Environmental Factors Associated with the Chain of Transmission of Nosocomial Infection in a Maternity Hospital in Yerevan, Armenia

Aim: Nosocomial infections are one of the leading causes of neonatal mortality, especially in Low and Middle-Income Countries. While maternal UTIs and ICU stays are well known risk factors, this study looks at hospital surfaces as well as the bacteria present on mothers' and workers' hands to identify additional sources of infection for nosocomial infections in newborns at hospitals in Yerevan, Armenia. Methods: This observational study was conducted at the Research Centre for Maternal and Child Health Care in Yerevan, Armenia. Microbial culture samples were taken from departments related to neonates as well as high traffic areas in the hospital (n=1099). Samples from healthcare workers (n=118) and mothers (n=107) were taken from palms, fingertips, and nails. All samples were appropriately cultured and data analysis included t-tests, χ 2 tests, and logistic regression. Results: Most of the sampled surfaces were negative for microbial growth (n=1009 (84%)), but 97% of positive cultures could be accounted for by S. aureus, Enterobacter spp., and E. coli. The maternity hospital had the greatest number of positive samples (26.5%). 52.8% of samples from healthcare workers showed growth of S. aureus, Enterobacter spp., and E. Coli. 53.3% of samples from mothers' hands showed growth, with 5% of samples also growing Pseudomonas. The presence of artificial nails and jewelry on mothers' hands showed a statistically significant increase in bacterial growth. Conclusion: This study highlights the need for continued microbiological surveillance and hand hygiene stewardship to understand local epidemiological trends and decrease rates of neonatal infections in Armenia.