Impacto do álcool gel nas bactérias das mãos de profissionais de saúde
DOI:
https://doi.org/10.17058/reci.v11i3.16493Palavras-chave:
Hand Hygiene, Health Personnel, Neonatal Intensive Care Units, Microbial Drug Resistance.Resumo
RESUMO
Justificativa e objetivos: As infecções relacionadas assistência à saúde são um problema relatado por hospitais em todo o mundo. As mãos dos profissionais de saúde ainda são as principais fontes de infecções, tornando a higienização das mãos extremamente importante para o controle de infecções. Este estudo tem como objetivo analisar as bactérias das mãos de profissionais de saúde de uma Unidade Neonatal antes e após higiene das mãos com álcool gel, bem como avaliar a susceptibilidade dos microrganismos aos antimicrobianos. Métodos: As amostras das mãos foram coletadas pelo método do suco de luva modificado, antes e após a higienização das mãos com álcool gel. As bactérias foram identificadas por MALDI-TOF e testes de sensibilidade de acordo com o documento M100-E29 do Clinical and Laboratory Standards Institute. Resultados: Foram obtidas 214 amostras, das quais 104 (48,6%) apresentaram crescimento bacteriano antes da higienização e 52 (24,3%) após a higienização com álcool gel. Houve 217 isolados nas culturas, sendo Staphylococcus coagulase negativa o mais frequente, com 41 (27,2%) e 24 (36,4%) culturas positivas, respectivamente antes e após a higienização das mãos. O segundo microrganismo mais frequente foi Klebsiella pneumoniae, com 32 (21,2%) e 16 (24,2%), respectivamente, antes e após a higienização das mãos. A multirresistência a antimicrobianos foi detectada em 58,1% das bactérias gram-positivas e 34,3% das gram-negativas. Conclusão: Observou-se diminuição, mas não a eliminação da carga microbiana após higienização das mãos com álcool gel, demonstrando a necessidade de melhorias na higienização das mãos.
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Tajeddin E, Rashidan M, Razaghi M, et al. The role of the intensive care unit environment and health-care workers in the transmission of bacteria associated with hospital acquired infections. J Infect Public Health. 2016; 9:13-23. https://doi.org/10.1016/j.jiph.2015.05.010
Bowen JR, Callander I, Richards R, et al. Decreasing infection in neonatal intensive care units through quality improvement. Arch Dis Child Fetal Neonatal Ed. 2017; 102: F51-F57. http://dx.doi.org/10.1136/archdischild-2015-310165
Chen YC, Lin CF, Rehn YF, et al. Reduced nosocomial infection rate in a neonatal intensive care unit during a 4-year surveillance period. J Chin Med Assoc. 2017; 80: 427-31. https://doi.org/10.1016/j.jcma.2017.02.006
Wang HP, Zhang HJ, Liu J, et al. Antimicrobial resistance of 3 types of gram-negative bacteria isolated from hospital surfaces and the hands of health care workers. Am J Infect Control. 2017; 45: e143-7. https://doi.org/10.1016/j.ajic.2017.06.002
Wolfensberger A, Clack L, Kuster SP, et al. Transfer of pathogens to and from patients, healthcare providers, and medical devices during care activity—a systematic review and meta-analysis. Infect. Control Hosp. Epidemiol. 2018; 39:1093-107. http://doi.org/10.1017/ice.2018.156
Hor SY, Hooker C, Iedema R, et al. Beyond hand hygiene: a qualitative study of the everyday work of preventing cross-contamination on hospital wards. BMJ Qual Saf. 2016; 26:1-7. http://dx.doi.org/10.1136/bmjqs-2016-005878
Brasil. Agência Nacional De Vigilância Sanitária - ANVISA. 2007. Segurança do Paciente: Higienização das mãos. http://www.anvisa.gov.br/servicosaude/manuais/paciente_hig_maos.pdf
Greenaway RE, Ormandy K, Fellows C, et al. Impact of hand sanitizer format (gel/foam/liquid) and dose amount on its sensory properties and acceptability for improving hand hygiene compliance. J Hosp Infect. 2018; 100:195-201. https://doi.org/10.1016/j.jhin.2018.07.011
Vermeil T, Peters A, Kilpatrick C, et al. Hand hygiene in hospitals: anatomy of a revolution. J Hosp Infect. 2019; 101:383-392. https://doi.org/10.1016/j.jhin.2018.09.003
World Health Organization. WHO guidelines on hand hygiene in health care 2009. WHO Press, Geneva, Switzerland. 2009.
American Society for Testing and Materials International. “ASTM E 1174-06: Standard test method for evaluation of the effectiveness of healthcare personnel handwash formulations”. West Conshohocken, PA: American Society for Testing and Materials; 2006.
Pellegrino FLPC, Chagas TPG, Alves MS, et al. Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) Applications in Bacteriology: Brazilian Contributions. HU Rev. 2017; 43: 285-294. https://doi.org/10.34019/1982-8047.2017.v43.2859
Mortier T, Wieme AD, Vandamme P, Waegeman W. Bacterial species identification using MALDI-TOF mass spectrometry and machine learning techniques: A large-scale benchmarking study. Comput. Struct. Biotechnol. J. 2021; 19: 6157–6168. https://doi.org/10.1016/j.csbj.2021.11.004
Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Testing: Twenty-ninth Edition Informational Supplement M100-E29. 2019. http://em100.edaptivedocs.net/dashboard.aspx
Magiorakos AP, Srinivasan A, Carey RB, et al. Multidrug‐resistant, extensively drug‐resistant and pandrug‐resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. CMI. 2012; 18:268-81. https://doi.org/10.1111/j.1469-0691.2011.03570.x
Visalachy S, Palraj KK, Kopula SS, et al. Carriage of multidrug resistant bacteria on frequently contacted surfaces and hands of health care workers. JCDR. 2016; 10:DC18-DC20. http://doi.org/10.7860/JCDR/2016/19692.7772
La Fauci V, Costa GB, Genovese C, et al. Drug-resistant bacteria on hands of healthcare workers and in the patient area: an environmental survey in Southern Italy’s hospital. Rev Esp Quimioter. 2019; 32:303-10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719646/
Ferng YH, Clock SA, Wong-Mcloughlin J, et al. Multicenter study of hand carriage of potential pathogens by neonatal ICU healthcare personnel. J Pediatric Infect Dis Soc. 2014; 4:276-9. https://doi.org/10.1093/jpids/piu022
Tselebonis A, Nena E, Nikolaidis C, et al. Monitoring of Frequency and Antimicrobial Susceptibility of Pathogens on the hands of Healthcare Workers in a Tertiary Hospital. Folia medica. 2016; 58:200-5. http://doi.org/10.1515/folmed-2016-0028
Medeiros FDVA, Herdy Alves V, Ortiz Sobrinho Valete C, et al. A correlação entre procedimentos assistenciais invasivos e a ocorrência de sepse neonatal. Acta paul. Enferm. 2016; 29:573-8. https://doi.org/10.1590/1982-0194201600079
Sanderson E, Yeo KT, Wang AY, et al. Dwell time and risk of central-line-associated bloodstream infection in neonates. J Hosp Infect. 2017; 97:267-74. https://doi.org/10.1016/j.jhin.2017.06.023
Brito DVD, Brito CS, Resende DS, et al. Nosocomial infections in a Brazilian neonatal intensive care unit: a 4-year surveillance study. Rev Soc Bras Med Trop. 2010; 43:633-7. https://dx.doi.org/10.1590/S0037-86822010000600006
Gadallah MAH, Fotouh AMA, Habil IS, et al. Surveillance of health care–associated infections in a tertiary hospital neonatal intensive care unit in Egypt: 1-year follow-up. Am J Infect Control. 2014; 42:1207-11. https://doi.org/10.1016/j.ajic.2014.07.020
Pires D, Soule H, Bellissimo-Rodrigues F, et al. Hand hygiene with alcohol-based hand rub: how long is long enough? Infect. Control Hosp. Epidemiol. 2017; 38:547-52. https://doi.org/10.1017/ice.2017.25
Kapil R, Bhavsar HK, Madan M. Hand hygiene in reducing transient flora on the hands of healthcare workers: an educational intervention. Indian J Med Microbiol. 2015; 33:125-128. http://dx.doi.org/10.4103/0255-0857.148409
Singh S, Singh AK. Prevalence of bacteria contaminating the hands of healthcare workers during routine patient care: A hospital-based study. Journal of The Academy of Clinical Microbiologists. 2016; 18:60-2. http://doi.org/10.4103/0972-1282.184764
Zubair M, Zafar A, Yaqoob A, et al. Comparison of Different Hand Washing Techniques to Control Transmission of Microorganisms. PJMHS. 2017; 11:1118-20.
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Copyright (c) 2022 Gabriel Faria, Ralciane Menezes, Priscila Alves, Lara Marques, Nagela Silva, Meliza Bessa, Felipe Silva, Denise Röder, Reginaldo Pedroso, Mario Penatti
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