الفهرس 
AIM OF THE STUDYOnly 14 pages are availabe for public view
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Abstract
Healthcare facilities consistently fall within the top of consumers of water in the community. The healthcare sector employs many water-use functions including food service, laundry, water purification, process water for vacuum systems, cooling towers, boilers, image processing for x-rays, sterilizing, as well as hygiene practices for patients, staff, and facilities. Healthcare facility water use varies widely depending on type, size, geographical location and water using equipment/practices. Several pathogens causing healthcare-associated infections (HAIs) can be transmitted through a waterborne route. Some pathogens that survive in water systems are opportunistic; they are part of the human microbiome (organisms that normally live harmlessly in or on humans) and cause infection only under certain conditions.
The present work aimed at estimating the effect of hospital water distribution system on the quality of water in the hospital.
This cross sectional study was conducted during a 12 months period from January 2014 to December 2014. A total of 240 water samples were included in this study. These samples were collected from main water system (24), tanks (36), taps (132), NICU filter (12), dental unit chair (24), and HD unit (12) during the period from January to December 2014.
Water samples were aseptically collected in 500ml sterile bottles. These bottles contained sodium thiosulfate to neutralize the lethal effect of chlorine on microorganisms.
The water samples were directly transferred to the laboratory and examined within 16 hours of collection. Each sample was vigorously shaken and subjected to microbiological and physical examination.
Microbiological examination: • Enumeration of HPC using standard spread plate method. • Enumeration of TC, FC and FS by MF method using M-Endo, M-FC and Mstreptococcus medium. • Isolation of fungi by MF method using SDA.
The study revealed the following results: 1. The mean value of pH, free chlorine, total alkalinity and temperature for water samples are 7.6, 0.5 mg/l, 120 ppm, and 28.7C° respectively. 2. The highest mean value of temperature (33.1 C°) was in summer months and the lowest value (20.08 C°) in winter months with mean value 28.7C°during the study period. 3. Out of 240 total water samples, 198 (82.5%) in which HPC was more than 50 CFU/ml.
Summary and conclusion
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4. Of the water sample from hospital and tank entrance, hospital tanks, hospital taps, NICU filter, dental unit and HD unit 4(16.7%), 36(100%),122 (92.4%),24(100%),12(100%) and 0.0(0.0%)in which HPC more than 50 CFU/ml . 5. The highest mean count for HPC was in tank 2 and patient room 406 (161.6± 43, 172.5±50) and the lowest mean count was in hospital entrance, tank entrance and sterilization room (38.3±16, 40±16 and 42.9±17). The difference of HPC mean counts regarding site of collection was statistically significant (p<0.05). 6. The highest mean count for HPC was in February and October (141±90.86, 137±52.77) and the lowest mean count was in September and November (76±32.37,73 ±23.97).The difference of HPC mean counts regarding site of collection was statistically significant (p<0.05). 7. The rinsing and hand pieces of the dental chair unit had high mean count of HPC (118,120 CFU/l) than dental unit tap (113CFU/ml) .The difference of HPC mean counts regarding site of collection was statistically non-significant (p>0.05). 8. The tank of the HD unit had high mean count of HPC (134 CFU/ml) than HD unit tap (113CFU/ml) and HD unit outlet (18CFU/ml) .the difference of HPC mean counts regarding site of collection was statistically significant (p<0.05). 9. The filter of the NICU had high mean count of HPC (2042 CFU/ml) than NICU tap (114CFU/ml).the difference of HPC mean counts regarding site of collection was statistically significant (p<0.05). 10. Tank 2 had high mean count of HPC (162 CFU/ml) followed by HD tank (134 CFU/ml) then tank 1 (108CFU/ml). 11. Of the240 total water samples 8(3.3%) in which total coliform was detected. 12. The month of April had high TC positive samples(3) (tank entrance, tank 2 and Dental chair Hand pieces) 13. All TC positive samples yield 1CFU/100ml except sample collected from sterilization room in month of August yield 3 CFU/100ml. 14. The samples collected from tank 2 gave 2 TC positive samples each of them yield 1CFU/100ml. 15. Klebsiella, is the major isolated organism from TC positive samples. 16. Of the 240 total water samples none yielded faecal coliforms or faecal streptococci. 17. Of the 240 total water samples 219(91.3%) in which fungi was detected. 18. The percentage of fungi positive sample between months ranging from 80% to 95% with 91.3%to total sample during the year. 19. The total count of fungal colony isolated from 219 positive samples was 1178 colony with mean 5.4CFU.
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20. The high count was in NICU filter (88/CFU) and the low count was in HD outlet (32/CFU). 21. The percentage of fungi positive sample between hospital sites ranging from 75% to 100% with 91.3% to total sample during the year. 22. The number of colonies of filamentous fungi was 1138 (96.6%) and number of yeast colonies was 40 (3.4%). 23. The percentage of isolated genera colonies of filamentous fungi Aspergillus, Penicilium, Alternaria,Cladosporium, Curvularia, Bipolaries ,Rhizopus ,Fusarium, and Nigrosporon were 675 (59.3%), 132 (11.6%),129 (11.6%),117 (10.3%),36 (3.2%),19 (1.7%),13 (1.1%),11 (1%), 6 (0.5%) respectively . 24. The differences of fungi mean counts regarding month and site of collection was statistically significant. 25. In the present study there was positive correlation between HPC total counts and filamentous fungi.
from the results of this study, it could be concluded that: 1. Water from hospital entrance with high quality. 2. Among all tested samples, hospital tanks had the highest percentage of HPC samples over legally permitted. 3. NICU had the highest count of HPC and fungi samples. 4. All water samples from taps had HPC count over legally permitted. 5. The isolated bacterial and fungal genera my cause serious modification in hospitalized patients. 6. RO unit works effectively with high quality. 7. RO unit cannot remove fungi completely but decreases their count. 8. Dental chair had no effect on the count of HPC.