Larissa da Silva Barcelos

Collection of tracheal aspirate: safety and microbiological concordance between two techniques

Objetivo: Avaliar a seguranca da execucao das tecnicas tradicional e protegida de colheita de aspirado traqueal e identificar a concordância qualitativa e quantitativa dos resultados de culturas microbiologicas entre as tecnicas. Metodo: Pesquisa clinica, prospectiva, comparativa, simples-cega. A amostra foi constituida de 54 pacientes com idade ≥18 anos, submetidos a ventilacao mecânica invasiva por periodo ≥48 horas e com suspeita de Pneumonia Associada a Ventilacao Mecânica. As duas tecnicas foram implementadas no mesmo paciente, uma imediatamente seguida da outra, sendo a ordem de execucao aleatoria, segundo randomizacao por software especializado. Resultados: Nao ocorreram eventos significativos de queda da saturacao de oxigenio, instabilidade hemodinâmica e hemorragias traqueobronquicas (p<0,05) e, embora tenham ocorrido divergencias em algumas cepas, houve concordância qualitativa e quantitativa entre as tecnicas (p<0,001). Conclusao: A utilizacao da tecnica protegida nao proporciona vantagem em detrimento da tradicional e a execucao de ambas as tecnicas foi segura para o paciente.OBJECTIVE To evaluate the safety of the performance of the traditional and protected collection techniques of tracheal aspirate and to identify qualitative and quantitative agreement of the results of microbiological cultures between the techniques. METHOD Clinical, prospective, comparative, single-blind research. The sample was composed of 54 patients of >18 years of age, undergoing invasive mechanical ventilation for a period of ≥ 48 hours and with suspected Ventilator Associated Pneumonia. The two techniques were implemented in the same patient, one immediately after the other, with an order of random execution, according to randomization by specialized software. RESULTS No significant events occurred oxygen desaturation, hemodynamic instability or tracheobronchial hemorrhage (p<0.05) and, although there were differences in some strains, there was qualitative and quantitative agreement between the techniques (p<0.001). CONCLUSION Utilization of the protected technique provided no advantage over the traditional and execution of both techniques was safe for the patient.

Colheita de aspirado traqueal: segurança e concordância microbiológica entre duas técnicas

Objetivo: Avaliar a seguranca da execucao das tecnicas tradicional e protegida de colheita de aspirado traqueal e identificar a concordância qualitativa e quantitativa dos resultados de culturas microbiologicas entre as tecnicas. Metodo: Pesquisa clinica, prospectiva, comparativa, simples-cega. A amostra foi constituida de 54 pacientes com idade ≥18 anos, submetidos a ventilacao mecânica invasiva por periodo ≥48 horas e com suspeita de Pneumonia Associada a Ventilacao Mecânica. As duas tecnicas foram implementadas no mesmo paciente, uma imediatamente seguida da outra, sendo a ordem de execucao aleatoria, segundo randomizacao por software especializado. Resultados: Nao ocorreram eventos significativos de queda da saturacao de oxigenio, instabilidade hemodinâmica e hemorragias traqueobronquicas (p<0,05) e, embora tenham ocorrido divergencias em algumas cepas, houve concordância qualitativa e quantitativa entre as tecnicas (p<0,001). Conclusao: A utilizacao da tecnica protegida nao proporciona vantagem em detrimento da tradicional e a execucao de ambas as tecnicas foi segura para o paciente.OBJECTIVE To evaluate the safety of the performance of the traditional and protected collection techniques of tracheal aspirate and to identify qualitative and quantitative agreement of the results of microbiological cultures between the techniques. METHOD Clinical, prospective, comparative, single-blind research. The sample was composed of 54 patients of >18 years of age, undergoing invasive mechanical ventilation for a period of ≥ 48 hours and with suspected Ventilator Associated Pneumonia. The two techniques were implemented in the same patient, one immediately after the other, with an order of random execution, according to randomization by specialized software. RESULTS No significant events occurred oxygen desaturation, hemodynamic instability or tracheobronchial hemorrhage (p<0.05) and, although there were differences in some strains, there was qualitative and quantitative agreement between the techniques (p<0.001). CONCLUSION Utilization of the protected technique provided no advantage over the traditional and execution of both techniques was safe for the patient.

Effectiveness of Surface Cleaning and Disinfection in a Brazilian Healthcare Facility

Background: Failures in the processes of cleaning and disinfecting health service surfaces may result in the spread and transfer of pathogens that are often associated with healthcare-related infections and outbreaks. Aims: To assess the effectiveness of environmental surface cleaning and disinfection in a hospital clinic. Method: The study was conducted in a nursing ward with 45 beds. A total of 80 samples from five high-touch surfaces were evaluated before and after cleaning and disinfection, using the following methods: visual inspection, adenosine triphosphate bioluminescence assay, aerobic colony count, Staphylococcus aureus colony count, and evaluation of resistance to methicillin. The data analysis used nonparametric comparative and correlative tests to observe any differences in the pre- and post- cleaning and disinfection results for the surfaces assessed. Results: Effective cleaning and disinfection had a significant effect on only two surfaces when measured for the presence of adenosine triphosphate, the inner bathroom door handle (p=0.007) and the toilet bowl (p=0.01). When evaluated for Staphylococcus aureus colony count, the toilet flush handle also demonstrated a significant effect (p=0.04). Conclusion: The effectiveness of cleaning and disinfection of the surfaces tested was not satisfactory. An educational intervention is recommended for the cleaning and disinfection staff and the nursing team at the healthcare facility. Relevance to Clinical Practice: The data in the study revealed that daily hospital cleaning and disinfection in the sampled sites are not sufficient in medical and surgical wards. Hospital cleanliness must be reevaluated from the point of view of materials, such as an adequate supply of clean cloths, in addition to establishing more precise cleanliness protocols and accurate monitoring systems.

Recolección de aspirado traqueal: seguridad y concordancia microbiológica entre dos técnicas

Objetivo: Avaliar a seguranca da execucao das tecnicas tradicional e protegida de colheita de aspirado traqueal e identificar a concordância qualitativa e quantitativa dos resultados de culturas microbiologicas entre as tecnicas. Metodo: Pesquisa clinica, prospectiva, comparativa, simples-cega. A amostra foi constituida de 54 pacientes com idade ≥18 anos, submetidos a ventilacao mecânica invasiva por periodo ≥48 horas e com suspeita de Pneumonia Associada a Ventilacao Mecânica. As duas tecnicas foram implementadas no mesmo paciente, uma imediatamente seguida da outra, sendo a ordem de execucao aleatoria, segundo randomizacao por software especializado. Resultados: Nao ocorreram eventos significativos de queda da saturacao de oxigenio, instabilidade hemodinâmica e hemorragias traqueobronquicas (p<0,05) e, embora tenham ocorrido divergencias em algumas cepas, houve concordância qualitativa e quantitativa entre as tecnicas (p<0,001). Conclusao: A utilizacao da tecnica protegida nao proporciona vantagem em detrimento da tradicional e a execucao de ambas as tecnicas foi segura para o paciente.OBJECTIVE To evaluate the safety of the performance of the traditional and protected collection techniques of tracheal aspirate and to identify qualitative and quantitative agreement of the results of microbiological cultures between the techniques. METHOD Clinical, prospective, comparative, single-blind research. The sample was composed of 54 patients of >18 years of age, undergoing invasive mechanical ventilation for a period of ≥ 48 hours and with suspected Ventilator Associated Pneumonia. The two techniques were implemented in the same patient, one immediately after the other, with an order of random execution, according to randomization by specialized software. RESULTS No significant events occurred oxygen desaturation, hemodynamic instability or tracheobronchial hemorrhage (p<0.05) and, although there were differences in some strains, there was qualitative and quantitative agreement between the techniques (p<0.001). CONCLUSION Utilization of the protected technique provided no advantage over the traditional and execution of both techniques was safe for the patient.