Desafios e perspectivas para a contenção da resistência bacteriana na óptica dos profissionais de saúde

RESUMO O presente estudo objetivou analisar o conhecimento sobre resistência bacteriana, o comportamento, os fatores intervenientes e as perspectivas para controle da disseminação dos micro-organismos resistentes na ótica dos profissionais de saúde de um hospital universitário. Estudo descritivo realizado por meio de questionário semi-estruturado na Unidade de Terapia Intensiva Adultos e Clínica Médica-cirúrgica. Foram entrevistados 43 profissionais: técnicos de enfermagem, 72,1%; fisioterapeutas, 11,6%; médicos, 9,3%; e enfermeiros, 7,0%. Os micro-organismos resistentes foram referidos por 95,3% como problema muito importante, apontando o Acinetobacter baumannii multirresistente e o Staphylococcus aureus resistente a meticilina como os mais prevalentes. A ocorrência de micro-organismos resistentes foi atribuída à não adoção de precaução padrão (34,9%) e aos procedimentos invasivos (21%); 76,7% afirmaram perceber a higienização das mãos como muito eficaz; 55,8% apontaram a categoria médica no foco de atenção para treinamentos. Apesar da percepção da resistência bacteriana pelos profissionais, tal fato não repercute em maior adesão às medidas de controle. Descritores: Infecção Hospitalar; Farmacorresistência Bacteriana; Pessoal de Saúde; Enfermagem

OXA-253, a variant of the carbapenem-hydrolyzing class D β-Lactamase OXA-143 in Acinetobacter baumannii

The carbapenem-hydrolyzing class D β-lactamase OXA-253 was identified in an Acinetobacter baumannii clinical isolate belonging to sequence type 113 (ST113) in Brazil. OXA-253 shares 93.8% amino acid identity with OXA-143. The blaOXA-253 gene is located on a ca. 20-kb plasmid. The genetic environment of the blaOXA-253 gene shares the highest identity with ubiquitous GR2 group plasmids usually carrying blaOXA-24/-40 genes

Variability of cutaneous and nasal population levels between patients colonized and infected by multidrug-resistant bacteria in two Brazilian intensive care units

Objective: To compare cutaneous and nasal population levels between patients colonized and infected by multidrug-resistant organisms in two intensive care units. Methods: A prospective cohort study was performed in adult intensive care units of two hospitals in Belo Horizonte, Brazil (April 2012 to February 2013). Clinical and demographic data were first collected by reviewing patients’ charts. Then, samples collected with nasal, groin, and perineum swabs were cultivated in selective media for 48 h at 37°C. After isolation, determination of antimicrobial susceptibility and biochemical identification were performed. Results: A total of 53 cases of colonization were observed by the following bacteria in decreasing frequencies: imipenem-resistant Acinetobacter baumannii (50.9%), vancomycin-resistant Enterococcus faecalis (43.4%), extended-spectrum beta-lactamase–producing Klebsiella pneumoniae (37.7%), imipenem-resistant Pseudomonas aeruginosa (32.1%), oxacillin-resistant Staphylococcus aureus (7.5%), and imipenem-resistant Klebsiella pneumoniae (5.7%). Among these colonization cases, 26 (49.0%) were followed by infection with bacteria phenotypically similar to those of the colonization. A relation between high population levels of colonization by most of the multidrug-resistant organisms at anatomical sites and a subsequent infection was observed. After colonization/infection, bacterial population levels decreased progressively and spontaneously until disappearance by day 45 in all the anatomical sites and for all the multidrug-resistant organisms. Conclusion: There was a correlation between high population levels of colonization by multidrug-resistant organisms at anatomical sites and a subsequent infection. Reduction in multidrug-resistant organism populations after colonization at anatomical sites could be a preventive measure to reduce evolution to infection as well as transmission of these bacteria between patients in intensive care unit

Occurrence of Aspergillus niger strains on a polychrome cotton painting and their elimination by anoxic treatment

This study aimed to isolate and identify the population of filamentous fungi colonizing a cotton painting, whose conservation status was compromised and showed signs of biodeterioration due to dirt accumulation and microbial metabolism. In addition, microbiological techniques such as cultivation-dependent approach and molecular biology were used to identify microbial populations and to eliminate their metabolic action. For this, the nondestructive anoxic atmosphere technique was used, in which the microbial metabolism was affected by the absence of oxygen. Prior to exposure to an anoxic atmosphere, only one fungal species, Aspergillus niger, was identified at 12 points sampled in the obverse and reverse of the artwork; no fungal species persisted as a result of anoxic treatment. These results showed that exposure to anoxic conditions was effective for the total elimination of isolated fungal strains as well as their spores. In conclusion, this study proved the unprecedented effectiveness of a nondestructive technique for artwork on textile colonized by black fungi species. Thus, this interdisciplinary work involving conservation, microbiology, and chemistry presents a tool to eliminate microorganisms, while maintaining the integrity of artwork and safety of the restorer, that can be applied prior to artwork restoration.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author