Marinésia Aparecida do Prado

Enterobactérias isoladas de baratas (Periplaneta americana) capturadas em um hospital brasileiro

OBJECTIVE To isolate and identify microorganisms from cockroaches that were captured in a public hospital and to test the antimicrobial susceptibility of these microorganisms. METHODS Cockroaches were captured in the morning and at night. They were placed in flasks rinsed with 70% alcohol, transferred to sterilized flasks, and then taken to the laboratory. Only cockroaches captured whole and live were utilized for the study. After being immobilized at 0 degree C, each cockroach was placed in a test tube with sterile saline solution (0.8%) and then homogenized. The resulting solution was then placed in the following five culture media: MacConkey agar, nutrient broth, brain-heart infusion agar, Sabouraud agar, and mannitol. The cultures were examined using a stereomicroscope, and colony-forming units were counted. The disk diffusion test was used to determine antimicrobial susceptibility. RESULTS We found a 56% prevalence of enterobacteria and an 18% prevalence of coagulase-negative staphylococci. Fifteen species of enterobacteria were identified. The most frequent were Klebsiella pneumoniae (17%), Enterobacter aerogenes (14%), Serratia marcescens (13%), Hafnia alvei (12%), Enterobacter gergoviae and Enterobacter cloacae (each 9%), and Serratia spp. (6%). Both the enterobacteria and the coagulase-negative staphylococci showed significant resistance to antimicrobials, including oxacillin. CONCLUSIONS The prevalence of enteropathogenic bacteria and coagulase-negative staphylococci isolated from Periplaneta americana cockroaches in the studied hospital reflects the weakness of the measures adopted both for vector control and for antimicrobial use. The results show the need to implement effective health-institution programs focusing on hygiene and the rational use of antimicrobials.

Profile of Antimicrobial Resistance of Bacteria Isolated from Cockroaches (Periplaneta americana) in a Brazilian Health Care Institution

Cockroaches carry microorganisms to sterilized materials, equipment and non-contaminated food in hospitals and in homes. Hence, they are regarded as major microbial vectors. We isolated and identified microorganisms from living cockroaches captured from a Brazilian health care institution and we determined the antimicrobial susceptibility profile of the isolates. Following collection, cockroaches were immobilized at 4 degrees C for 10 to 20 minutes, immersed in 0.8% saline solution and then homogenized. Next, the suspension was seeded in culture media: brain and heart agar infusion, MacConkey agar, Naito agar, and they were incubated for up to 48 hours at 37 degrees C. Sabouraud agar cultures were incubated at ambient temperature. The microbial colonies were analyzed with a stereomicroscope to count and phenotypically identify the colony-forming units (cfu). The disc-diffusion method was used to determine the profile of susceptibility to antimicrobials. Among the 103 cockroaches analyzed, fungi were found in 97%, enterobacteria in 74.6% and coagulase-negative staphylococci (CNS) in 25.40%. Among the enterobacteria, 96% were resistant to gentamicin, 84% to ampicillin, 75.3% to caphalothin, 66.7% to ampicillin-sulbactam, 50% to aztreonam and 30% to chloramphenicol. Among the CNS, 61% were resistant to oxacillin. We concluded that cockroaches carry organisms associated with nosocomial infections and that are resistant to antimicrobials. This fact contributes to the epidemiological chain, complicating therapeutics, and consequently, medical costs are increased.

DESAFIOS PARA O CONTROLE DE INFECÇÃO NAS INSTITUIÇÕES DE SAÚDE: PERCEPÇÃO DOS ENFERMEIROS

RESUMO A multiplicidade de fatores que envolve o controle das infeccoes tem dificultado a implementacao de um efetivo programa de prevencao e controle e representa desafios cada vez maiores aos profissionais de saude. Este estudo de abordagem qualitativa visa identificar, entre os enfermeiros, os desafios para o controle de infeccao hospitalar. Participaram do estudo enfermeiras candidatas ao curso de especializacao em controle de infeccao hospitalar. Os relatos foram obtidos por livre registro das participantes que, a partir de suas experiencias e visoes discorreram acerca da questao norteadora: os desafios no controle de infeccao nas instituicoes de saude. Apos leitura exaustiva, apreendemos seis categorias de analise que englobam em suas estruturas, subcategorias explicitadas pelos sujeitos como desafios para o controle de infeccao: estrutura organizacional; batalha biologica; envolvimento profissional; capacitacao profissional; epidemiologia das infeccoes; medidas de prevencao e controle. Os desafios encontrados vao desde a adocao de medidas simples de controle ate a complicada estrutura organizacional das instituicoes normatizadoras, provedoras e executoras. Entretanto, os maiores desafios apontados foram as politicas instituidas, as relacoes de trabalho e o pouco envolvimento dos profissionais.

Resíduos potencialmente infectantes em serviços de hemoterapia e as interfaces com as doenças infecciosas

Objetivou-se identificar o processamento de residuos potencialmente infectantes e de perfurocortantes em unidades de hemoterapia e sua possivel relacao com a saude dos trabalhadores. Nenhum servico apresentou plano estruturado para o gerenciamento de residuos de servicos de saude e para o programa de seguranca ocupacional. Verificou-se um indice de acidentes ocupacionais de 32, 82 % e que 9,16% dos trabalhadores estavam com esquema incompleto de vacinacao contra hepatite B. Os treinamentos em servicos para manejo de residuos e saude ocupacional nao sao padronizados. O indice de soroconversao para VHB e VHC apos exposicao ocupacional foi de 11,63%. Concluimos que o processamento de residuos potencialmente infectantes e perfurocortantes nas unidades de hemoterapias pesquisadas tem exposto os trabalhadores a aquisicao de doencas infecciosas.

Potentially infectious residues at hemotherapy services and interfaces with infectious diseases

Objetivou-se identificar o processamento de residuos potencialmente infectantes e de perfurocortantes em unidades de hemoterapia e sua possivel relacao com a saude dos trabalhadores. Nenhum servico apresentou plano estruturado para o gerenciamento de residuos de servicos de saude e para o programa de seguranca ocupacional. Verificou-se um indice de acidentes ocupacionais de 32, 82 % e que 9,16% dos trabalhadores estavam com esquema incompleto de vacinacao contra hepatite B. Os treinamentos em servicos para manejo de residuos e saude ocupacional nao sao padronizados. O indice de soroconversao para VHB e VHC apos exposicao ocupacional foi de 11,63%. Concluimos que o processamento de residuos potencialmente infectantes e perfurocortantes nas unidades de hemoterapias pesquisadas tem exposto os trabalhadores a aquisicao de doencas infecciosas.

FATURAMENTO DE CURATIVOS GRAU II E REGISTROS: CONTRIBUIÇÕES DA ENFERMAGEM

Objective: to verify whether an educational action developed with nurses contributed to improved documentation on wound treatment, thereby enabling more accurate billing related to level II wound treatment Methods: exploratory, descriptive and quantitative study. Data were collected from the prescription and evaluation sheets of the clinical record, and from the hospital data processing center, before and after the educational action focusing on the importance of nursing records. Among 532 events reviewed, 266 were before and 266 after the intervention. The variables were analyzed according to frequencies and percentages, namely: prescription, evaluation, schedule time, documentation, professional category of the prescriber and the person performing the procedure. The associations between variables were analyzed using the Chi-square or the test for the difference in proportions. Results: the amount of prescriptions, schedule time, and documentation increased after the educational action, which directly influences billing for the procedure; costs were R

STAPHYLOCOCCUS AUREUS IN NURSING PROFESSIONALS AND THE MICROORGANISM’S SUSCEPTIBILITY PROFILE TO ANTIMICROBIALS

9,201.60 before and R

STAPHYLOCOCCUS AUREUS EM PROFISSIONAIS DE ENFERMAGEM E O PERFIL DE SUSCETIBILIDADE DO MICRORGANISMO AOS ANTIMICROBIANOS

25,142.40 after the action. No significant change was identified in the nursing evaluation related to the procedure. Conclusion: an increase in prescriptions after the educational action was verified, which, in turn, resulted in an increase in billable services. Further studies involving billing as a result of nursing records of interventions are necessary, as well as the investment of the managers in educational actions

STAPHYLOCOCCUS AUREUS EN PROFESIONALES DE ENFERMERIA Y EL PERFIL DE SUSCEPTIBILIDAD DE LOS MICROORGANISMOS A LOS ANTIMICROBIANOS

ABSTRACTObjective: to identify the carrier’s state and the susceptibility profile of Staphylococcus aureus isolated from saliva and nasal secretion of nursing professionals to antibiotics. Method: cross-sectional study that used saliva and nasal secretion samples of 100 nursing professionals who provide care for patients with HIV/Aids. Results: forty-three percent of the participants presented positive saliva or nasal secretion samples for Staphylococcus aureus . Of the 74 nasal secretion samples with Staphylococcus aureus , 14.9% presented oxacillin resistance; 91.9% presented penicillin resistance; 44.6% presented erythromycin resistance, and 41.9% presented clindamycin resistance. Of the 12 positive saliva samples, 16.7% presented oxacillin resistance; 100.0% presented penicillin resistance; 33.4% presented erythromycin resistance, and 25.0% presented clindamycin resistance. Conclusion: nursing professionals, once aware of their carrier state of multi-resistant microorganisms, will supervise their care practices and more efficiently adopt measures for prevention and control of the epidemiological chain of these bacteria in their work environment.

Contaminação de torniquetes para punção intravenosa periférica

ABSTRACTObjective: to identify the carrier’s state and the susceptibility profile of Staphylococcus aureus isolated from saliva and nasal secretion of nursing professionals to antibiotics. Method: cross-sectional study that used saliva and nasal secretion samples of 100 nursing professionals who provide care for patients with HIV/Aids. Results: forty-three percent of the participants presented positive saliva or nasal secretion samples for Staphylococcus aureus . Of the 74 nasal secretion samples with Staphylococcus aureus , 14.9% presented oxacillin resistance; 91.9% presented penicillin resistance; 44.6% presented erythromycin resistance, and 41.9% presented clindamycin resistance. Of the 12 positive saliva samples, 16.7% presented oxacillin resistance; 100.0% presented penicillin resistance; 33.4% presented erythromycin resistance, and 25.0% presented clindamycin resistance. Conclusion: nursing professionals, once aware of their carrier state of multi-resistant microorganisms, will supervise their care practices and more efficiently adopt measures for prevention and control of the epidemiological chain of these bacteria in their work environment.