Avaliação da contaminação de pranchetas em uso em unidades de terapia intensiva

Abstract

INTRODUCTION: Healthcare facility surfaces have been widely recognized as reservoirs of relevant microorganisms in the context of healthcare associated infections. Surfaces most frequently touched/handled by healthcare workers (HCW), such as clipboards used to hold patient records, are pointed as the most frequently contaminated, mainly due to the low adherence of these professionals to hand hygiene. AIM: To evaluate the microbiological conditions of clipboards used in clinical and surgical intensive care units (ICU). MATERIALS AND METHODS: This is a descriptive, cross-sectional study, conducted in October 2018, in a large teaching hospital (246 active beds) in the Midwest region. Eight acrylic clipboards, four from each ICU, were collected using aseptic technique. Two 1.5cmX1.5cm fragments were extracted from the upper, where the clip is located, and from the right hand side of the clipboards, which were previously defined as the most touched by HCW through non-participant observation in the investigated units. One upper and one right hand side fragment of each clipboard, totaling 16 samples, were randomly selected and subjected to bacteriological culture. One upper or right hand side fragment of each clipboard, totaling eight samples, were selected for analysis by Scanning Electron Microscopy (SEM). RESULTS: Bacterial growth was observed in the upper and/or right hand side area of all clipboards (n = 8). A total of 32 bacteria were isolated, and most of them were isolated from the upper area (n = 19). Most of the isolated bacteria belonged to the Staphylococcus (n = 15) and Bacillus (n = 7) genera. Pathogenic bacteria, such as Staphylococcus aureus, Staphylococcus epidermidis and Enterococcus faecium, and multidrug resistant bacteria, including oxacillin-resistant S. epidermidis and the MLSb group, were isolated from clipboards from both ICUs. Structure suggestive of biofilm or singly adhered cell, presence of soil and/or structural damage were detected in all clipboards analyzed by SEM. Biofilms were detected on two clipboards, one from each ICU. CONCLUSION: Contamination by pathogenic and potentially pathogenic bacteria, including multidrug-resistant, and the presence of soil, structural damage, and biofilm were detected on clipboards intended to hold records of patients classified as at high risk for infection. These results indicate the need for cleaning/disinfection protocols for these surfaces, as well as educational measures aimed to improve hand hygiene adherence by the multiprofessional team.