Bacilos gram-positivos isolados de implantes cirúrgicos ortopédicos consignados em uso na prática clínica antes do processamento pelo serviço de saúde
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Data
2020-12-04
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Universidade Federal de Goiás
Resumo
Surgical Site Infection (SSI) is a public health problem. One of the important measures for its prevention is the reprocessing of surgical reusable devices, such as orthopedic implants, for instance plates and screws. These, despite classified as single-use, are submitted to multiple reprocessing until they are implanted in the patient, exposing them to physical, chemical and biological agents, favoring the formation of biofilm on these devices, thus compromises the patient safety. Therefore, this study aimed to characterize phenotypically Gram-Positive Bacilli (GPB) isolated from loaned orthopedic implants (plates and screws) in use in clinical practice, before reprocessing by the healthcare service, as well as to determine the susceptibility profile of isolated bacteria to antimicrobials. The study was carried out from May 2018 to September 2019, at the Sterilizing Service Unit of a general teaching hospital located in the state of Goiás, linked to the Unified Health System (SUS). Fifteen plates and 15 screws were collected from five boxes of surgical orthopedic instruments/implant, named “Small Fragments”, totaling 30 implants. The implants were subjected to bacteriological analysis according to standard procedures for the isolation and identification of BGP, as well as the evaluation of the susceptibility profile of the isolates to antimicrobials. Of the 30 implants evaluated, 12 (40.0%) were contaminated with BGP, with 50.0% plates and 50.0% screws. One BGP was isolated per implant (n = 12), nine (75.0%) of which were identified as Bacillus sp. and three (25.0%) as from the Corineformes group. All (100.0%) BGPs were resistant to penicillin and oxacillin and/or cefoxitin, and 83.3% (n=10) were resistant or intermediate to clindamycin, and nine (75%) to rifampicin. One BGP was resistant or intermediate, concomitantly, to eight (66.7%) of the evaluated antimicrobials. All (100.0%) isolates were sensitive to ciprofloxacin. In conclusion, BGP (Bacillus sp. and Corineforme group), including multidrug-resistant, were identified on implantable orthopedic plates and screws acquired through loaner system, upon delivery to the healthcare service and before processing. The findings of this study point to the need for new policies that address the management of these implants, in order to provide safe surgical reusable devices that, instead of adverse events, bring benefits to the patient.
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Palavras-chave
Bacillus, Grupo corineforme, Próteses e implantes, Corineforme group, Prostheses and implants
Citação
SILVA, Emerson Oliveira; OLIVEIRA, Natalia Rodrigues. Bacilos gram-positivos isolados de implantes cirúrgicos ortopédicos consignados em uso na prática clínica antes do processamento pelo serviço de saúde. 2020. 60 p. Trabalho de Conclusão de Curso (Graduação) – Faculdade de Farmácia, Universidade Federal de Goiás, Goiânia, 2020.