Environmental contamination with antimicrobial resistant pathogenic bacteria and Cryptococcus spp isolated from pigeon and marabou stork faecal matter in Mulago Hospital, Kampala

Abstract

Background: Environmental contamination with pathogenic microorganisms in routine medical care settings poses an increased risk of health care associated infections through cross-transmission as most outdoor hospital environment has been found to be an underestimated vital reservoir for certain pathogens. Antimicrobial resistance can complicate treatment and lead to poor management and prognostic outcomes of patients. Objective: The study was carried out to determine the existence of antimicrobial and antifungal resistant pathogenic microorganisms in faecal matter of pigeons and marabou stork birds that dwell and feed from Mulago hospital environment. Method: Specimens (n=150) of faecal matter were collected aseptically and analyzed in the laboratory. Colony characteristics and Gram technique were used to differentiate the organisms. Biochemical tests were done to confirm the species of the bacteria and Cryptococcus organisms. Sensitivity testing was done on the isolates using the disc diffusion method. Results: Pathogenic organisms were recovered from 92.4% of the specimens. The isolates were: E.coli37 (24.67%), Klebsiella pneumoniae 5 (3.33%), Staphylococcus aureus 8 (5.33%), Coagulase negative Staphylococcusspp43 (28.67%), Candida spp13 (8.67%), Citrobacter spp34 (22.67%), Proteus spp2 (1.33%) and Acinetobacter spp 1 (0.67%). Samples from Marabou stork generally had slightly more isolates than samples from pigeons. All E.coli isolates were susceptible to Cefotaxime, Amoxicillin/Clavulanic Acid, Ceftriaxone, Ciprofloxacin, Chloramphenicol, Amikacin, Doripenem, and Imipenem. Some isolates were resistant to Trimethoprim (10%), Gentamicin (70%) and Ampicilin (10%). E.coli isolates from marabou stork were susceptible to all antibiotics. Klebsiella pneumoniae isolates from both marabou storks and pigeons were susceptible to all antibiotics. All Staphylococcus aureus isolates were susceptible to Cefoxitin and Gentamicin. 83.3% of the isolates were resistant Clindamycin, Oxacillin and Tetracycline. 16.7% were resistant to Penicillin, Ciprofloxacin and Ceftriaxone, 66.7% were resistant to Erythromycin and 33.3% were resistant to Vancomycin and Trimethoprim. Conclusion: Since a high proportion of samples had positive cultures, the access of the hospital environment by these pathogen carrying birds should be controlled. Attention should also be given to the outdoor hospital environment as potential habour for pathogens which could be transmitted to the hospital users. There is need to develop national surveillance of antibiotic- resistant organisms and also consider pigeons and marabou storks a risk species for spreading in the hospital environment antimicrobial resistant organisms.