J Olaitan, O Adeleke
bacteria, day-care-centres, enteric-diseases
J Olaitan, O Adeleke. Bacteria In Day Care Environment. The Internet Journal of Microbiology. 2006 Volume 3 Number 1.
With the need for women to get involved in economic enhancement of the family and with career mothers in the increase in our society, there has been increase in the need to have day care centers to keep the little baby while both parents go to work.
Often children come home from some of the Day Care centres with episodes of diarrhea, gastroenteritis and skin diseases. A number of these centers are established in our country without any supervision as to standard of the environment.
Five Day-Care centers in the city of Abeokuta were involved in this study. Swabs from the floor, cots of the baby, the toilet and the hands of the nurses involved in their care were collected. The samples were analyzed and tested for total viable bacteria count plating to determine microbial count and types.
A total of eleven different bacterial isolates were identified. Almost all the bacteria isolated in this study were enteric which are mostly responsible for enteric diseases in young children.
There is a need to improve hygienic behaviours in our Day Care Centres and governments must oversee these centres and ensure the proprietors/proprietresses abide with the minimum standard.
Day care Centre is a place where infants and children are kept, for a particular period of time for nursing care, nutrition, sleep, excretion, general comfort and follow up of the children (Wallace HM and Ebrahim, 1981). With the need for women to get involved in economic enhancement of the family and with career mothers in the increase in our society, there has been increase in the need to have these day care centers to keep the little baby while both parents go to work. This has also reduced the age at which these children are taken to these Day care centers for care.
The ease of spread of communicable diseases generally depends on the environment, the children themselves and the employees of these Day care centers who take care of these children. Often these children come home with episodes of diarrhea, gastroenteritis, chest and skin diseases.
Five of such centers in Abeokuta, the capital city of Ogun state, in south western Nigeria, were involved in this study. The aim was to determine the level of hygiene in these centers. The bacteria isolated as well as the bacteria count were determined. The results are reported in this paper.
Materials And Methods
Five different day care centers within Abeokuta township were involved in this study. The general environment of the Day Care Centres was noticed. Sterile cotton buds were used to collect samples from the floor, cots of the babies, the toilets and the hands of the nurses/assistants involved in their care. Each cotton bud was put inside sterile 10ml normal saline immediately after swabbing to keep the organisms alive from the Centre to the laboratory. Aseptic techniques were observed during collection of the samples.
The samples were analyzed and tested for total viable bacteria count, plating to determine microbial number and types.
The microorganisms isolated, from the five Day Care Centers differ from one center to the other and were both pathogenic and non-pathogenic organisms. Various bacteria were isolated from all the Day care centres. These isolates were gotten from the floor, toilet, cot and the hands of the nurses. The bacterial isolates were
Four of the Day Care Centres were highly contaminated. There were eleven different bacterial isolates from Day Care Centre 1, four different isolates from Day Care Centre 2, eight isolates from Day Care Centre 3, five isolates from Day Care Centre 4, and six different isolates from Day Care Centre 5 (Table 1). It was observed that all the samples collected from Day Care Centre I when cultured appeared to be members of the family Enterobacteriaceae. All the centres were contaminated with
Most of these organisms were enteric bacteria, which possibly found their way through chance contamination from lack of good personal and public hygiene suggesting faecal contamination.
In summary, it was noticed that all the samples collected from each day care centres showed significant growth of bacteria. The implication of this on the children kept in these Day care centres can only be imagined.
Day care Centre is a place where infants and children are kept for a particular period1. It is also defined as a valuable component of the services for preschool children. Day care Centre has also been described as a place which is directed to a group of children or infants and given by a nurse who is accountable for such care on 24 hours basis or less until the children leave the place3.
In Day care centers the nurses take responsibility in nursing care, nutrition, sleep, excretion, general comfort, plans for discharge and follow up of the children2. Day care center means supplying the provision, attention and support to meet the physical, mental, and social needs of the growing child4. The children group comprises about 45% of the population in developing countries and the infection rate is highest in the 0-5years of age5.
Infants and young children are more prone to infectious diseases and are more amenable to immediate care because some of the diseases suffered are environmental in origin and can be contained and prevented by an intelligent nurse who has acquired the relevant basic hygiene skill6.
Infections are major health problem in this (0-5years) age group including the common communicable diseases of childhood. Children in the Day care centers are exposed to infection due to the physical environment of the place3. Dirty environment may harbour infectious agent and predispose to skin infections. A good Day care is however able to keep its environment in good working order, free from all preventable epidemics.
The care of the infants require greater skill and attention both because the child is small and “slippery” and also because he is easily infected by microorganisms in contact with7.
Microorganisms are very ubiquitous8. They are present on the floor, body, air, toilet e.t.c. In the current study, the types and number of microorganism found in the Day care centers differ from one another. Edward9 has reported that Day care centers have been implicated as settings for the spread of communicable diseases, especially diarrhoea, among young, susceptible children (1-5years) due to poor hygiene with the staff of the Day care Centre. Almost all the bacteria isolated in this study were enteric which are mostly responsible for enteric diseases in young children.
Of the many species of pseudomonas, the species most frequently encountered in human clinical specimen is
Infection then passes to another person either directly or indirectly by physical touch or indirect by contaminated food. Outbreaks are common under conditions of overcrowding where hygiene practices are poor such as day care centres.
It has been observed that gastrointestinal diseases continue to be a major health problem in primary schools in the United Kingdom due to surface contamination of carpets12. This report is in line with the highest percentage of isolates from day care centre IV much contamination of the floor with microorganisms.
The conclusion of Alvarez
Habit of hand washing program suggested to prevent at least some of the diarrhoea in day care centres has been suggested14 and it has been suggested that in controlling the occurrence of diarrhea among children, sanitation facilities seemed to be more important than the supply of drinking water15.
The toilet of these young children should be maintained very well by washing with disinfectants to reduce the number of pathogenic microorganisms.
With increasing numbers of women in the workforce, day care centres have been increasing in number and the children at this age are at a higher risk of gastroenteritis diseases caused by a large number of enteric pathogens and the risk is increased by the greater potential from person to person transmission within the group care. Of all the five different day care centres sampled none was free from microorganism.
This study revealed that enteric organisms were present in day care centres studied and these were probably spread by the hands of the children and employees. Hand washing has been recommended as a preventive measure.
Faeces should be disposed off in a sanitary manner. Use of sufficient toilet paper should be stressed to reduce hands and fingers from coming into contact with faeces in these centres. Flies should be controlled by screening with nets, by spraying with insecticides, and by the use of insecticide baits and traps. Fly breeding should be controlled by the frequent collection and disposal of garbage. Scrupulous cleanliness should be used in handling and preparing food. There should be strict hygiene about the hand washing enforced in setting such as day care centres, the Texas Department of Health (TDH) warns, “one child's infection can spread throughout a group to become a persistent problem”.
Day care personnel must always be at alert to signs of the common infections, and should be aware that if one child has diarrhea, the probability is high that others also may be exposed, they have to separate the infected children from the rest children to avoid or reduce the rate of spreading of the infection.
Surveillance of the buildings and indeed the environment of Day care centres must be regular and routine. This will allow for proper monitoring of these centres and reduce the chance of children coming from Day care centres with infections.
Dr J.O.Olaitan Department of Microbiology, College of Natural Sciences, University of Agriculture, Abeokuta, Ogun state, Nigeria E-MAIL: firstname.lastname@example.org Phone number: 08055624130