Surgery: In general, it is the one that occurs as a result of a break in the natural defensive barrier (skin) due to an intentional or accident or as a result of a surgical procedure, which results in rupture and pressure on the tissue, and as a general rule any surgical procedure in which an incision occurs in the tissue is considered a surgical operation, (1).
Microbiological Contamination: Refers to the non-intended or accidental introduction of infectious material like bacteria, yeast, mould, fungi, virus, prions, protozoa or their toxins and by-products, (2).
A nosocomial Infection: Also called (Hospital-Acquired-Infection) is defined as: An infection occurring in a patient in a hospital or other healthcare facility in whom the infection wasn't present or incubating at the time of admission. This includes infections acquired in the hospital but appearing after discharge, and also occupational infections among staff of the facility, (2).
Staphylococci: This genus is a gram-positive spherical cells that exist in the form of single globules, pairs, or grouped in the form of clusters. It can also exist in the form of short chains and most of its types are immobile. Glucose fermentation, and there are about 32 types, (2).
The most important known species are staphylococcus aurous, which gives a positive coagulation enzyme reaction test, while staphylococcus epidermis and staphylococcus saprophytic don't have the ability to produce coagulation enzyme, and some strains have the ability to form a preservative or form a sticky layer that helps them resist antibacterial. Most species are facultatively anaerobic, but most strains prefer to grow in aerobic conditions. Also, this bacterial genus has the ability to ferment carbohydrates to obtain carbon and energy, and the bacterial type Staphylococcus aurous is considered one of the most important pathogenic opportunistic bacterial species and causes several infections, including wound infections, the formation of pustules, beggary, impetigo, as well as ulcers. This bacterial genus can also cause bone infection, And mastitis, meningitis, bacteremia, pneumonia, as well as pyoderma fatalist, and this bacterial genus causes food poisoning, and it is known that this bacterial genus constitutes the normal flora of the nose and skin in healthy people, where about 50% of newborns carry this bacterium in the nose. The bacterial type Staphylococcus saprophyticus causes urinary tract infections in women. And the bacterial type Staphylococcus epidermidis causes inflammation of the lining of the heart and sepsis as a result of infection with this type of bacteria, (1)
Streptococcus: This type of bacteria is Gram-positive and its cells are dilated globules and are often found in Diplococcic. They may exist singly or in the form of short chains. When grown in the laboratory on blood agar, it will result of incomplete decomposition of blood cells. Red blood cell, which is known as the alpha hemolytic type, as is the case in streptococcus viridians, and this decomposition is what distinguishes this bacterial type from group (A). This type of bacteria does not have spores. It is also non-motile and is able to ferment glucose sugar to produce lactic acid. It also does not secrete the enzyme catalase. It can be grown in laboratory when anaerobic environmental conditions are available in the presence of 5% carbon dioxide as a requirement that stimulates it to Growth, and this type of bacteria has the ability to self-transform its colonies, as the transparent colonies have the ability to exist and grow in the nasopharynx, while the dark colonies have the ability to exist and grow in the blood, this type of bacteria is found naturally in the upper respiratory tract, and this type of bacteria can cause pneumonia, and has the ability to cause sinusitis, middle ear infection, and meningitis, and this type of bacteria can also cause osteoporosis, arthritis, and endocarditis. Heart disease, inflammation of the abdominal cavity, as well as cellular tissue infections, brain abscesses, bacteremia, and conjunctivitis. It is also considered the main cause of many severe infections in children and elderly people, as well as people who suffer from a defect in the immune system, (1).
Escherichia coli: They are Gram-negative bacterial cells that do not form spores and are motile because they contain multiple flagella and a delicate case that gives them stickiness when grown on the appropriate nutrient media. They are also facultative anaerobes and have ability to ferment carbohydrates producing gas. Its cells are rods. The size of which ranges from about 2.0- 6.0 micrometers longitudinally. And about 1.1-1.5 in width and the apparent shape of the cells may be spherical or long filiform bacilli. This bacterial type has cilia that help it attach to the host cells, and these cilia differ in terms of structure in the different strains of Escherichia coli, and this bacterial type is responsible for the outbreak of most cases of diarrhea during the summer and some cases of diarrhea in children and cases of food poisoning, and this bacterial type is present as a natural inhabitant in the intestines of humans and animals, and sometimes it turns into pathogenic bacteria, and is considered the main cause of respiratory infections, and there are many strains of this type of bacteria that have the ability to cause diarrhea, (1).
Klebsiella: The cells of this bacterial type are facultatively anaerobic bacilli and don't have the ability to grow in anaerobic environmental conditions. The length of its cells ranges from about 1-2 micrometers and its width is about 0.5-0.8 micrometers. They are found singly, in pairs, or in the form of short chains. The ability to ferment the sugar lactose, and it is a non-motile bacteria, but there are species that have ciliates. This type of bacteria has the ability to grow in varying temperatures ranging from 12-43 degrees Celsius and is affected when exposed to moist heat at a temperature of 55 degrees Celsius for 30 minutes. And when the appropriate environmental conditions are available, it forms a large gelatinous preservative of polysaccharides. It is considered one of the main causes of pneumonia and results in abscess formation. These infections are often opportunistic and occur in people who suffer from chest diseases, diabetics and malnourished patients. Important in causing nosocomial infections, as it can cause urinary tract infection and sepsis, while the bacterial type Klebsiella aerogenes that causes nasal sclerosus known as granuloma that affects the nose and pharynx, and sometimes chronic infections may lead to deformation of the airways. The bacterial type Klebsiella ozaena is present in the nasal mucosa and is considered one of the rare causes of respiratory system infections that lead to damage to the mucous membranes, (1).
Pseudomonas: The cells of this bacterial genus are aerobic bacillus with a size of 0.6 in width and 2 micrometers in length. They are Gram-negative, non-spore-forming, and are mobile by flagella (one or two flagella) located on the poles of the cell. Some strains of the bacterial type, Pseudomonas aeruginosin, maybe it is a preservative and is considered one of the most important pathogenic bacteria species out of 200 species of this genus. It has the ability to grow at a temperature of 37-42 degrees Celsius and secretes two soluble dyes, namely pyocyanin, which gives it a greenish yellow color. The dye is secreted abundantly in the food medium that contains a small amount of iron. There are two other types of dyes secreted by this bacterial genus, namely Puroprene, which gives it a red color, and Melanin, which gives it a brown color, (1)
Contamination of operating rooms is one of the most life-threatening sources of infection for patients acquired in hospitals. Multiple sources have been identified responsible for contamination in hospitals, particularly in hospital room's surgical operations, where surface contamination is one of the most important causes of contamination in room's surgical operations, and the medical staff is still a major source of contamination. The first major developments in the prevention of infection at the surgical site were the mid-nineteenth century with the use of sterilization technique. Before the nineteenth century, surgical patients usually had a fever after surgeries, followed by purulent secretions from wounds, infection, and often death, but in the 1860s, the incidence of pathogenesis decreased due to wound infection after surgeries, thanks to the scientist Joseph Lister, who clarified the foundation of antisepsis, as these efforts led to a fundamental change in surgical medicine, as it became an activity accompanied by injury and death to an important branch of medicine that could help patients get rid of pathological suffering and prolong life, (3) Staphylococcus, Streptococcus, Escherichia coli, Klebsiella and Pseudomonas are the most common bacteria in surgical infections. In most cases, the source of infection is a bacteria on the surface of the patient's skin or contamination of the surgeon's hand or contamination of some surgical tools and transmission through the air or even due to the presence of germs inside the body and their spread to the wound site in cases of weak immunity, (4).
Infections acquired during health care delivery, more appropriately called health care-associated infections "HAIs", are a significant public health problem around world. It is estimated that 5% - 10% of patients admitted to acute care hospitals in developed countries, acquire one or more infections. In developing countries the risk of infection is 2 – 20 times higher and the proportion of patients infected can exceed 25%, Hospital hygiene is the state of a hospital which is safe, clean, free of contamination and pathogens, in which incidence of health care-associated infections "HAIs" are under monitoring and control, (5).
When we was visited El-mak Nimer Hospital, we observed some patients undergoing surgery were exposed to infection of surgical sites for several reasons such as inefficiency of sterilization operations and others reasons. Our study aimed to detect and identification of bacterial contamination because Assisting and identifying the sources of contamination within the hospital's surgical unit, Significantly reduce health costs for families and the hospital mortality and morbidity rate that occurs due to hospital infections and reducing the mortality and morbidity rate that occurs due to hospital infections.