ABSTRACT
The transmission of infection via
fomites constitutes a major threat to public health especially in the
developing countries. This study was carried out to investigate the
microbial carriage and antibiotics pattern of bacteria on the door
handles of campus shuttle operating in the Federal University of
Technology Akure. Samples were randomly collected from a total of one
hundred and fifty (150) door handles following standard laboratory
techniques. Enumeration of the bacterial counts was carried out using
pour plating technique while the bacteria isolates were identified using
cultural, morphological and biochemical characteristics. The
results show that the drivers’ door handles, front passengers’ door
handles and back passengers’ door handles had overall mean aerobic
bacterial counts of 195.56 ± 2.05 (x104cfu/ml), 228.08 ± 1.56 (104cfu/ml)and 176.92 ± 2.70 (x104cfu/ml) respectively. Bacteria isolated and identified were Enterobacter aerogenes (17.1%), Escherichia coli (12.4%), Klebsiella pneumoniae (10.1%), Proteus spp. (4.7%), Pseudomonas aeruginosa (4.7%), Salmonella enteritidis (2.3%), Staphylococcus aureus (17.1), Staphyloccoccus epidermidis (22.5) and Streptococcus pneumoniae (9.3%) while the fungal isolates were Aspergillus fumigatus (29.3%), Aspergillus niger (19.5%), Candida spp. (6.1%), Fusarium spp. (14.6%), Mucor spp. (9%), Penicillium spp. (15.9%), and Rhizopus spp.
(3.7%). The antibiotics pattern of the bacteria indicated that all the
bacteria isolated were susceptible to pefloxacin (19.25 ± 4.031-26.33 ±
4.041mm) and gentamycin (15.00 ± 2.685-25.00 ± 3.916mm) while all were
resistant to amoxicillin (3.67 ± 0.082-13.75 ± 2.217mm) except Enterobacter aerogenes.
These campus shuttles aside their usage as a means of transportation
could also serve as a means of transmission of both pathogenic and
non-pathogenic microorganisms which pose public health risks. Personal
hygiene and sanitation such as hand washing and the use of antimicrobial
wipe to clean the hands could serve as a means of reducing the
incidence of microbial transmission to drivers and passengers.
CHAPTER ONE
1.0 Introduction
The spread of infectious disease through
hand contact has been an area of major public health concern because of
the frequent contact of the hand with fomites which are potential
carriers of pathogenic organisms may lead to an alarming rate of
outbreaks of infections transmitted by the fomites. Worldwide annually
there are 1.7 million deaths from diarrhoeal diseases and 1.5 million
deaths from respiratory infections (Pruss-Ustun and Covahan, 2006),
these are examples of diseases which could be contracted by humans via
fomites. According to (Itah, 2004), Gram positive Staphylococcus aureus, and Gram negative bacteria such as Escherichia coli, Klebsiella species, Pseudomonas species,
were found to contaminate various contact surfaces including chairs,
tables, windows, door handles and many other common household fixtures.
The presence of these pathogenic bacteria on environmental surfaces
poses a potential risk to vulnerable, immune-compromised individuals
(Pruss-Ustun and Covahan, 2006).
It has been shown that hard, non-porous surfaces such as door handles have the highest bacterial transfer rates to hands (Rusin et al.,
2002). In recent past, a lot of effort has been invested in emphasized
hand hygiene through hand wipes and hand sanitizers (Hota, 2004). Hand
wipes with higher ethanol content are more effective in not only
antimicrobial activities but also remover of endospores via mechanical
action (Stout et al., 2010). Even though people are commonly
aware of such practices, the possibility of inaccessibility or lack of
use of these practices do exist. According to Hansen and Knochel (2010)
up to 60% 0f adults do not wash their hands when appropriate. People
believe that microbes are only present in research laboratories,
hospitals or clinics and thus they have a misleading feeling of security
in other places or while touching other surfaces such as door handles
(Stout et al., 2010). Lack of knowledge of the roles of
micro-habitat such as door handles in dissemination of microorganisms is
a threat to public health. In fact 80% of infections are spread through
hand contact with hands or other objects (Reynold and Hurst, 2005).
Reynold and Hurst (2005) used an invisible fluorescent tracer for
artificial contamination of public surfaces. They found that
contamination from outside surfaces was transferred to 86% of exposed
individual’s and 82% tracked the tracer to their home or personal
belongings hours later. The viability of Gram positive and Gram negative
organism under various environment conditions have been described
(Noskin et al., 1995). Some microbes are infectious at very low
doses and can survive for hours to weeks on nonporous surfaces, such as
countertops, telephone and door handles (Reynold and Hurst, 2005). Enterococci
have been found to survive in dry conditions and on various fabrics
utilized in the health care environment. Infectious doses of pathogen
may be transferred to the mouth after handling everyday contaminated
objects such as the door handles. Door handles are contaminated with
various types of microorganisms including varying species of bacteria
and fungi and this may be a source of nocosomial infections in
hospitals. Scientific information about the occurrence of microorganisms
on various objects outside the health care facilities is very little
and needs to be enriched in order to educate people on the necessity of
improving the habit of hand washing to reduce microbial transmission.
In the past 60 years, antibiotics have
been critical in achieving a dramatic rise in life expectancy and
significant improvements in public health (El-Astal, 2005). However,
disease-causing microbes have become increasingly resistant to the
antibiotics commonly in use (El-Astal, 2005). It has been clearly shown
that the use of antimicrobials leads to selection of resistant strains
both in the individual and in the community, and overuse or
inappropriate use only increases this risk (Reynold and Hurst, 2005).
History suggests that microbes will never run out of ways of developing
resistance, but we may run out of effective antimicrobials (Reynold and
Hurst, 2005). The Gram negative enteric bacilli are common causes of a
wide variety of infections involving diverse anatomic sites in both
healthy and compromised hosts (El-Astal, 2005). In general, among
adults, the incidence of infection due to these agents increases with
age. Thus, as the mean age of the population increases, so will the
number of these infections (Reynold and Hurst, 2005). Drug resistance is
a serious medical problem. Progressive increase in resistance to
commonly used antibiotics with many gram-negative bacilli being
multidrug-resistant has been noticed (Reynold and Hurst, 2005). The
emergence of antibiotic resistance in the management of infections is a
serious public health issue, particularly in the developing world where
apart from high level of poverty and ignorance, there is also high
prevalence of fake and spurious drugs of questionable quality in
circulation (El-Astal, 2005). This has led to a significant increase in
morbidity.
There also appears to be a significant
lack of studies highlighting the susceptibility patterns of locally
prevalent microorganisms (El-Astal, 2005). Knowledge of etiological
agents of infections and their sensitivities to available drugs is of
immense value to the rational selection and use of antimicrobial agents
and to the development of appropriate prescribing policies (El-Astal,
2005). Microbial transmission via several surfaces such as automated
teller machines, mobile phones, door handles and currency has been
extensively studied but the role of commercial buses door handles in the
dissemination of pathogenic microorganisms have not been properly
investigated. Therefore this research project will be centered on the
role of commercial buses door handle in the transmission of pathogenic
microorganism to human via hand contact and the antibiotics pattern of
the potential isolates.
1.1 The objectives of the study
The aim and objectives of this research are to:
(a) assess the role of campus shuttle door handles in dissemination of pathogenic microorganisms; and
(b) determine the antibiotics susceptibility and resistance pattern of the potential isolates.
1.2 Justification
Over the years, different researches has
been conducted to examine the role of various surfaces, such as tables,
computer key boards and mobile phones on the carriage and dissemination
of pathogenic infection, but the role of door handles of commercial
shuttle buses as a route of microbial transmission has not been
reported. Hence the need to assess the carriage and transmission of
microorganism by shuttle door handles. The knowledge of this is expected
to broaden our understanding of the microbial carriage of the door
handles and their antibiotics pattern. This will help the University
management to implement public health preventive and control measure to
forestall future outbreak of infection that may result from this
pathogenic microorganisms associated with the shuttle door handles.