulkahar, I. M., Mohammed, H. N., & Mansour, S. A. (2017). The Effect of Applying the International Guidelines for Clean Surgery on Infection Control of Patient’s Close Intimate Environments. Science Journal of University of Zakho, 5(2), 147–153. https://doi.org/10.25271/2017.5.2.358

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Section

Science Journal of University of Zakho