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Bacterial contamination of door handles/knobs in selected public conveniences in Abuja metropolis, Nigeria: A public health threat.

  • June 2012
Authors:
Ukpai A Eze at De Montfort University
Ukpai A Eze
Amos Nworie at Ebonyi State University
Amos Nworie
Ayeni J. A.
Ayeni J. A.
Ayeni J. A.
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Azi Simon at Universiti Putra Malaysia
Azi Simon
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The increasing incidence of epidemic outbreaks of certain diseases and its rate of spread from one community to the other has become a major public health concern. Door handles/knobs of public conveniences of selected public offices, motor parks, and markets in Abuja metropolis were investigated for bacteria contamination. Out of the 180 swab samples cultured, 156 (86.7%) were positive. They were more positive samples from female toilet handles/knobs (41.7%) and bathroom door handles/knobs (11.5%) than males. The study also found that toilet door handles/knobs in markets, motor parks and restaurants had higher rate of contamination compared to Government offices, and banks. Contamination was also higher in toilet door handles/knobs (87.2%) than in bathroom door handles/knobs (85%). Most of the bacteria contaminants were Coliforms. The isolated bacterial contaminants were Staphylococcus aureus (30.1%), Klebsiella Pneumoniae (25.7%), Escherichia coli (16.1%), Enterobacter species (11.2%), Citrobacter species (7.1%), Pseudomonas aeruginosa (5.9%), and Proteus Species (4.5%). This shows that the city’s convenient places habours highly pathogenic bacteria which have the potentials of causing epidemics in the near future. Therefore, community health superintendents, sanitary officers and Environmental Protection Board as well as private organizations should educate the populace on personal and environmental hygiene.
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7
Continental J. Medical Research 6 (1): 7 - 11, 2012 ISSN: 2141 – 4211
© Wilolud Journals, 2012 http://www.wiloludjournal.com
` Printed in Nigeria
BACTERIAL CONTAMINATION OF DOOR HANDLES/KNOBS IN SELECTED PUBLIC CONVENIENCES IN
ABUJA METROPOLIS, NIGERIA: A PUBLIC HEALTH THREAT
1
Nworie .A.,
2
Ayeni .J. A.,
1
Eze .U. A.,
1
Azi .S. O.
1
Department of Medical Laboratory Science, College of Health Sciences,
Ebonyi State University, Abakaliki, Nigeria.
2
Department of Medical Microbiology, Federal School of Medical
Laboratory Sciences, Jos University Teaching Hospital, Plateau State,
Nigeria.
ABSTRACT
The increasing incidence of epidemic outbreaks of certain diseases and its rate of spread from one community
to the other has become a major public health concern. Door handles/knobs of public conveniences of selected
public offices, motor parks, and markets in Abuja metropolis were investigated for bacteria contamination. Out
of the 180 swab samples cultured, 156 (86.7%) were positive. They were more positive samples from female
toilet handles/knobs (41.7%) and bathroom door handles/knobs (11.5%) than males. The study also found that
toilet door handles/knobs in markets, motor parks and restaurants had higher rate of contamination compared to
Government offices, and banks. Contamination was also higher in toilet door handles/knobs (87.2%) than in
bathroom door handles/knobs (85%). Most of the bacteria contaminants were Coliforms. The isolated bacterial
contaminants were Staphylococcus aureus (30.1%), Klebsiella Pneumoniae (25.7%), Escherichia coli (16
community health superintendents, sanitary officers and Environmental Protection Board as well as private
organizations to educate the populace on personal and environmental hygiene. 1%), Enterobacter species
(11.2%), Citrobacter species (7.1%), Pseudomonas aeruginosa (5.9%), and Proteus Species (4.5%). This
shows that the city’s convenient places habours highly pathogenic bacteria which have the potentials of causing
epidemics in the near future. Therefore, community health superintendents, sanitary officers and Environmental
Protection Board as well as private organizations should educate the populace on personal and environmental
hygiene.
KEYWORDS: Public conveniences, Door handles/knobs, Bacterial contamination, Pathogenic bacteria,
Epidemics, Environmental hygiene.
INTRODUCTION
Microorganisms are found everywhere and constitute a major part of every ecosystem. In these environments, they live
either freely or as parasites (Sleigh and Timbury, 1998). In some cases, they live as transient contaminants in fomites or
hands where they constitute a major health hazards as sources of community and hospital-acquired infections (Pittet et
al., 1999). The increasing incidence of epidemic outbreaks of certain diseases and its rate of spread from one
community to the other has become a major public health concern (Scott et al., 1982; Galtelli et al., 2006).
Although it
is accepted that the infection risk in general community is less than that associated with patients in hospital, the yearly
increases in food poisoning cases in which household outbreaks are a major factor, requires an assessment of the
probable causes and sources (Scott et al., 1982).
Besides the day to day interaction of people, which constitute one way of spreading disease, the major source of and
spread of community acquired infections are formites (Prescott et al., 1993; Li et al., 2009). Formites when in constant
contact with humans or natural habitats of pathogenic organism constitute a major source of spread of infectious
diseases (Osterholm et al., 1995). Such formites include door handles of conveniences, showers, toilet seats and
faucets, sinks, lockers, chairs, and tables, especially those found in public offices, hospitals, hotels, restaurants and
restrooms (Bright et al., 2010). One of the most implicated probable sources of infections is door handles of toilets and
bathroom (Reynolds, 2005). Public toilets and bathrooms have large traffic of users who throng in with their own
microbial flora and other organisms they have picked elsewhere and deposit them on door handles/knobs while going
into the convenience and on their way out (Goldhammer et al., 2006).
However, the risk of disease transmission through formites is determined by the frequency of site contamination and
exposure; level of pathogen excreted by the host; likelihood of transfer of the infectious agent to a susceptible
individual; virulence of the organism; immuno-competence of the persons in contact; the practice of control measure
8
Nworie .A et al.,: Continental J. Medical Research 6 (1): 7 - 11, 2012
such as disinfectant use and personal hygiene (Reynolds, 2005). Unfortunately, majority of public toilets found in parks
and markets, especially Nigeria, lack water system and where they have such systems, water are never available.
Consequently, users can hardly wash their hands after usage, carrying them contaminants from such conveniences
(Giannini et al., 2009) and such could result to community-associated methicillin resistant Staphylococcus aureus (CA-
MRSA) outbreak in high prevalence areas and cholera outbreak Giannini et al., 2009).
This study was therefore designed to determine the level of bacterial contamination of door handles/knobs of public
toilets and bathrooms, as well as, identify the bacterial contaminants in selected public places in Abuja metropolis, the
capital of Nigeria in order to provide scientific information that would have policy relevance, and which will aid the
hand washing programmes in Nigeria.
MATERIALS AND METHODS
Abuja is the capital territory of Nigeria. It is made up of civil servants, public servants and traders with a population of
776,298 (www.wikipedia.com). Samples were obtained from the toilet door handles/knobs in selected public places in
Abuja metropolis using full aseptic precaution. Samples were collected using the swab-rinse technique of the American
Public Health Association as described by Reynolds, (2005). Door handles/knobs were swabbed with sterile, cotton-
tipped applicator (swab stick) moistened with sterile peptone water. It was then introduced into bijou bottles containing
sterile peptone water, shaken, and loosely capped. The bijou bottles were covered with cellophane and transported in ice
pack from Abuja to Jos University Teaching Hospital where the samples were analysed. The peptone water, in which
the swab samples from door handles/knobs were rinsed into, were thawed, gently shaken and poured on MacConkey
agar, Blood agar, and Chocolate agar plates, and spread evenly over their entire surfaces using a sterile bent-glass rod.
This was to allow quick recovery of all organisms picked up in the swab. Then, the plates were incubated aerobically
for 24 hours at 37
o
C (Angelotti and Foter, 1958).
Identification and characterisation of bacterial contaminants
Bacterial isolates were first differentiated by macroscopic examination of the colonies. The colonies were differentiated
based on size, colour, pigmentation, elevation, surface texture, margin, haemolysis on blood and chocolate agar plates,
and lactose fermentation on MacConkey agar. Several biochemical tests were also carried out to further identify the
various bacterial isolates as described by Barrow and Feltham, (1993).
RESULTS
Both toilet and bathroom door handles/knobs of selected public places in Abuja metropolis were sampled for bacterial
contamination. One hundred and eighty (180) swab samples; 70 were from male toilets, 70 from female toilets, 20 from
male bathrooms, and 20 from female bathrooms respectively. Out of the 180 samples, 156 (86.7%) showed positive for
bacterial contamination (table 1). Out of the 140 samples collected from toilet door handles/knobs, 122 (87.1%) showed
bacterial contamination while 34 (85%) of the 40 samples collected from bathroom door handles/knobs showed
bacterial contamination (Table 2). Among the bacteria contaminants isolated, Staphylococcus aureus had the highest
prevalence 30.1%, followed by Klebsiella pneumoniae 25.7%, Escherichia coli 15.6%, Enterobacter species 11.2%,
Citrobacter species 7.1%, and Pseudomonas aeruginosa 5.9% while Proteus species had the least prevalence, 4.5% as
shown in table 4.
Table 1: Distribution and percentages of positive samples of male and female toilets and bathrooms door
handles/knobs.
Door handles/knobs Total samples
Examined Number positive % of positive samples
Male toilets 70 57 36.5
Female toilets 70 65 41.7
Male bathrooms 20 16 10.3
Female bathrooms 20 18 11.5
Total 180 156 86.7
Table 2: Distribution of bacterial contamination on toilets and bathroom door handles/knobs swabbed.
Toilets Bathrooms
Number of samples Culture positive (%) Number of samples Culture positive (%)
140 122 (87.1) 40 34 (85)
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Nworie .A et al.,: Continental J. Medical Research 6 (1): 7 - 11, 2012
Table 3: Distribution and percentage bacterial contamination of toilets and bathroom door handles/knobs in relation to
the establishments sampled.
Banks Markets/parks Churches Restaurants Government
establishments
Number of samples 8 80 4 4 84
Number of positive
samples 5 72 3 4 72
Percentage of positive
samples 62.5 90 75 100 85.7
Table 4: Prevalence and degree of growth of bacteria isolated from contaminated door handles/knobs.
Bacteria Number isolated Degree of growth Prevalence (%)
Staphylococcus aureus 81 ++++ 30.1
Klebsiella pneumoniae 69 +++ 25.7
Escherichia coli 42 ++++ 15.6
Enterobacter spp. 30 +++ 11.2
Citrobacter spp. 19 +++ 7.1
Pseudomonas aeruginosa 16 ++ 5.9
Proteus spp. 12 +++ 4.5
Key:
+ One or few colonies
++ Scanty growth
+++ Medium growth
++++ Full and luxuriant growth
DISCUSSION
Bacterial, fungal, and viral contamination of door handles and knobs are well documented and these formites in turn
serve as vehicles for cross-infections and recontamination of washed hands (Monarca et al., 2000; Otter and French,
2009; Bright et al., 2010). Some of the contaminants can be highly pathogenic and can be transferred from one person
to another or may result in auto-inoculation (Kennedy et al., 2005; Li et al., 2009).
In this study, door handles and knobs of toilets and bathrooms in churches, markets/parks, banks, restaurants and
government establishments in Abuja metropolis, Nigeria were evaluated to determine the level of bacteria
contamination and to identify the bacteria contaminants. Out of the 180 samples assessed, 156 (86.7%) showed bacterial
contamination. This is slightly lower than that obtained by Otter and French, (2009) who reported 95% positive cultures
in similar environments. This may be attributed to the use of water system in these conveniences, especially in the
public offices examined. It could also be due to constant cleaning of these toilets by cleaning companies engaged by
these institutions.
This study also shows that the level of contamination of toilet door handles/knobs (87.1%) were slightly higher than on
bathrooms door handles/knobs (85%). This difference in the level of contamination of the two may be attributed to a
larger population usage of toilets than bathrooms. It is a common knowledge that fewer people take their baths in public
bathrooms as compared to those that walk into the toilets to ease themselves. Furthermore, this work shows that female
toilets and bathroom door handles/knobs had higher bacterial contamination (41.7% and 11.5% respectively) compared
to male toilet and bathroom door handles/knobs (36.5% and 10.3% respectively). This is similar to the findings of
Kennedy et al., (2005). This may be due to certain habits of women which tend to enhance contamination. For instance,
women carry a lot of artifact of beauty (hand creams and lotions, eye pencils, papers, mirrors, make-ups, and a lot more)
in their bags which they use each time they enter public conveniences. The consequences of this life style are that
contaminants from those items are left on doors, a situation rarely seen in male lavatories.
In this study, it was also discovered that toilet and bathroom door handles/knobs of markets/parks and restaurants were
highly contaminated (90% and 100% respectively) compared to banks, churches and government establishments
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Nworie .A et al.,: Continental J. Medical Research 6 (1): 7 - 11, 2012
(62.5%, 75% and 85.7% respectively). This is in tandem with findings of Boone and Gerba, (2010) who reported that
the levels of contamination of conveniences vary depending on traffic, exposure and environment. The traffic level in
the use of lavatories in the later group is quite higher than in the former comprising banks, churches and public
establishments. In the former, usage is often restricted to staff and/or is constantly cleaned by contract staff who clean
and wipe the door handles/knobs after few usages thereby reducing bacterial contaminants on the surfaces while in the
later, the traffic to their toilets and bathrooms are always higher, but there are few of these facilities in such places. This
is similar to the report of Kennedy et al., (2005) who reported that there was more contamination in high traffic
restrooms such as airports, bus terminals, educational institutions, and restrooms with one or fewer urinals. Apart from
these, restaurants, motor parks and markets lack cleaners and a few that are available are neither trained nor have the
equipments and disinfectants to do their job resulting to high level of contamination in these places.
Previous works have shown that frequently or heavily used formites are most likely contaminated and therefore carry
higher heterotrophic bacterial loads (Bright et al., 2010). In this study, the most common bacterial contaminants are
Staphylococcus aureus (30.1%), followed by Klebsiella Pneumoniae (25.7%), and Escherichia coli (15.6%).
Pseudomonas aeruginosa was also isolated (5.9%) which portends a great health hazard to the ever growing population
of Abuja metropolis. This report is similar to that of Kennedy et al., (2005) and Rusin et al., (2002). Most of the
positive samples examined had more than one type of bacterial isolate, but majority of the cases are from the samples
collected from parks and markets. The fact that these contaminants were at high level in these environments is of great
concern, especially with the increasing number of immuno-compromised patients and transplantation cases.
CONCLUSION
In conclusion, it is important to note that there is high level of bacterial contamination as well as high level of
prevalence of the bacterial contaminants. This may lie as a time bomb because of its potential to cause epidemics.
Forestalling this will require community health superintendents, sanitary officers and Environmental Protection Board
as well as private organizations to educate the populace on personal and environmental hygiene.
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Received for Publication: 24/02/2012
Accepted for Publication: 01/04/2012
Corresponding author
Nworie .A.
Department of Medical Laboratory Sciences, College of Health Sciences, Ebonyi State University, P.M.B. 053,
Abakaliki, Nigeria.
E-mail: nworieamos@yahoo.com
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This study was conducted to determine the bacterial contamination in door handles of washrooms of a hospital, to determine the prevalence and antibiotic susceptibility pattern of the isolates. Plasmid profile was done to observe the presence or absence of plasmid among isolated bacteria from door handles of washrooms of a hospital. Washrooms of four different wards of a hospital were included in this study. Manual of Systematic Bacteriology and antibiotic susceptibility test was done by Kirby-Bauer method. Plasmid extraction was done according to modified hot alkaline method and staining technique and biochemixcal testing. Out of the 16 samples processed, 16 (100%) of them showed bacterial growth. A total of forty three (43) isolates were obtained. The bacteria isolated were spp. (37.21%), spp.(18.6%), .(16.28%), Fecal Coliform (13.95%), Micrococcus spp.(6.98%), spp.(4.65%), spp.(2.33%).Plasmid profiling revealed (11 out of 43) bacterial isolates contained 1 or more plasmids with different profiles.. Among the 43 isolates, 83.72% were found resistant to more than two antibiotics. Highest resistance percentage of the isolates was observed against Penicillin G (95.35%) followed by SXT (74.42%) and amoxicillin (65.12%), rifampicin (55.81%), tetracycline (18.60%), ciprofloxacin (23.26%), chloramphenicol (4.65%), gentamycin, (2.33%) and streptomycin (6.98%). Findings of this study indicate the presence of bacterial strains resistant to more than two antibiotics in door handles of washrooms of a hospital which can serve as potential source of diseases.
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... Trillions and trillions of microorganisms are found in the environment: the oceans, polar ice, in the depth of earth's crust, the human body, animals and plants. Few of them are harmful to humans (pathogenic) and the non-pathogenic types are widely spread in the environment [1,2]. Infectious diseases can threat public health from infected tools in environment. ...
Investigation of Virulence Factors in Microbial Organisms that Associated with Public Health Risk Isolates from Different Environmental Regions
Article
Full-text available
  • Feb 2023
Infectious diseases caused by infected tools in the environments are threaten to the safety and public health. Transmission sources of these infectious diseases are unknown, but it is thought that non-living materials called fomites, are the major source of acquired infections. Three hundred and one swabs were taken from different sources and cultured on blood agar to study heamolysis ability of isolated bacteria. In this study, MacConkey agar was used to isolate Gram-negative bacteria and Sabouraud agar (SDA) to isolate fungi. The biofilm formation test was done by Congo red plate assay. 41 (13.6%) bacterial isolates were obtained and (18.27%) of fungi were isolated on Sabouraud agar (SDA). Staphylococcus aureus was the more frequent bacterial species that isolated in this study. 29% of samples showed hemolysin activity on blood agar and 32%of the isolates were biofilm- producer. Results revealed that (7.9%) of Gram-negative bacteria harbored the fimH gene, (9%) harbored the icaA were Gram-positive and 6.3 % of fungal samples had HWP1 gene. Furthermore, (9.3%) from the total samples are bacterial samples harbored hla gene belong to Staphylococcus spp. Furthermore, (5.07%) of tested samples possessed hlyA gene were Gram-negative bacteria. We found in our study that infectious organisms can be transmitted from one individual to another by fomites responsible for acquired infection.
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... The presence of these organisms indicates the poor sanitary condition. Nworie et al. (2012) isolated S. aureus, K. pneumonia, and P. aeruginosa from door handle/knobs in selected public conveniences in Abuja Metropolis, Nigeria. The contamination of door handles might be due to direct contact with contaminants that can transmit bacterial species, most of which are bacteria of medical importance. ...
Incidence and antibiotic susceptibility profile of bacteria from door handles in Faculty of Science complex, Sokoto State University Sokoto
Article
Full-text available
  • Jan 2023
The incidence and antibiotic susceptibility profile of bacteria from door handles were studied to X-ray the public health implication of bacterial infections in the complex. Eleven genera were identified: Staphylococcus aureus, Staphylococcus intermidis, Streptococcus pneumonia, Listeria monocytogenes, Staphylococcus cohinii, and Streptococcus pyogenes, Staphylococcus epidermidis, Staphylococcus chromogenes, Staphylococcus capitis, Escherichia coli, Pseudomonas aeruginosa. The antibiotic susceptibility pattern revealed that Gentamycin exhibited the highest zone of inhibition to all isolates, followed by ciprofloxacin, oflaxacin, nitrofurantoin and Ampicillin. The frequency of bacterial isolates showed that Staphylococcus aureus had the highest percentage of 30%, followed by Escherichia coli (12.5%), Streptococcus pyogenes (10.0%). Streptococcus pneumonia, Staphylococcus cohinii, and Staphylococcus capitis each had (7.5%); the least was Listeria monocytogenes and Staphylococcus intermidis (2.5%). Finally, the public health implications of the isolates were discussed.
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Commonly Used Public Facility Devices as Potential Sources of Infections
Chapter
  • Jun 2023
Surfaces and devices in public institutions are likely to be contaminated with various microorganisms as people congregate there for various reasons. Swab samples from devices like ATMs, seats, teller counters, door handles, pens, writing desks, toilet flush handles, and tap heads were obtained from banks and churches. 60 samples in all were cultured and isolates were identified using Gram stain reaction, morphological, and biochemical characteristics. Results indicated a 100% microbial contamination on all surfaces with Staphylococcus aureus having the highest frequency, 35(31.5%). Bacilli spp had the next highest frequency, 23(20.7%). Klebsiella spp 13 (11.7%), Salmonella spp 13(11.7%), Enterobacter spp 13(11.7%), Serratia spp 6(5.4%), Citrobacter spp 4(3.6%), Proteus 3(2.8%) and Streptococcus 1(0.90%) followed in that order. Commonly used public facilities' devices could serve as potential sources of infections due to their microbial contamination. It is highly recommended amidst this pandemic to have frequent proper hand hygiene to avoid unknowing contamination.
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Prevalence and Antimicrobial Resistance Profile of Diarrheagenic Escherichia coli from Fomites in Rural Households in South Africa
Article
Full-text available
  • Aug 2023
Citation: Rakhalaru, P.; Munzhedzi, L.; Abia, A.L.K.; Kabue, J.P.; Potgieter, N.; Traore, A.N. Prevalence and Antimicrobial Resistance Profile of Diarrheagenic Escherichia coli from Fomites in Abstract: Diarrheagenic Escherichia coli (DEC) pathotypes are the leading cause of mortality and morbidity in South Asia and sub-Saharan Africa. Daily interaction between people contributes to the spreading of Escherichia coli (E. coli), and fomites are a common source of community-acquired bacterial infections. The spread of bacterial infectious diseases from inanimate objects to the surrounding environment and humans is a serious problem for public health, safety, and development. This study aimed to determine the prevalence and antibiotic resistance of diarrheagenic E. coli found in toilets and kitchen cloths in the Vhembe district, South Africa. One hundred and five samples were cultured to isolate E. coli: thirty-five samples were kitchen cloths and seventy-five samples were toilet swabs. Biochemical tests, API20E, and the VITEK ®-2 automated system were used to identify E. coli. Pathotypes of E. coli were characterised using Multiplex Polymerase Chain Reaction (mPCR). Nine amplified gene fragments were sequenced using partial sequencing. A total of eight antibiotics were used for the antibiotic susceptibility testing of E. coli isolates using the Kirby-Bauer disc diffusion method. Among the collected samples, 47% were positive for E. coli. DEC prevalence was high (81%), with ETEC (51%) harboring lt and st genes being the most dominant pathotype found on both kitchen cloths and toilet surfaces. Diarrheagenic E. coli pathotypes were more prevalent in the kitchen cloths (79.6%) compared with the toilet surfaces. Notably, hybrid pathotypes were detected in 44.2% of the isolates, showcasing the coexistence of multiple pathotypes within a single E. coli strain. The antibiotic resistance testing of E. coli isolates from kitchen cloths and toilets showed high resistance to ampicillin (100%) and amoxicillin (100%). Only E. coli isolates with hybrid pathotypes were found to be resistant to more than three antibiotics. This study emphasizes the significance of fomites as potential sources of bacterial contamination in rural settings. The results highlight the importance of implementing proactive measures to improve hygiene practices and antibiotic stewardship in these communities. These measures are essential for reducing the impact of DEC infections and antibiotic resistance, ultimately safeguarding public health.
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Behavioural Response of Whitefly Bemisia tabaci (Hemiptera: Aleyrodidae) Towards Volatile Organic Compounds Emitted from Eggplant Leaves
Article
Full-text available
  • Feb 2023
The whitefly Bemisia tabaci is considered one of the most destructive insect pests that can attack several vegetable crops worldwide. The behavior of choosing a host plant by whitefly can be significantly influenced by volatile organic compounds. The aim of this investigation is to identify and bioassay the volatile organic compounds emitted from uninfested and infested eggplant leaves with B. tabaci. The current study focuses on the interaction between whitefly and eggplant with the identification of volatile organic compounds emitted from leaves that were collected by headspace solid phase microextraction fiber and gas chromatography mass spectrum analyzed. Both uninfested and infested eggplant leaves released a total of 11 compounds. The amount of volatile organic compounds emitted from affected eggplant leaves by whitefly was higher than from uninfested eggplant leaves. Using a Y-shaped olfactometer bioassay, whitefly preferred to attract toward volatile emitted by eggplant leaves in both uninfested and infested eggplant leaves. Our results suggest these chemical compounds can play a key mediator in host finding behavior. The exploitation of one or more of these compounds can apply in an integrated management program of this pest as a lure in the sticky trap or manipulating insect behavior.
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Occurrence of Bacteria and Viruses on Elementary Classroom Surfaces and the Potential Role of Classroom Hygiene in the Spread of Infectious Diseases
Article
Full-text available
The presence of microorganisms on common classroom contact surfaces (fomites) was determined to identify the areas most likely to become contaminated. Six elementary classrooms were divided into control and intervention groups (cleaned daily with a quaternary ammonium wipe) and tested for heterotrophic bacteria. Three classrooms were also tested for norovirus and influenza A virus. Frequently used fomites were the most contaminated; water fountain toggles, pencil sharpeners, keyboards, and faucet handles were the most bacterially contaminated; desktops, faucet handles, and paper towel dispensers were the most contaminated with viruses. Influenza A virus was detected on up to 50% and norovirus on up to 22% of surfaces throughout the day. Children in the control classrooms were 2.32 times more likely to report absenteeism due to illness than children in the intervention classrooms and were absent longer (on average). Improved classroom hygiene may reduce the incidence of infection and thus student absenteeism.
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An investigation of microbial contamination in the home
Article
Full-text available
An investigation of the bacterial flora in over 200 homes is reported. The occurrence of potential pathogens and the levels of contamination at individual sites, particularly in the kitchen, toilet and bathroom is described and the implications for hygiene practices in the home discussed.
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Bacterial Contamination of the Hands of Hospital Staff During Routine Patient Care
Article
Full-text available
Cross-transmission of microorganisms by the hands of health care workers is considered the main route of spread of nosocomial infections. To study the process of bacterial contamination of health care workers' hands during routine patient care in a large teaching hospital. Structured observations of 417 episodes of care were conducted by trained external observers (S.T. and V.S.). Each observation period started after a hand-cleansing procedure and ended when the health care worker proceeded to clean his or her hands or at the end of a coherent episode of care. At the end of each period of observation, an imprint of the 5 fingertips of the dominant hand was taken and bacterial colony counts were quantified. Regression methods were used to model the intensity of bacterial contamination as a function of method of hand cleansing, use of gloves during patient care, duration and type of care, and hospital ward. Bacterial contamination increased linearly with time on ungloved hands during patient care (average, 16 colony-forming units [CFUs] per minute; 95% confidence interval, 11-21 CFUs per minute). Patient care activities independently (P<.05 for all) associated with higher contamination levels were direct patient contact, respiratory care, handling of body fluid secretions, and rupture in the sequence of patient care. Contamination levels varied with hospital location; the medical rehabilitation ward had higher levels (49 CFUs; P=.03) than did other wards. Finally, simple hand washing before patient care, without hand antisepsis, was also associated with higher colony counts (52 CFUs; P=.03). The duration and type of patient care affect hand contamination. Furthermore, because hand antisepsis was superior to hand washing, intervention trials should explore the role of systematic hand antisepsis as a cornerstone of infection control to reduce cross-transmission in hospitals.
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Hygiene of environmental surfaces in a cattle barn
Article
  • Jan 2014
Microbiological dipslides are widely used e.g. in food production facilities for HACCP (hazard analysis & critical control points) measurements and hygiene monitoring surveys, as well as for other cleanability studies. In this study the suitability of microbiological dipslide methods to measure the hygiene level of the environmental surfaces in a cattle barn was tested. A total of 1112 measurements were carried out during five measurement days. When evaluating the rooms by combining the results of the individual sampling sites and different dipslide types (total microbes, enterobacteria and β-glucuronidase-positive organisms, yeasts and moulds), the corridor and personnel rooms had the highest hygiene status. The office and personnel kitchen and the milk room were generally the next cleanest, depending on the evaluation criteria. The poorest hygiene level was observed in the barn and the second dirtiest in the washing room. It was demonstrated that the hygiene level of cattle barn surfaces with no excessive amounts of visible soil can be measured using microbiological dipslides. The results provided preliminary reference values for future studies and constitute an information source for training and self-monitoring systems.
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Comparative surface-to-hand and fingertip-to-mouth transfer efficiency of Gram-positive bacteria, Gram-negative bacteria, and phage
Article
  • Oct 2002
To determine the transfer efficiency of micro-organisms from fomites to hands and the subsequent transfer from the fingertip to the lip. Volunteers hands were sampled after the normal usage of fomites seeded with a pooled culture of a Gram-positive bacterium (Micrococcus luteus), a Gram-negative bacterium (Serratia rubidea) and phage PRD-1 (Period A). Activities included wringing out a dishcloth/sponge, turning on/off a kitchen faucet, cutting up a carrot, making hamburger patties, holding a phone receiver, and removing laundry from the washing machine. Transfer efficiencies were 38.47% to 65.80% and 27.59% to 40.03% for the phone receiver and faucet, respectively. Transfer efficiencies from porous fomites were <0.01%. In most cases, M.luteus was transferred most efficiently, followed by phage PRD-1 and S. rubidea. When the volunteers' fingertips were inoculated with the pooled organisms and held to the lip area (Period B), transfer rates of 40.99%, 33.97%, and 33.90% occurred with M. luteus, S. rubidea, and PRD-1, respectively. The highest bacteral transfer rates from fomites to the hands were seen with the hard, non-porous surfaces. Even with low transfer rates, the numbers of bacteria transferred to the hands were still high (up to 10(6) cells). Transfer of bacteria from the fingertip to the lip is similar to that observed from hard surfaces to hands. Infectious doses of pathogens may be transferred to the mouth after handling an everyday contaminated household object.
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Notes on Medical Mirobiology, 5 th edition
  • Jan 1998
  • Dj Sleigh
  • Mc Timbury
Sleigh DJ, Timbury MC. (1998): Notes on Medical Mirobiology, 5 th edition. Churchill-Livingstone, New York. P.173.