Bacterial Profiles and Antimicrobial Susceptibility Pattern of Isolates from Inanimate Hospital Environments at Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia

Figures & data

Table 1 The Frequency of Isolated Bacteria at TASH, 2018

Isolates	N (%)
Gram negative	80(43.7)
Acinetobacter baumannii	39(21.3)
Pseudomonas aeruginosa	14(7.7)
Escherichia coli	9(4.9)
Serratia marcescens	4(2.2)
Klebsiella pneumoniae	6(3.3)
Klebsiella oxytoca	4(2.2)
Others*	4(2.2)
Gram positive	103(56.3)
Staphylococci aureus	63(34.4)
CoNS	28(15.3)
Bacillus spp	6(3.3)
Streptococcus agalactiae	3(1.6)
Enterococcus spp	3(1.6)

Notes: *Others, Enterobacter cloacae, Shigella spp, Klebsiella rhinoscleromatis.

Abbreviation: CoNS, coagulase-negative staphylococci.

Table 2 Distribution of Potentially Pathogenic Bacteria Between ICUs and OTs at TASH, 2018

Bacteria	ICUs (N= 92)				OTs (N=91)
	Surgical n (%)	Pediatric n (%)	Medical n (%)	Medical-Surgical n (%)	Emergency n (%)	Neurology n (%)	Endo-Renal n (%)	Gyn-obs n (%)	Pediatric n (%)	Cardo-Vs n (%)	GIT n (%)
S. aureus	4(25)	4(16.7)	3(13.6)	10(33.3)	8(66.7)	7(53.8)	5(31.3)	6(60)	4(33.3)	6(42.9)	6(42.9)
CoNS	1(6.3)	0(0)	3(13.6)	1(3.3)	4(33.3)	2(15.4)	0(0)	3(30)	6(50)	6(42.9)	2(14.3)
Bacillus spp	0(0)	0(0)	0(0)	0(0)	0(0)	2(15.4)	0(0)	1(10)	0(0)	0(0)	3(21.4)
Enterococcus spp	0(0)	1(4.2)	1(4.5)	0(0)	0(0)	0(0)	0(0)	0(0)	1(8.3)	0(0)	0(0)
GBS	0(0)	0(0)	0(0)	2(6.7)	0(0)	1(7.7)	0(0)	0(0)	0(0)	0(0)	0(0)
A. baumannii	6 (37.5)	6 (25)	10 (45.5)	10 (33.3)	0(0)	0(0)	4(25)	0(0)	1(8.3)	1(7.1)	1(7.1)
P. aeruginosa	2(12.5)	5(20.8)	2(9.1)	0(0)	0(0)	1(7.7)	2(12.5)	0(0)	0(0)	0(0)	2(14.3)
Klebsiella spp	1(6.3)	4(16.7)	2(9.1)	2(6.7)	0(0)	0(0)	2(12.5)	0(0)	0(0)	0(0)	0(0)
E. coli	1(6.3)	4(16.7)	1(4.5)	3(10)	0(0)	0(0)	0(0)	0(0)	0(0)	0(0)	0(0)
S. marcescens	1(6.3)	0(0)	0(0)	0(0)	0(0)	0(0)	2(12.5)	0(0)	0(0)	1(7.1)	0(0)
Others *	0(0)	0(0)	0(0)	2(6.7)	0(0)	0(0)	1(6.3)	0(0)	0(0)	0(0)	0(0)
Total, N (%)	16 (8.7)	24(13.1)	22(12)	30(16.4)	12(6.6)	13(7.1)	16(8.7)	10(5.5)	12(6.6)	14(7.7)	14(7.7)

Notes: Others* (Shigella spp, E. cloacae); Klebsiella spp (K. pneumoniae, K. oxytoca, and K. rhinoscleromatis).

Abbreviations: GIT, gastro-intestinal tract unit, Cardo-Vs, cardiovascular unit; Gyn-obs, gynaecology obstetrics; GBS, Group B Streptococcus (Streptococcus agalactiae); CoNS, coagulase-negative staphylococci; OTs, operation theaters; ICUs, intensive care units.

Table 3 Distribution of Bacteria Over Different Surfaces in ICU and OTs at TASH, Addis Ababa, Ethiopia, 2018

Sampling Points	Bacteria, n (%)
	S. aureus	CoNS	Bacillus spp	Enterococcus spp	GBS	A. baumannii	P. aeruginosa	Klebsiella spp	E. coli	S. marcescens	Others ^A
Anastasia machine	5(7.9)	2(7.1)	1(16.7)	0(0)	0(0)	1(2.6)	1(7.1)	0(0)	0(0)	0(0)	0(0)
Bed	8(12.7)	2(7.1)	0(0)	0(0)	1(33.3)	8(20.5)	1(7.1)	1(9.1)	2(22.2)	0(0)	0(0)
Environmental surface*	6(9.5)	6(21.4)	3(50)	1(33.3)	0(0)	3(7.7)	1(7.1)	1(9.1)	0(0)	1(25)	0(0)
Monitor	5(7.9)	3(10.7)	0(0)	0(0)	1(33.3)	4(10.3)	1(7.1)	0(0)	1(11.1)	0(0)	1(33.3)
Sink	6(9.5)	0(0)	0(0)	0(0)	0(0)	2(5.1)	1(7.1)	0(0)	0(0)	0(0)	1(33.3)
Suction Machine	7(11.1)	3(10.7)	0(0)	1(33.3)	0(0)	5(12.8)	3(21.4)	0(0)	1(11.1)	0(0)	0(0)
Linens	5(7.9)	4(14.3)	0(0)	0(0)	1(33.3)	6(15.4)	3(21.4)	6(54.5)	2(22.2)	0(0)	0(0)
Lobby (furniture)	5(7.9)	3(10.7)	0(0)	0(0)	0(0)	5(12.8)	0(0)	0(0)	1(11.1)	1(25)	0(0)
Ventilator	1(1.6)	1(3.6)	0(0)	0(0)	0(0)	3(7.7)	1(7.1)	3(27.3)	2(22.2)	0(0)	0(0)
Work station	6(9.5)	1(3.6)	2(33.3)	0(0)	0(0)	2(5.1)	0(0)	0(0)	0(0)	2(50)	0(0)
Others ^B	9(14.3)	3(10.7)	0(0)	1(33.3)	0(0)	0(0)	2(14.3)	0(0)	0(0)	0(0)	1(33.3)
Total	n=63	n=28	n=6	n=3	n=3	n=39	n=14	n=11	n=9	n=4	n=3

Notes: Others^A(Shigella spp, Enterobacter cloacae); Others^B(Laparoscopy, Operation room (OR)-Light, oxygen cylinder, Trowels); *Environmental surfaces (Doorknob, Floor, Corroder and Wall).

Abbreviations: GBS, Group B Streptococcus; CoNS, coagulase-negative Staphylococci.

Table 4 Antimicrobial Susceptibility Pattern of Gram-Positive Bacteria at TASH, 2018

Isolates	Ptn	Antimicrobial Agents N (%)
		GEN	CIP	CHL	SXT	VAN	ERY	DA	DOX	FOX	PEN
CoNS	R	5(17.9)	10(35.7)	6(21.4)	11(39.3)	NT	16(57.1)	1(3.6)	15(53.6)	22(78.6)	26(92.9)
	S	23(82.1)	18(64.3)	22(78.6)	17(60.7)	NT	12(42.9)	27(96.4)	13(46.4)	6(21.4)	2(7.1)
Enterococcus spp	R	NT	1(33.3)	1(33.3)	NT	1(33.3)	2(67.7)	2(66.7)	1(33.3)	NT	2(66.7)
	S	NT	2(66.7)	2(67.7)	NT	2(66.7)	1(33.3)	1(33.3)	2(66.7)	NT	1(33.3)
GBS	R	NT	NT	2(66.7)	NT	2(66.7)	3(100)	0(0)	1(33.3)	NT	3(100)
	S	NT	NT	1(33.3)	NT	1(33.3)	0(0)	3(100)	2(66.7)	NT	0(0)
S. aureus	R	10(15.9)	12(19)	15(23.8)	30(47.6)	NT	31(49.2)	7(11.3)	24(38.1)	54(85.7)	59(93.7)
	S	53(84.1)	51(81)	48(76.2)	33(52.4)	NT	32(50.8)	55(88.7)	39(61.9)	9(14.3)	4(6.3)
Total	R	15(16.5)	23(24.5)	23(24)	41(45)	3(50)	52(53.6)	10(10.4)	41(42.3)	76(83.5)	90(92.8)
	S	76(83.5)	71(75.5)	73(76)	50(55)	3(50)	45(46.4)	86(89.6)	56(57.7)	15(16.5)	7(7.2)

Abbreviations: N, number of tested strains; R, resistant; S, sensitive; Ptn, pattern; FOX, cefoxitin; GEN, gentamicin; CIP, ciprofloxacin; CHL, chloramphenicol; SXT, trimethoprim-sulfamethoxazole; VAN, vancomycin; ERY, erythromycin; DA, clindamycin; DOX, doxycycline; PEN, penicillin; NT, not tested; GBS, Group B Streptococcus (Streptococcus agalactiae); CoNS, coagulase-negative Staphylococci.

Table 5 Antimicrobial Susceptibility Pattern of Gram-Negative Bacteria at TASH, 2018

Isolates	Ptn	Antimicrobial Agent’s n (%)
		AMP	AZM	CTX	CRO	CTZ	FOX	FEP	AMC	TZP	MRP	AK	GEN	CIP	SXT
Acinetobacter baumannii	R	39(100)	39(100)	36(92.3)	38(97.4)	39(100)	37(94.9)	34(87.2)	39(100)	34(87.2)	29(74.4)	14(35.9)	27(69.2)	18(46.2)	31(79.5)
	S	0(0)	0(0)	3(7.7)	1(2.6)	0(0)	2(5.1)	5(12.8)	0(0)	5(12.8)	10(25.6)	25(64.1)	12(30.8)	21(53.8)	8(20.5)
Escherichia coli	R	9(100)	6(66.7)	7(77.8)	7(77.8)	7(77.8)	4(44.4)	7(77.7)	5(55.6)	5(55.6)	3(33.3)	2(22.2)	4(44.4)	4(44.4)	7(77.8)
	S	0(0)	3(33.3)	2(22.2)	2(22.2)	2(22.2)	5(55.6)	2(33.3)	4(44.4)	4(44.4)	6(66.7)	7(77.8)	5(55.6)	5(55.6)	2(22.2)
Enterobacter cloacae	R	2(100)	2(100)	2(100)	2(100)	2(100)	2(100)	2(100)	2(100)	2(100)	1(50)	0(0)	1(50)	2(100)	2(100)
	S	0(0)	0(0)	0(0)	0(0)	0(0)	0(0)	0(0)	0(0)	0(0)	1(50)	2(100)	1(50)	0(0)	0(0)
Klebsiella oxytoca	R	4(100)	3(75)	3(75)	4(100)	3(75)	3(75)	3(75)	3(75)	2(50)	1(25)	1(25)	1(25)	2(50)	2(50)
	S	0(0)	1(25)	1(25)	0(0)	1(25)	1(25)	1(25)	1(25)	2(50)	3(75)	3(75)	3(75)	2(50)	2(50)
Klebsiella pneumoniae	R	5(83.3)	4(66.7)	4(66.7)	6(100)	5(83.3)	3(50)	5(83.3)	6(100)	4(66.7)	4(66.7)	3(50)	2(33.3)	2(33.3)	5(83.3)
	S	1(16.7)	2(33.3)	2(33.3)	0(0)	1(16.7)	3(50)	1(16.7)	0(0)	2(33.3)	2(33.3)	3(50)	4(66.7)	4(66.7)	1(16.7)
Klebsiella rhinoscleromatis	R	1(100)	1(100)	1(100)	1(100)	1(100)	0(0)	1(100)	1(100)	0(0)	0(0)	0(0)	0(0)	0(0)	0(0)
	S	0(0)	0(0)	0(0)	0(0)	0(0)	1(100)	0(0)	0(0)	1(100)	1(100)	1(100)	1(100)	1(100)	1(100)
Pseudomonas aeruginosa	R	13(92.9)	13(92.9)	12(85.7)	12(85.7)	11(78.6)	11(78.6)	5(35.7)	8(57.1)	5(35.7)	6(42.9)	0(0)	2(14.3)	2(14.3)	8(57.1)
	S	1(7.1)	1(7.1)	2(14.3)	2(14.3)	3(21.4)	3(21.4)	9(64.3)	6(42.9)	9(64.3)	8(57.1)	14(100)	12(85.7)	12(85.7)	6(42.9)
Serratia marcescens	R	4(100)	3(75)	1(25)	2(50)	4(100)	1(25)	3(75)	3(75)	2(50)	1(25)	0(0)	0(0)	0(0)	1(25)
	S	0(0)	1(25)	3(75)	2(50)	0(0)	3(75)	1(25)	1(25)	2(50)	3(75)	4(100)	4(100)	4(100)	3(75)
Shigella spp	R	1(100)	1(100)	1(100)	1(100)	1(100)	0(0)	0(0)	1(100)	1(100)	0(0)	0(0)	0(0)	0(0)	1(100)
	S	0(0)	0(0)	0(0)	0(0)	0(0)	1(100)	1(100)	0(0)	0(0)	1(100)	1(100)	1(100)	1(100)	0(0)
Total	R	78(97.5)	72(90)	67(83.8)	73(91.3)	73(91.3)	61(76.3)	60(75)	68(85)	55(68.7)	45(56.3)	20(25)	37(46.3)	30(37.5)	57(71.3)
	S	2(2.5)	8(10)	13(16.2)	7(8.7)	7(8.7)	19(23.7)	20(25)	12(15)	25(31.3)	35(43.7)	60(75)	43(53.7)	50(62.5)	23(28.7)

Abbreviations: N, number of tested strains; R, resistant; S, sensitive; %, percentage; Ptn, pattern; AMP, ampicillin; AZT, aztreonam; CTX, cefotaxime; CRO, ceftriaxone; CTZ, ceftazidime; FOX, cefoxitin; FEP, cefepime; AMC, amoxicillin and clavulanic acid; CHL, chloramphenicol; MRP, meropenem; AK, amikacin; GEN, gentamicin; CIP, ciprofloxacin; SXT, sulfamethoxazole + trimethoprim.