Exploration microbiologique des surfaces d'un centre d'hémodialyse de la ville de Fès : étude descriptive transversale

The reality of the risk of infection in haemodialysis has been studied by several publications which claim that nosocomial infections are 100 times more frequent in this environment than in the general population. The microbiological monitoring of the hospital setting is a focus of policies to combat these infections, although the precise involvement of the environment in their occurrence is not known. In the framework of a quality approach and in order to control the infection risk linked to the haemodialysis environment, we carried out two descriptive transversal studies at the haemodialysis unit of Al Ghassani hospital in Fez (Morocco): the first was carried out before the renovation of the unit, the second after the work was completed and the unit began operating again. The main objectives were to evaluate the rate of contamination of the surfaces of patients' treatment rooms and to identify isolated germs. In total, 184 samples were taken. The surface points analysed included the dialysate supply systems, the tables, the beds and the objects most frequently handled by patients, such as remote controls. We recorded an overall contamination rate of 96%. This concerned the dialysate supply systems as well as the tables, beds and other objects. Bacteria accounted for 94.64% of the infectious agents and mould 5.36%. The overall distribution of the bacterial strains showed that the genus Staphylococcus was the most frequently found (61.3%), with a predominance of Staphylococcus sp. The Streptococcus were isolated with a frequency of 9.4% compared to 14.1% for the Bacillus sp. Non-fermenting oxidase positive gram-negative bacilli (NF Ox P GNB) were found with a frequency of 10.9%, while non-fermenting oxidase negative gram-negative bacilli (NF Ox N GNB) occurred with a relatively low frequency of 4.3%. A significant reduction in the contamination of surfaces was noted after the renovation of the unit. Further efforts need to be made to train staff in hospital hygiene and to control the cleaning and disinfection protocol.