Caracterização de Enterobacteriaceae isoladas da cavidade bucal de trabalhadores de um hospital oncológico: colonização e interfaces com as infecções
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2013-03-28
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Universidade Federal de Goiás
Resumo
The health care environment presents numerous risks making it anharmful place, propitious to colonization and development of infections. Inserted in this scenario are the healthcare
workers which are vulnerable to the carrier condition. and the oral cavity represents an important site of colonization. This study aimed to characterize the phenotype of Enterobacteriaceae isolated from the oral cavity of healthcare workers from an oncologic reference hospital in the central area of Brazil. We also aimed to detect co-colonization by Staphylococcus and Pseudomonas, as well as describe the profile socio-demographic,
professional, disease/infection and behavioral of individuals colonized by Enterobacteriaceae. It was a descriptive cross-sectional epidemiological study conducted from May/2009 to November/2010 and saliva was collected a from each subjected. A total of 294 individuals participated in the research, being 149 healthcare members and 145 from the
support team. The microbiological procedures were performed according to recommended techniques and data collection obtained by a questionnaire and analyzed through descriptive statistics. Among the participants, 55 (18.7%) were colonized by Enterobacteriaceae in the oral cavity. Were isolated 64 bacteria, including species potentially pathogenic. The most prevalent specie was gergoviae Enterobacter (17.2%). The highest rates of resistance were observed to β-lactams and 48.4% of isolates were considered multiresistant. The Extended Spectrum β-lactamases (ESBL) production was negative for the Enterobacteriaceae and none
Klebsiella pneumoniae produced Carbapenemase (KPC). However, among the 43 CESP
isolates group (Citrobacter, Enterobacter, Serratia, Providencia), 51.2% produced AmpC β-
lactamase by induction and 48.8% were hiper producers. Staphylococcus and Pseudomonas
were detected in the saliva of 56.4% individuals. The majory of the healthcare workers
colonized by Enterobacteriaceae was men over 40 years. The nursing technician was the
professional category most colonized (52.7%), followed by the cleaning staff (23.6%). The
cleaning and hygiene sector (23.6%) and nursing stations (18.2%) represented the largest number of workers colonized. Some professionals (27.3%) had second job in another health service, while 41.8% remained in the institution around 40 hours or more a week. Some infection was reported among carriers, as tonsillitis, sinusitis and pharyngitis, being the first
the most frequent (52.7%). Enterobacteriaceae carriage (18.2%) reported the use of personal
protective equipment (PPE) as unnecessary to their s activity, 7.3% did not use the mask as
precautionary measure, 23.6% realized sporadically the exchange of mask and 1.8 % never changed. The use of oral antiseptics was observed in 29.1% of the workers, the recent use of
antimicrobials in 16.4% and self-medication in 27.3%. Among the colonized persons was
observed lack of knowledge about multiresistant microorganisms. The prevalence
Enterobacteriaceae carriage is considered high and the resistance is a problem especially due to multidrug resistance and production of β-lactamase AmpC observed. The results of this research contribute with important subsidies to the programs for nosocomial infections
prevention and control of, since knowledge of carrier status reduces the risk of transmission of
microorganisms.
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LEÃO-VASCONCELOS, L. S. N. O. Caracterização de Enterobacteriaceae isoladas da cavidade bucal de trabalhadores de um hospital oncológico: colonização e interfaces com as infecções. 2013. 170 f. Tese (Programa de Pós-graduação em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2013.