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GPHC has no guideline for sterility checks of NICU

Nov 08, 2018 News

There is currently no guideline at the country’s premier health institution – the Georgetown Public Hospital Corporation [GPHC] – which stipulates that environmental sterility checks must be performed routinely.
Admitting to this state of affairs in the National Assembly recently was Senior Minister of Public Health, Ms. Volda Lawrence.
The Minister was at the time responding to questions posed by her colleague on the opposition side of the house, Dr. Vindyha Persaud regarding the hospital’s Neonatal Intensive Care Unit [NICU].
Sterility checks are performed when nosocomial organisms [hospital-acquired infections] are identified so that the sources of transmission can be addressed.
In order to ascertain the presence of such infections, medical personnel are tasked with assessing blood cultures.
Blood culture is the culture of micro-organisms from blood for the laboratory diagnosis of bacteraemia, infective endocarditis and other conditions associated with pyrexia [fever] of unknown origin.
Since the manifestations of such conditions have been known to have fatal outcomes, health workers have long been advised that early positive results from a blood culture can provide valuable diagnostic information on which appropriate antimicrobial therapy can be based.
Health facilities are usually expected to have bottles in place for blood cultures to be collected and assessed.
Recognising the importance of blood cultures in safeguarding the wellbeing of young patients, Dr. Persaud enquired of the Public Health Minister whether the Public Health Hospital even had enough blood culture bottles to identify infectious organisms.
Minister Lawrence assured the House that for the period June to December 2017 blood culture bottles were available 100 percent of the time, but noted that for January to June 2018 they were only available 39.2 percent of the time.
The Minister was required to provide an answer to concerns about the identification of multi-drug resistant organisms in the cases of sepsis.
Indeed, she shared that a multi-drug resistant organism, Klebsiella pneumonia, was isolated. In fact she disclosed that of a blood sample size of 578, a total of 19 were required to be isolated.
According to the Minister, while there were occasions when prescribed medications were not available, substitutes were used to ensure good patient outcomes. She shared too, in responding to questions about death by infectious organisms, that “it is difficult to determine the time of infection of a baby, since infections in newborns occur prenatally, perinatally or postnatally.
It is therefore challenging for doctors to diagnose an infection that a baby had because of the care that they received while in hospital.”
Referencing a suspected death by infectious organisms, Minister Lawrence maintained that “the cause of death due to Iatrogenic infections could not be determined.” She however disclosed that sterility checks were conducted on equipment and surfaces when nosocomial organisms were identified through patient cultures.
Additionally, the Minister related that thorough cleaning with soap and water and disinfection with a bleach solution as well as 70 percent alcohol was used to deter these organisms.
According to her, slides were set strategically in the NICU, tested at the GPHC laboratory, and results obtained were analyzed.
Further, she disclosed that based on findings, appropriate actions were taken to sanitise the NICU and cleaning was done in accordance with the GPHC Infection Control Manual and the Centre for Disease Control [CDC] guidelines for environmental infection control for health care facilities.

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