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Title:	Incidence and risks of cronobacter spp. in neonatal intensive care units of selected Malaysian hospitals
Authors:	Sri Harminda Pahm Hartantyo (P38440)
Supervisor:	Norrakiah Abdullah Sani, Dr.
Keywords:	Hospital Cronobacter spp. Enterobacteriaceae Universiti Kebangsaan Malaysia -- Dissertations
Issue Date:	25-Apr-2012
Description:	The incidence Cronobacter spp. and the risks of exposure to it in neonatal intensive care units (NICU), particularly in infant milk preparation lines in Putrajaya Hospital, Serdang Hospital and the Universiti Kebangsaan Malaysia Medical Center were determined. In line with this, five sub-studies were conducted. The first aimed to survey the presence of Cronobacter spp. and other related organisms in powdered infant formula, follow up formulas and infant foods available in the Malaysian market. It was indicated that 87% (78/90) of samples had aerobic plate counts within the permitted <104 CFU/g level. The most frequently isolated Enterobacteriaceae was Enterobacter cloacae, present in 4/90 samples. Other Enterobacteriaceae detected were Citrobacter spp., Klebsiella spp. and Enterobacter spp. No Cronobacter sakazakii was found in all samples. None of the product labels instructed that water for formula preparation should be at 70oC, as specified by WHO guidelines. The second and third studies observed the prevalence of C. sakazakii and other selected organisms and evaluated the milk preparation procedures in the NICU. The highest aerobic plate count (3.02 ± 0.21 log CFU/faucet) and S. aureus level (1.46 ± 0.11 log CFU/faucet) were detected on faucets; the highest coliforms (2.69 ± 0.07 log CFU/strainer) and Enterobacteriaceae levels were found in strainers. No E. coli were observed in any of the samples collected across hospitals. From 472 swab samples, 18 (3.8%) were suspected to contain C. sakazakii but upon further biochemical tests using ID 32E, VITEK 2, BIOLOG GEN III and molecular identification using polymerase chain reaction targeting the α-glucosidase (gluA), only four (0.85%) of the suspect colonies were confirmed as such. The size of the NICU as well as the number of patients to which it caters to does not play a direct role in the microbiological quality of the area. The fourth study determined the knowledge, attitudes and practices (KAP) of hospital staff involved in milk preparation. From 50 respondents, the overall mean scores for food handling KAP were 64.8 ± 13.26, 72.12 ± 22.8 and 85.4 ± 6.6, respectively. All respondents had a generally positive attitude towards food and milk handling as well as personal hygiene but inconsistent associations were observed for the respondent's responses and their demographic and work-related characteristics. Lastly, the risk of infection in the NICU was determined. Risk Ranger software was used to generate risk estimates and model different processing scenarios. The probability of contracting Cronobacter spp. infection per day per neonate was 4.29 x 10-1 and the total number of predicted illnesses per year for the target population was 2.96 x 104. The risk rank was 77. It is recommended that proper hygiene and sanitation as well as good manufacturing procedures in terms of milk preparation be consistently followed and monitored by milk handlers in order to ensure that milk prepared in NICUs are safe from harmful pathogens.,Certification of Master's/Doctoral Thesis" is not available
Pages:	286
Call Number:	QR82.E6H377 2012 tesis
Publisher:	UKM, Bangi
Appears in Collections:	Faculty of Information Science and Technology / Fakulti Teknologi dan Sains Maklumat

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