الفهرس 
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Abstract
Obstetrics and gynecology clinic is one of outpatients’ clinics that provide a variety of services as family planning, obstetrics, and gynecological services to a number of clients that visit the clinic every day.
Many instruments and devices used by HCWs inside obstetrics and gynecology clinic while delivering the different services, these instruments and devices may carry a risk for transmitting infection if not properly goes under a decontamination process.
Environmental surfaces either clinical contact surfaces or housekeeping surfaces inside the clinic also may play an important role in transmitting infection between clients if not thoroughly decontaminated by the proper method.
The aim of the current study was to evaluate the role of educational program in eliminating potential infection hazards in Obstetrics and gynecology clinic in Alexandria.
This study included three phases; phase I (before intervention) in which swabs were collected 3 times per week for 3 months, phase II ( interventional phase) in which educational sessions about standard precautions, reprocessing medical devices, and environmental cleaning was conducted for 1 month, and phase III (post intervention) in which swabs were collected 3 times per week for 3 months.
Swabs were taken from environmental clinical contact surfaces (examination bed and medication table), from medical devices (stethoscope and U/S abdominal probe), and from vaginal speculum before and after cleaning and after sterilization.
The level of contamination in this study assessed by two main parameters; quantitative (number of organisms found within a specified area with bench mark of a total plate count >5 CFU/cm2) and qualitative (identification of an indicator organism of potential high risk to patients (≥1CFU/cm2) as S.aureus and Gram negative bacteria).
In phase I, the contamination level was 77.8% in procedure bed, 83.3% in medication table, 63.9% in stethoscope, 80.6% in U/S abdominal probe, 50% in vaginal speculum after cleaning, and 16.7% in vaginal speculum after sterilization.
The prevalence of indicator organisms found in phase I were [MRSA (13.9%), Pseudomonas spp. (11.1%), Acinetobacter spp. (5.6%)] in bed, MRSA (16.7%) in medication table, [MRSA (8.3%), Pseudomonas spp. (2.8%)] in stethoscope, [MRSA (30.6%), Pseudomonas spp. (22.2%), Acinetobacter spp. (25%)] in U/S probe, [MRSA (16.7%), E.coli (11.1%), Acinetobacter spp. (5.5%)] in vaginal speculum before cleaning, and MRSA (8.3%) in vaginal speculum after cleaning.
In phase III, the contamination level decreased to 38.9% in procedure bed, 38.9% in medication table, 30.6% in stethoscope, 27.8% in U/S abdominal probe, 13.9% in vaginal speculum after cleaning, and 0% in vaginal speculum after sterilization.
The prevalence of indicator organisms in phase III were MRSA (8.3%) in medication table, MRSA (2.8%) in stethoscope, [MRSA (2.8%), Pseudomonas spp. (5.6%)] in U/S probe, and [MRSA (25%), Pseudomonas spp. (5.5%) E.coli(2.8%), Acinetobacter spp. (5.5%), Klebsiella spp. (8.3%)] in vaginal speculum before cleaning.
Antibiotics susceptibility test was done for all S.aureus and all gram negative bacteria isolates. All (100%) S.aureus isolates (48/48) were MRSA, all (100%) Acinetobacter spp. (15/15), E.coli (5/5), and Klebsiella spp. (3/3) were MDR, and 88.2% (15/17) of Pseudomonas spp. isolates were MDR.