Recuperação de bactérias resistentes de relevância epidemiológica dos colchões de pacientes em precaução por contato de um hospital de Belo Horizonte

Abstract

Healthcare associated infections (HAI) are a risk to patient safety in health services, often related to cross-contamination. Hospital mattresses have been highlighted, because it can became contaminated by microorganisms with epidemiological relevance even after being subjected to terminal cleaning surfaces. The clarification of the role of environmental surfaces in the transmission of pathogens, especially those in direct contact with patients, such as mattresses, becomes relevant by the need for strategies to control the spread of microorganisms that may impact on the occurrence of HAI and antibiotic resistant bacteria. The aim of the study was to assess the recovery of resistant bacteria of epidemiological relevance of mattresses patients colonized andor infected from a hospital in Belo Horizonte. This was a cross-sectional study. Samples of the mattress surface were obtained in the period of May to July 2014, using RODAC plates with Infused culture media Brain Heart (BHI) and MacConkey, cultured at 37° for 48 hours. Tests were performed for identification (Vitek), antibiogram - Bauer-Kirby method. Data related to the patient occupant of the mates were also obtained.We evaluated 51 mattresses. Of these, 26 had on its surface bacteria resistant with epidemiological relevance, especially, Acinetobacter baumannii (69,2%), Klebsiella pneumoniae (11,5%) and Pseudomonas aeruginosa (11,5%). Phenotypic similarity of antimicrobial resistance was observed among the strains of Acinetobacter baumannii in four wards. 13 (50,0%) mattresses showed phenotypically different bacterial species associated with those patients, and seven of these had previously been occupied by bacteria carriers identified in the same mattress. Patients in contact precautions that took part in this study were mostly elderly (51,0%), female (53,0 %), the clinical type (54,9%), with median time of stay and mattress occupation, respectively, 41 and 18 days. Presented as current diagnosis, especially, blood disorders, hematopoietic organs and immune disorders (17,6%). Were admitted to clinical units (76,5%) with infectious disease (76,4%) in use of invasive devices (68,6%) and antibiotics (58,8%). The vancomycin-resistant Enterococcus stood out as colonizing microorganism (41,7%) and Acinetobacter baumannii and Klebsiella pneumoniae as the main species associated with infections (38,4%). The median time of diagnosis as resistant bacteria carrier was 18 days. Some patients had also pressure ulcer (41,2%), bodily injury (37,3%) and incontinence (11,8%). The factors related to the patients in contact precautions and the recovery of epidemiological relevant bacterias were: age, patient diagnosis time with resistant bacteria, prior use of the antibiotic and the presence of pressure ulcers. This results highlights the importance of given attention to surfaces such as mattresses to reduce and control the potential spread of microorganisms in health services.