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PRESENCE OF PATHOGENIC BACTERIA IN AIR CONDITIONING UNITS OF

ADVENTIST MEDICAL CENTER ILIGAN CITY

Presented to the Faculty of the Department of Medical Technology


Adventist Medical Center College
Brgy. San Miguel, Iligan City

In Partial Fulfillment
of the Requirements for the Degree
BACHELOR OF SCIENCE IN MEDICAL TECHNOLOGY

DOMIL VINCENT BUNGABONG


MARTIN CLYDE G. PAGLINAWAN
LORAINE ZOE C. REDAJA
LEONARDO VITTORIO A. RODRIGO
JOHN RUXEL A. VALMORIA
CHAPTER 1

THE PROBLEM AND ITS SCOPE

Introduction

Nowadays, air-conditioning units is one of the most essential and

common technology that can be found in our households and other important

places like hospitals and laboratories because with these, the temperature of a

room can easily be modified which can allow people to live more comfortably

and contentedly in harsh climate like our country and brings environmental

flexibility. The comfort, the ease and happiness that air-conditioners brings to

our lives is limited and controlled because cooling towers of air-conditioning

units is one of the environment and habitation of a many pathogenic bacteria

that causes nosocomial infections or even worse.

In the past years of Adventist Medical Center Iligan City, there has been a

rapid development of new buildings and offices and a substantial increase in

the number of people working in such spaces in the hospital. Since some of the

rooms of the hospital is required with fresh ambient air in this type of

environment, an air-conditioning (AC) systems is practically the only technical

solution used to both improve the air quality and provide the healthcare
workers and patients with proper working conditions. The atmospheric air,

which is delivered into the building through the AC system, should be free from

most common pollutants and ensure an ideal temperature and moisture.

Unfortunately, bad maintenance of AC systems or their low efficiency can often

lead to unintentional bacterial contamination. In addition, the air circulation

can transmit infectious respiratory disease and allergic reactions. AC units

can spread indoor pollutants such as bacteria, molds, mildew, viruses, and

pollens, however the scope of this study focuses only in bacteria that may

spread through AC units of the hospital that causes nosocomial infections.

According to Kroqulski (2010) the air is not favorable to the growth and

survival of microorganisms, which has no nutrients and usually low moisture

content, it is the most important medium for carrying and spreading of

biological agents. Bacteria suspended in the air can be viable (culturable and

non-culturable) as well as nonviable forms. They can be also attached to dust

particles formed from inorganic matter or to water or saliva droplets.

This study deals with the detection of bacteria present in the air-

conditioning systems of the Adventist Medical Center Iligan City. In addition,

the aim of this study is to assess and evaluate the level of bacterial

contamination in air-conditioned rooms of the hospital and determine what

implications can be derive from the results of the study. Nosocomial infections
are periodic and a local problem in hospitals and nursing homes, where

bacteria may spread easily and patients in hospitals are vulnerable and

susceptible to infection. Through this study, the researchers can detect the

pathogenic bacteria present in air-conditioning units of the hospital.

Conceptual Framework

The concept of the study is shown in schematic diagram on Figure 1. It

shows the different variable in the study. The water samples collected is the

independent variable. The dependent variables comprises the isolated and

identified bacteria. Identified bacteria is a dependent variable.

Independent Variables Dependent Variables


Confirmato
Swab samples ry of
from Bacterial isolation identifies
air-conditioning and identification bacteria in
units selective
medium
Statement of the Problem

This study aims to find out Detection of Bacteria in Air Conditioning Units of
Adventist Medical Center Iligan City

Specifically, it will seek answers to the following questions:

1) Is there any presence of bacteria in the samples as will be tested in the

laboratory? What are the bacteria found in air-conditioning units?


2) What are the pathogenic and non-pathogenic bacteria found in air

conditioning units?
3) What implications can be derived from the study?

Scope and Limitation

This research is bound to identify the significant presence or absence of

pathogenic bacteria in air-conditioning units of Adventist Medical Center Iligan

City. If there is a presence of bacteria, the researchers will attempt to know its

health risks.

The study will use at least thirty samples from different air-conditioning units

of Adventist Medical Center Iligan City. They will be tested for the presence or

absence of bacteria. Specific laboratory procedure using different media will be

employed to obtain and acquire the needed information or data results.


Chapter 2

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter represents on the discussion of some literature and studies

which are relevant to the present study. Concepts and ideas from these

scientific literatures have opened an avenue of understanding that would lead

to the solution of the problems set in the study.

Related Literature

The sources of the infecting bacteria are environmental, and geographic

variation in the frequency of infection has been documented. Airborne

dissemination of bacteria from cooling towers and evaporative condensers has

been responsible for some epidemics, but potable water systems are perhaps

more important sources.(Winn, 1988)

According to Pasquarella et al. (2010) in their article entitled Air

microbial sampling: the state of art that air microbial sampling is a subject of

great interest in different fields of human activity; however, generally accepted

indications, concerning both the sampling methods to be used and the


interpretation of the results, are still lacking. The whole theme is greatly

debated and several problems remains to be solved. The aim of this article is to

provide knowledge relating to the problems associated with air microbial

sampling, underlining the aspects to be considered in order to choice the

sampling method on the basis of the objective of the sampling itself and on the

knowledge of the characteristics and limits of the different methods.

The relationship between hospitals location and bacteria and fungi

concentration in hospitals rooms was investigated. Hospitals situated in the

city centre and outside the city were chosen to investigation. The relationship

between bacteria and fungi concentration in indoor and ambient air was

analyzed. In the investigation air-conditioned rooms were isolated. (Kroqulski,

2008)

In addition to what Kroqulski (2010) stated in his article entitled

Microbial air purity in hospitals, Operating theatres with air-conditioning

system that the aim of this study was to show the influence of air conditioning

control for microbial contamination of air inside the operating theatres

equipped with correctly working air-conditioning system. This work was based

on the results of bacteria and fungi concentration in hospital air obtained since

2001. Assays of microbial air purity conducted on atmospheric air in parallel


with indoor air demonstrated that air filters applied in air-conditioning systems

worked correctly in every case. To show the problem of fluctuation of bacteria

concentration more precisely, every sequences of single results from successive

measure series were examined independently.

According to Bardaquim et al. (2014) Sixty samples were collected with

the aid of sterile swabs soaked in peptone water and rubbed into quadrants of

20 cm2. The surfaces investigated were: medication tables, surgical tables,

marble countertops and air conditioning grilles.

Related Studies

Kohler, Gross, Salvaggio, and Hawkins (1976) found that antigens from

thermophilic Actinomycetes species growing in air conditioners and humidifiers

have been implicated in causing hypersensitivity pneumonitis. A similar role for

thermotolerant bacteria has not been documented despite the fact that these

organisms are uniformly present in contaminated humidifiers and air

conditioners, exceeding Actinomycetes colonies by approximately 15-fold, and

often are recovered when cultures are negative for thermophilic Actinomycetes.
In fact, to prevent overgrowth by thermophilic bacteria, inhibitors are

frequently included in media used for culturing Actinomycetes.

Hwan, Park, and Hyun (2014) found that the characterization and

measurement of the concentration of airborne infectious microorganisms in a

laboratory is difficult because of the diversity of infectious microorganisms

handled in a bio laboratory, variation in the efficiencies of air sampling

equipment, different viability of each infectious microorganism, and lack of a

standardized method for measuring individual microorganisms in the air. The

measurement of total airborne bacteria (TAB) has been used by indoor

environment experts as an index of microbial contamination in the air. The

TAB test method has not been demonstrated to be a successful indicator of the

performance of biosafety cabinets (BSCs); however, the assessment of total

airborne fungi has been evaluated to be an indicator of BSC performance.

Tang (2013) posted that hospital indoor air pollution is associated with

inadequate building environments, including building materials, air

conditioning systems, ventilation rates, and human factors, such as over-

crowding in constrained spaces. Evaluations of operating theater air quality

assessed levels of particulate matter (PM), microbial agents, and volatile organic
compounds (VOCs). Employees, patients, and visitors are significant sources of

airborne microbes in hospitals.

In addition to what Kroqulski (2010) stated in his article entitled

Microbial air purity in hospitals, Operating theatres with air-conditioning

system that aim of this study was to show the influence of air conditioning

control for microbial contamination of air inside the operating theatres

equipped with correctly working air-conditioning system. This work was based

on the results of bacteria and fungi concentration in hospital air obtained since

2001. Assays of microbial air purity conducted on atmospheric air in parallel

with indoor air demonstrated that air filters applied in air-conditioning systems

worked correctly in every case. To show the problem of fluctuation of bacteria

concentration more precisely, every sequences of single result from successive

measure series were examined independently.

Research Design

The researchers use the experimental research method. This is use to

obtain about the presence of bacteria in airconditioners of Adventist Medical

Center Iligan City. The experimental research design is use to determine the

possible presence of bacteria in air conditioners. The true experiment is use

because the researchers find the data gathered in the presence of bacteria.
Sampling Design

A purposive sampling design is use in the study which involved taking the

number from the same probability distribution. Cotton swab were made with

the specimen streak using the blood agar and inoculate in 37 C overnight.
Data Gathering Procedure
Collection of specimen

Specimen preparation

Culture, isolation and bacterial


inoculation

Gram staining

Gram positive bacteria Gram negative bacteria


(Cocci) (Bacilli)

Catalase test Oxidase test

Coagulase
Biochemical
test
tests

Figure 1: Flow chart in identification of bacteria in air-conditioning units


STATISTICAL TOOLS

1. Percentage is a frequency distribution with counts or the frequencies are

expressed as a percentage of total frequency equated to 100.


No. of bacteria
Percentage=_______________________ x 100
No. of total bacteria

2. The Chi Square Test is a statistical hypothesis test in which the

sampling distribution of the test statistic is a chi square distribution

when the hypothesis is true.


2
Observe-expected

X2= ______________
expected
References

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df

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