Abstract:
Healthcare-Associated Infections are gradually becoming a new public health challenge in healthcare settings, particularly in maternity wards. To explore the interplay of microbial air quality and vernix caseosa on the health of neonates during the first seven days after birth, a cross-sectional study was conducted using 845 samples obtained from the maternity ward of the University of Cape Coast hospital in Cape Coast from October to December 2023. These included air samples, swabbing of 17 items, nurses' palms and 59 neonates who were born in the maternity block within a five week- period of the study. Indoor air was sampled at the various rooms with agar plates placed at different height, 1.5 m above the ground level for the delivery room, and at 84 cm above the ground level in the lying-in rooms. Categorical analysis of samples from the palms of nurses, mothers and the bodies of the neonates indicated 22.0%, 67.8% and 79.7% bacterial growth respectively. Staphylococcus epidermis had the highest infection rate among the organisms isolated from the neonates, nurses, and mothers, with 29 neonates, 6 nurses, and 14 mothers affected. A multivariate analysis was conducted on the categorical data from swabs taken from the neonates, nurses' palms, and mothers' palms to assess the likelihood that the neonates were infected by organisms originating from either the nurses' palms, the air, or the mothers. It was found that the organisms from the palm of nurses were significantly associated with the infection of the neonates (p-values of 0.040). Three to seven days after discharge, the number of neonates that were susceptible were 11 (18.6%) of those infected and out of this, Staphylococcus epidermis still recorded the highest number out of the organisms isolated (54.5%). A cross-tabulation and Pearson’s chi- square analysis was performed to study the relationship between the categorical variable of organisms isolated right after birth and those isolated three to seven days after birth. it was found that, all the babies that had no infection right after birth still had no infection after 3 to 7 days of infection. The relationship showed a p-value of 0.063. This study highlights that despite the delivery ward being regarded as a critical area where high levels of cleanliness and sterility are essential, it is still prone to microbial contamination. Significant microorganism was detected in the air, signifying that the maternity ward environment can be a potential reservoir for bacteria and other microorganisms. This highlights the need for stringent infection control measures, including the regular maintenance of ventilation systems, the use of appropriate personal protective equipment, and adherence to aseptic techniques.
