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Evaluation of Efficacy of the Current Disinfectants on Gram-Negative Bacteria Isolated from Hospital in Yazd in 2014

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Evaluation of Efficacy of the Current Disinfectants on Gram-Negative Bacteria Isolated from Hospital in Yazd in 2014 Iranian Journal of Health Sciences 2016; 4(1): 45-52 http://jhs.mazums.ac.ir Original Article Evaluation of Efficacy of the Current Disinfectants on Gram-Negative Bacteria Isolated from Hospital in Yazd in 2014 Tahereh Jasemizad 1 Mehdi Mokhtari 1 Hengameh Zandi 2 Taher Shahriari 3 *Fatemeh Sahlabadi 3 Akram Montazeri 4 Arefeh Dehghani Tafti 5 1- Department of Environmental Health Engineering, School of Public Health AND Environmental Science and Technology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 2- Department of Microbiology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 3- Department of Environmental Health Engineering, School of Public Health AND Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran 4- Environmental Health Expert, Shahid Sadoughi Accidents Burns Hospital, Yazd, Iran 5- Department of Biostatistics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran *[email protected] (Received: 5 Jul 2015; Revised: 16 Nov 2015; Accepted: 22 Dec 2015) Abstract Background and Purpose: The burn unit is a suitable environment for growing of bacteria such as Pseudomonas, Acinetobacter, and Staphylococcus that appropriate disinfection can reduce these pathogens. The aim of this study was to evaluate the effect of different disinfectants on Gram-negative bacteria isolated from the surface of accidents and burn hospital in Yazd. Materials and Methods: In this study, 240 samples were randomly collected from different parts of accidents and burn hospital before and after disinfection. The samples were cultured on blood agar and Eusion-Metilen-Blue agar media in the Microbiology Laboratory of Medicine School of Shahid Sadoughi University in Yazd and Colony counting were determined. Identification was done by biochemical tests after incubation at 37° C for 48 hours. The studied disinfectants were Deconex 50AF, Descoscid, Epimax SC, and Silvosept. At last, data were analyzed with using paired t-test . Results: The Gram-negative bacteria were isolated from burn unit before disinfection included Pseudomonas aeruginosa, Escherichia coli, Proteus spp., Klebsiella spp., Acinetobacter spp., and Enterobacter spp. According to the results, all disinfectants reduced the pollution before and after disinfection; nevertheless, this reduction at the time of using Epimax SC and Silvosept only showed a significant difference for P. aeruginosa (P = 0.001 and 0.003) and for E. coli Downloaded from jhs.mazums.ac.ir at 2:20 +0430 on Saturday May 2nd 2020 [ DOI: 10.18869/acadpub.jhs.4.1.45 ] (P = 0.020 and 0.005), respectively. Conclusion: All disinfectants were effective on Gram-negative bacteria isolated from surfaces and had shown a significant difference only between P. aeruginosa and E. coli number before and after disinfection by Epimax SC and Silvosept. The most effective disinfectant on P. aeruginosa and E. coli was Epimax SC and Silvosept, respectively. [Jasemizad T, Mokhtari M, Zandi H, Shahriari T, *Sahlabadi F, Montazeri A, Dehghani Tafti A. Evaluation of Efficacy of the Current Disinfectants on Gram-Negative Bacteria Isolated from Hospital in Yazd in 2014 . Iran J Health Sci 2016; 4(1): 45-52] http://jhs.mazums.ac.ir Key words : Burn Unit, Disinfectant, Gram-negative Bacteria Iran J Health Sci 2016; 4(1): 45 Evaluation of the current disinfectants efficacy on Gram-negative bacteria T. Jasemizad et al. 1. Introduction transfer (12). An important factor in the The increasing nosocomial infections are one spread of nosocomial infections is an of the main problems that the education-health improper use of disinfectants (13). centers and also hospitals are currently faced Disinfection is the process to remove all or with it. Environmental surfaces in contact most of pathogenic microorganisms on with patients are infected by epidemiological inanimate surfaces except bacterial spores. important microorganisms which survive on Disinfection should be done following the different levels of the hospital (1). Many cleanup (14) because the cleaning methods by Gram-negative bacteria such as Acinetobacter detergents may be insufficient to kill the can remain resistant from 3 days to 5 months pathogens in the hospital environment (1). on dry surfaces (2,3). Burn unit is a suitable Sanitizers or disinfectants are used for environment for the growth of bacteria such as sterilization and disinfection of medical Pseudomonas, Enterobacter, and devices, the operating rooms and maternity, Staphylococcus (4). burn sections, physical surfaces, and hallways Burned patients are highly susceptible to every day (15). Effective use of disinfectants infection due to losing skin that is a border to is an important factor in the prevention of prevent the penetration of microorganisms. In nosocomial infections (10). Activity against addition, the immune system of these patients key pathogens and lethal speed are the most is very active in response to burn injuries and important factors in disinfectant choice (16). changes occur in their immune system (5). At The use of safe and effective disinfectant the first burn wound is sterile; nonetheless, the solution with minimal damage to equipment bacteria grow in it within 12 hours (6). and personnel is one of the fundamental Since Pseudomonas aeruginosa is a principles of disinfection. None of the bacterium with low required food for growth disinfectants are suitable for all different and can remain in the environment and easily needs, the choice of disinfectant is also be transferred to susceptible patients. important in medical centers. Therefore, an According to available reports, this bacterium investigation to determine the effects of is the first bacteria for creating nosocomial different disinfection is necessary to select a infections in burn medical centers; therefore, suitable disinfectant (13). In this study, the these infections are often in burned patients disinfection effects of Deconex 50AF (Irenic (7). In another study in 2002, Weis et al. in Company, Switzerland), Descoscid Germany found Staphylococcus, (Altonafarin Company, Germany), Epimax Enterococcus, Escherichia coli, Pseudomonas, SC (Emad Company, Iran), and Silvosept Acinetobacter, and Enterobacter in burn (Chitotech Company, Iran) evaluated and patients (6). Acinetobacter baumannii is also compared on Gram-negative bacteria Downloaded from jhs.mazums.ac.ir at 2:20 +0430 on Saturday May 2nd 2020 [ DOI: 10.18869/acadpub.jhs.4.1.45 ] an important pathogen of burn wound (P. aeruginosa, Acinetobacter, E. coli, Proteus, infections, especially in immunocompromised Klebsiella, and Enterobacter) that were patients and patients who are in the intensive isolated from different parts of Shahid care unit (ICU) (8). Sadoughi Burn Hospital in Yazd in 2014. The pollution of environmental surfaces may play a role in transfer of pollutions (9-11). The infection incidence in healthcare 2. Materials and Methods and education-health centers causes Sampling contaminants enter into the environment from This is a descriptive-analytical study and the various ways and mechanisms; therefore, sampling was random. To evaluate the several factors can have a role to the infection disinfectants efficacy (Deconex 50 AF, Iran J Health Sci 2016; 4(1): 46 Evaluation of the current disinfectants efficacy on Gram-negative bacteria T. Jasemizad et al. Epimax SC, Descoscid, and Silvosept) using a All culture media used in this study were statistical formula and to determine the manufactured by Merck, Germany. It should sample size on α = 0.05, P = 0.800, d = 0.15, be noted that all of the samples was performed the sample size was calculated equivalent 30. with the alcoholic lamp. A total of 30 samples The location of the samples was selected and were taken before and 30 after disinfection. marked according to the highest level of Physiologic serum was used as positive patient contact and personnel from different controls. In this study, each disinfectant used parts of the hospital rooms, isolation room, according to the manufacturer’s recommended dressing room, and the hospital corridor of concentration for surfaces disinfection. burn injuries in the Medical University of 2.3. Comparison of studied bacteria colony Shahid Sadoughi in Yazd in 2014. count Sampling was carried out at the end of the After identification of bacteria, the numbers of business day and before disinfecting the bacterial colonies were counted before surfaces, a sterile cotton swab moistened with disinfection and by considering the dilution sterile saline, and sampled from the entire factor, their number was determined in 1 ml areas and placed in the tube containing 3 ml of (cfu/mL). If investigated colony exists on the tryptic soy broth medium. Then, the marked plate, this method also was used after places were disinfected by a disinfectant disinfection for counting. This method was according to the instructions and after used to compare the number of investigated finishing contact time and drying disinfectant; bacteria in all places and all of the above sampling was done again according to the disinfectants. mentioned methods and cultured. 2.4. Statistical analysis 2.2. Sample culture To analyze the data, the descriptive tables For culturing the samples, a tube containing were used and for the normal data, paired the sample was mixed by Vortex, and then t-test (paired t-test) was used. 100 µl of sample was transferred to plates containing blood agar medium and
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