Abstract

Background: Infections due to extended spectrum beta lactamase (ESBL) producing gram
negative bacteria (GNB) have been a global challenge. The magnitude of ESBL producing GNB
contaminating medical examination equipments (MEEs) and clinical coats was not clearly
known.

Objective: This study determined the magnitude and associated factors of ESBL producing
GNB contaminating MEEs and clinical coats at Bugando Medical Centre, Mwanza.

Methods: This was a cross sectional hospital based study involving 407 swabs specimen from
clinical coats (n=157) and MEE (n=250), conducted from April to July 2017. Swabs were
cultured on plain MacConkey agar and MacConkey agar supplemented with 2μg/ml cefotaxime.
Isolated GNB were identified by in-house biochemical identification tests. ESBL production was
confirmed by double disc synergy technique.

Results: Overall, the magnitude of GNB contaminating clinical coats and MEE was 35.9%
(146/407), and out of 146 GNB, 34 (23.3%) were ESBL producers. Clinical coats were highly
contaminated with GNB and ESBL producing bacteria than MEE; 57.3% (90/157) vs. 22.4%
(56/250), p<0.001 and 24.7% (23/93) vs. 18.9% (11/58), p˂0.001, respectively. ESBL producers
were highly resistant to gentamicin 73.5% (25/34) and highly sensitive to meropenem 97.1%
(33/34).

Conclusions: The magnitude of MEEs and clinical coats contamination with ESBL producing
GNB is high. Clinical coats are significantly more contaminated. Therefore, MEE and clinical
coats should also be potential niches of focus in the infection prevention and control strategies in
this hospital.

Keywords: clinical coats, ESBL, medical examination equipment, Tanzania