At a large referral hospital in eastern Ethiopia, more than three quarters of the medical equipment and inanimate surfaces sampled by researchers were contaminated with bacteria, and many of the isolates recovered showed resistance to the antibiotics most commonly used in the region. The findings come from a hospital-based cross-sectional study conducted at Sheikh Hassan Yabare Comprehensive Specialized Hospital in Jigjiga, the capital of Ethiopia’s Somali Regional State, and published as an open-access research article in the journal Discover Bacteria.
Between December 2022 and June 2023, the research team collected 125 swab specimens from medical devices and hospital surfaces that patients and healthcare workers touch frequently. The sampled equipment included stethoscopes, blood pressure cuffs, pulse oximeters and suction machines, while the inanimate surfaces comprised beds, chairs, tables and doorknobs. Samples were drawn from five service areas of the hospital: the adult ward, the gynecology and obstetrics ward, the neonatal intensive care unit, the pediatric ward and the surgical ward. Specimens were collected aseptically with sterile swabs moistened in normal saline, transported to a microbiology laboratory within one hour, and processed using standard culture and biochemical identification methods.
The headline result was stark: 98 of the 125 sampled items, or 78.4 percent, tested positive for bacterial contamination. From those contaminated devices and surfaces, the researchers isolated 163 bacterial strains, with between one and three different species recovered per positive sample. Contamination was not confined to one corner of the hospital. Bacterial growth was detected in 72.5 percent of samples from the adult ward, 86.2 percent from gynecology and obstetrics, 70.6 percent from pediatrics, 76.9 percent from the neonatal intensive care unit and 92.3 percent from surgical services. Every swab taken from medical equipment in the gynecology and obstetrics and surgical services yielded bacterial growth.
The distribution of organisms revealed a familiar hierarchy of hospital contaminants. Coagulase-negative staphylococci, a group of skin-dwelling bacteria that are increasingly recognized as opportunistic pathogens, were the most frequent isolates at 39.2 percent of the total. Staphylococcus aureus followed at 22.1 percent. Among Gram-negative bacteria, Klebsiella species were the most common at 18.4 percent, then Escherichia coli at 14.1 percent, Proteus species at 4.3 percent and Pseudomonas aeruginosa at 1.8 percent. In absolute numbers, the 125 screened objects yielded 64 coagulase-negative staphylococcal isolates, 36 S. aureus isolates, 30 Klebsiella isolates and 23 E. coli isolates.
Certain items stood out as particular reservoirs. All specimens collected from suction machines and pulse oximeters were contaminated, a 100 percent contamination rate for those two device types. Among inanimate surfaces, doorknobs were the most heavily contaminated at 82.4 percent, followed by beds at 81.5 percent. Overall, bacteria were recovered from 76 percent of swabs taken from medical equipment and 80 percent of those taken from inanimate surfaces. The authors attribute these levels partly to inadequate infection prevention and control practices and to differences in how thoroughly equipment and surfaces are cleaned between uses.
To assess antimicrobial susceptibility, the team tested all 163 isolates against eight antibiotics representing drugs commonly used in the study area: amoxicillin-clavulanic acid, vancomycin, ampicillin, ciprofloxacin, gentamicin, cefoxitin, erythromycin and amikacin. Testing followed the modified Kirby-Bauer disk diffusion method according to the Clinical and Laboratory Standards Institute M100 guideline from 2020, with reference strains of S. aureus, P. aeruginosa and E. coli used for quality control. Inhibition zone diameters were measured in millimeters and interpreted as sensitive, intermediate or resistant.
The resistance data showed substantial levels of drug resistance among the Gram-positive isolates. Of the 64 coagulase-negative staphylococcal isolates, 48.4 percent were resistant to amoxicillin-clavulanic acid, 39.1 percent to erythromycin, 26.5 percent to vancomycin and 18.75 percent to gentamicin. Among the 36 S. aureus isolates, half were resistant to erythromycin, 25 percent to gentamicin and 19.4 percent to ciprofloxacin. The authors note that these S. aureus resistance levels were lower than those reported in earlier studies from Ethiopia and Sudan, a difference they suggest may relate to variations in drug administration practices.
The Gram-negative isolates displayed their own troubling patterns. Klebsiella species showed resistance to amikacin at 46.6 percent, gentamicin at 36.6 percent and amoxicillin-clavulanic acid at 33.3 percent, although every Klebsiella isolate remained sensitive to ciprofloxacin. Among E. coli isolates, 56.5 percent were resistant to amoxicillin-clavulanic acid, 47.8 percent to ampicillin and 34.7 percent to gentamicin, while ciprofloxacin was the most active drug against this species. Proteus species showed high resistance to ampicillin at 85.7 percent and gentamicin at 57.14 percent, yet neither Proteus nor P. aeruginosa isolates showed any resistance to ciprofloxacin, and P. aeruginosa was fully sensitive to amikacin. Only 30 percent of P. aeruginosa isolates were sensitive to amoxicillin-clavulanic acid, however.
Multidrug resistance, defined in the study as resistance to at least three antibiotic classes, was widespread across both Gram-positive and Gram-negative isolates. Just over half of the S. aureus isolates, 52.7 percent, met the multidrug-resistance definition, as did 23 percent of coagulase-negative staphylococci, 66.6 percent of P. aeruginosa isolates, 28.6 percent of Proteus isolates and 17 percent of E. coli isolates, the lowest figure recorded. The authors report that Klebsiella isolates were resistant to many of the drugs tested. These proportions place the Jigjiga findings within the broader pattern of rising multidrug-resistant hospital infections in low- and middle-income countries, where the study’s introduction notes that severe resistant infections are an increasing problem that raises case fatality.
The study’s authors conclude that the hospital’s medical devices and inanimate surfaces showed high bacterial contamination and that strengthening infection prevention and control practices is needed to reduce the risk these reservoirs pose to patients and staff. The team also acknowledges limitations: the investigation did not cover all microorganisms capable of causing hospital-acquired infections, since fungi and anaerobic bacteria were not included in the sampling. As a single-hospital cross-sectional survey, the study captures contamination and resistance patterns at one facility during one period rather than trends over time, and its findings describe contamination of objects rather than confirmed infections in patients. Even so, the near-universal contamination of suction machines and pulse oximeters, and the prevalence of multidrug-resistant isolates on everyday surfaces such as doorknobs and beds, underline how frequently touched hospital items can serve as persistent reservoirs of resistant bacteria in resource-limited settings.
Subject of Research: Bacterial contamination and antimicrobial resistance patterns of medical equipment and inanimate surfaces at an Ethiopian hospital
Article Title: Bacterial profiles, antimicrobial susceptibility pattern of bacterial isolates from medical equipment and inanimate surfaces of Shiek Hassan Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia
Article References: Gebrezihier, B. G., Beyene, G. A., Sileshi, H., & Missale, A. T. (2026). Bacterial profiles, antimicrobial susceptibility pattern of bacterial isolates from medical equipment and inanimate surfaces of Shiek Hassan Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia. Discover Bacteria, 3(1), Article 10. https://doi.org/10.1007/s44351-026-00047-9
Image Credits: AI Generated
DOI: 10.1007/s44351-026-00047-9
Keywords: hospital-acquired infections, antimicrobial resistance, bacterial contamination, Ethiopia, medical equipment, inanimate surfaces, Staphylococcus aureus, Klebsiella, multidrug resistance, infection prevention and control, disk diffusion, cross-sectional study
News Source: Kristina Jarvis. (October 29, 2026). Four in Five Hospital Devices and Surfaces in Ethiopian Study Carried Bacteria. Scienmag.
