Water birthing: Results from a 18 months-long microbiological surveillance

Objectives: The aim of our study was to monitor the effectiveness of the cleaning and disinfecting procedures used in the pool for pre-delivery courses and single tubs for water birthing at “Careggi” Hospital (Florence, Italy). Methods We conducted a cross-sectional study collecting water samples and swabs. After microbiological analysis data were organized in a database and then exported for statistical analysis. Results: We collected 15 water samples from the pool: Escherichia coli, Pseudomonas aeruginosa and Enterococci resulted negative. We collected 142 samples from the 4 tubs for the water birth. There was a statistically significant difference (p=0.01; OR=0.28) in the presence of Staphylococcus spp. in the two examined years: in 2017 their presence was significantly lower (N=5) then 2016 (N=23). There was also a statistically significant difference (p=0.03) in the presence of yeasts in the 2 examined years: in 2017 six samples resulted positive, in 2016 no one. Chi square test evidenced that the water discharge system was at a higher risk of being contaminated by staphylococci (p=0.01, OR=3.08). Conclusion: A continuous monitoring and the implementation of training programs are important to increase the knowledge of the right cleaning procedures by operators and avoid infections.