Comparison of microbial culture results before and after implementation of an icu-acquired infection prevention protocol at imam khomeini hospital, ardabil, iran

Document Type : Original Article

Authors

1 Department of Internal Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

2 Department of Anesthesiology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

3 Department of Nursing, Khalkhal University of Medical Sciences, Khalkhal, Iran

4 School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

10.22038/psj.2025.90018.1479

Abstract

Introduction:
Nosocomial (hospital-acquired) infections, particularly in intensive care units (ICUs), pose a significant challenge to healthcare systems. Effective control of ICU-related infections is crucial, as it can reduce patient mortality rates and shorten hospital stays.
 Materials and Methods:
In the interventional study, 74 samples for microbial cultivation were selected of different parts and equipment and sent to the laboratory for analysis. Subsequently, the ICU departments underwent thorough cleaning, and staff received training on proper hand hygiene protocols. Post-intervention sampling was then conducted. Data from both pre- and post-intervention measurements (two sampling rounds each with 37 samples) were analyzed and sent to the laboratory. The microbial culture results were recorded in the researcher-designed checklist for further evaluation and collected data were analyzed by statistical methods in SPSS version 24.
 Results:
Microbial contamination analysis revealed coagulase-negative Staphylococci, Escherichia coli, and Citrobacter freundii as the most prevalent pathogens (25% each) in pre-intervention samples. Following decontamination protocols and staff training, post-intervention cultures showed a reduction in overall contamination, with coagulase-negative Staphylococci and Acinetobacter spp. emerging as the dominant species (20% each). This observed decrease in microbial load suggests the educational intervention may have contributed to improved infection control practices.
Conclusion:
The results demonstrated a significant reduction in Gram-positive and Gram-negative bacterial contamination across both medical equipment and hospital surfaces following the decontamination protocol. This observed decrease in microbial load, particularly of pathogenic species, suggests the infection control training program effectively improved sterilization practices among healthcare staff.

Keywords

Main Subjects

References

  1. Mosadeghrad AM, Sadeghi M. Medical tourism: Reasons for choosing Iran. Payesh 2021; 20(2): 145-66.
  2. Bharmal A, Ng C, Vijh R. COVID-19 Prevention Assessments: A Promising Tool for Preventing Outbreaks in Long-Term Care Homes. J Am Med Dir Assoc 2021;22(10):2032-3.
  3. Zazouli M-A, Yazdani-charati J, Ahanjan M, Eslamifar M. Bacterial contamination of. environmental surfaces in two educational hospitals under the auspices of Mazandaran University of Medical Sciences. Journal of Health in the Field 2017;3(1):36-41.
  4. Pachori P, Gothalwal R, Gandhi P. Emergence of antibiotic resistance Pseudomonas aeruginosa in intensive care unit; a critical review. Genes & diseases 2019;6(2):109-19.
  5. Willyard C. The drug-resistant bacteria that pose the greatest health threats. Nature 2017; 543(7643): 15.
  6. Ghafouri M, Hashemi SA, Azimian A, Garevani T, Seyed Sharifi SH. Evaluation of Antibiotic Resistance to Bacteria Isolated from Patients with Nosocomial Infections Hospitalized in Imam Reza in Bojnurd Cityin 2013. J Rafsanjan Univ Med Sci 2015; 14(7): 599-610
  7. Babamahmoodi F, Ahangarkani F, Davoudi A. Hospital-acquired infections, bacterial causative agents and antibiotic resistance pattern in intensive care units at teaching hospitals in North of Iran. Int J Med Invest 2015; 4(1): 152-160.
  8. Foroughi A, et al. Assessment of indoor and outdoor airborne fungi in an Educational, Research and Treatment Center. Italian Journal of Medicine 2017; 11: 52-56.
  9. Zarrinfar H, Bathla C. Is Phaeohyphomycosis an Emerging Fungal Infection in Iran? A Short Communication. Journal of Patient Safety & Quality Improvement 2020; 8(2): 123-126.
  10. Habibian R, Imani R, Khoshdel A. Changes of trend of antibiotic susceptibility in isolated bacteria from culture of ICU patients of Shahrekord Ayatollah Kashanani Hospital, I. R. Iran. J Shahrekord Univ Med Sci 2012; 14(1): 77-83.
  11. Nadi E, Nekouii B, Mobin A, Nekouii A, Moghim Beigi A. Frequency of Nosocomial Pneumonia in ICUs of Hospitals of Hamadan University of Medical Sciences. Journal of Isfahan Medical School 2011; 29(153): 1255-1262.
  12. Bharmal A, Ng C, Vijh R. COVID-19 Prevention Assessments: A Promising Tool for Preventing Outbreaks in Long-Term Care Homes. J Am Med Dir Assoc 2021;22(10):2032-3.
  13. Rahimi M, Badredin M, Mousavi L, Mikayili L. A survey of medical students’ awareness of Bu-Ali Hospital and Ali (AS) of the control and prevention of nosocomial infections. Medical Sciences Journal of Islamic Azad University 2006; 16(2): 107-111.
  14. Mosadeghrad AM, Qazanfari F, Keykhani S. Hospital Infection Control accreditation standards: A Comparative Review. J Health Saf Work 2022;12(1):99-122.
  15. Abdullahi A, Rahmani A H, Khodabakhshi B, Behnam pour N. Determine the knowledge, attitude and practice nurses Golestan University of Medical Sciences hospital infection control. J Gorgan Univ Med Sci 2003; 11(5): 80.
  16. Orsi G.B, Scorzolini L, Franchi C, Mondillo V, Rosa G, Venditti M. Hospital – acquired infection surveillance in a neurosurgical intensive care unit. J psoH tcefnI 2006; 64(1):23-9.
  17. Ndegwa L, Hatfield KM, Sinkowitz-Cochran R, D’Iorio E, Gupta N, Kimotho J, et al. Evaluation of a program to improve hand hygiene in Kenyan hospitals through production and promotion of alcohol-based Handrub–2012-2014. Antimicrobial Resistance & Infection Control 2019;8(1):1-6.
  18. Rahimi-Bashar F, Karami P, Khaledi A, Dehghan A, Seifrabie MA, Yaghoobi MH. Evaluation of the prevalence of nosocomial infection in different wards of Be’sat hospital of Hamedan. Avicenna Journal of Clinical Microbiology and Infection 2018;5(2):31-5.
  19. Mukhopadhyay C. Infection Control in Intensive Care Units, Indian J Respir Care 2018; 7(2): 14-21.
  20. Rajabi M, Abdar ME, Rafiei H, Aflatoonia MR, Abdar ZE. Nosocomial Infections and Epidemiology of Antibiotic Resistance in Teaching Hospitals in South East of Iran. Glob J Health Sci 2015;8(2):190-7.
  21. Kim KM, Kim HJ, Choi JS. Knowledge and Performance Level of Infection Control and Influencing Factors of Oriental Medical Doctors and Nurses in Korea. Korean J Adult Nurs 2012; 24(1): 74-84.
  22. Bijari, B. Nosocomial Infections and Related Factors in Southern Khorasan Hospitals. Iran J Med Microbiol 2014; 8(4): 69-73.
  23. Dasgupta S, Das S, Chawan NS, Hazra A. Nosocomial Infections in the Intensive Care Unit: Incidence, Risk Factors, Outcome and Associated Pathogens in a Public Tertiary Teaching Hospital of Eastern India, Indian J Crit Care Med 2015; 19(1):14-20.
  24. Dancer S. The role of environmental cleaning in the control of hospital-acquired infection. J Hosp Infec 2009:73; 378-85.
  25. Weber DJ, Rutala WA, Miller MB, Huslage K, Sickbert-Bennett E. Role of hospital surfaces in the transmission of emerging health careassociated pathogens: Norovirus, Clostridium difficile, and Acinetobacter specie. Am J Infect Control 2010; 38:S25-33.
  26. Ekrami A, Hosseini MA, Fallahi-Khoshknab M. Assessing the sensitivity of the Nano-Biosensor Color Indicator as a method for identifying nosocomial infection reservoirs. Health Tech Ass Act 2023;6(3).
  27. AslaniY, Saadat M, Etimadifar SH, Afzali M. The Evaluation of Different Hospital Equipment Microbial Contamination in Medical Training Center Hajar of Shahrekord. Avicenna J Nurs Midwifery Care 2009; 17(12): 19-29.
  28. Nazeri M, Salmani Arani J, Ziloochi N, Delkhah H, Hesami Arani M, Asgari E, et al. Microbial contamination of keyboards and electronic equipment of ICU (Intensive Care Units) in Kashan University of medical sciences and health service hospitals. MethodsX 2019; 6:666-71.
  29. Karami G, Khazei M, Rasuli Ravandi F, Emtiyazipoor Z. Evaluating the effect of hospital medical instruments on the nosocomial infection risk Nurs Midwifery J 2015;13(7):579-87.
  30. Najafi Saleh H, Kavosi A, Pakdel M, Yousefi M, Baghal Asghari F, Mohammadi AA. Assessment health status of ICU medical equipment levels at Neyshabur hospitals using ICNA and ACC indices. MethodsX 2018;5:1364-72.

31.Davoodian P, Karmostaji A, Vaeghi Z. Study of nosocomial infection and pattern of antibiotic resistance in Shahid mohamadi hospital of Bandarabas. Medical Journal of Hormozgan 2001; 5(3).

  1. Cason C, D'Accolti M, Campisciano G, Soffritti I, Ponis G, Mazzacane S, Maggiore A, et al. Microbial Contamination in Hospital Environment Has the Potential to Colonize Preterm Newborns' Nasal Cavities. Pathogens 2021;10(5):615.

33.Yosefi Mashof R, Heidari Z. Survey on microbial contamination of intensive care wards of Hamedan hospitals. Zahedan Medical Journal 2001;3: 93-98.

34.Nooralhhi H, Rostami M. Prevalence of infections and their etiological factors in Alzahra ground medical center (Isfahan). J Gorgan Univ Med Sci 2000; 2:33-40.

35.Davari HA, Sodavi M, Kainpoor M. Bacterial contamination of intensive care wards of Hamedan hospitals. Journal of Research in Medical Sciences 1998;3(4): 267-271.

 




Journal of Patient Safety & Quality Improvement
Volume 13, Issue 3
July 2025
Pages 185-193

Files

Share

How to cite

Statistics