Otimização aplicada ao processo de transmissão de Acinetobacter spp em unidades de terapia intensiva
Carregando...
Data
2018-02-28
Autores
Araújo, Aurélio de Aquino
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Originadas na década de 1970, as Infecções Hospitalares vêm cada vez mais tomando proporções colossais, acarretando óbito em cerca de 30% dos pacientes em Unidades de Terapia Intensiva (UTI). Os pacientes diagnosticados com a infecções permanecem muito tempo internados, gerando um custo muito alto para os hospitais. No ambiente hospitalar a bactéria Acinetobacter baumannii a principal responsável por tais infecções, devido a sua facilidade de sobreviver em ambientes secos e úmidos, podendo sobreviver tanto no organismo humano, quanto nos ambientes que os profissionais da saúde entram em contato (computadores, equipamentos médicos, etc). Os principais vetores desta bactéria são os próprios agentes de saúde, visto que os pacientes na UTI estão todos acamados. No entanto, medidas de higienização extremamente necessárias para conter surtos da infecções o. Por outro lado, devido as emergências nestas unidades, muitas vezes não há tempo hábil para tais procedimentos. Visto que impossível uma medida total de higienização e uma taxa nula de contato da equipe de trabalho com o ambiente em UTIs, importante conhecer quais são as mínimas medidas necessárias para a diminuição de infecções hospitalares. Neste contexto, o objetivo deste trabalho propor e analisar um modelo que descreva a dinâmica de transmissão da infecção dentro de uma UTI, considerando pacientes e profissionais da saúde, assim como, propor um modelo de otimização visando determinar quais as mínimas medidas de higienização são necessárias para a minimização do número de pacientes infectados. Uma metaheurística Variable Neighborhood Search foi proposta para resolução do modelo de otimização. Para validação dos modelos foram realizadas simulações computacionais. Tais simulação mostraram que as medidas de higienização e contato com ambiente exercem grande influência na transmissão da bactéria Acinetobacter baumannii, e que a metodologia de otimização proposta é capaz de determinar medidas mínimas para o controle das infecções.
Originated in the 1970s, Hospital Infections come every time more taking colossal proportions, causing death in about 30% of patients in Intensive Care Units (ICU). Patients diagnosed with infections remain long hospitalized, generating a very high cost for hospitals. In the hospital environment, Acinetobacter baumannii is the main responsible for such infections due to their ease of survival in dry and humid, and can survive both in the human body and in the environments that health workers contact (computers, medical equipment, etc.). The main vectors of this bacterium are the health agents themselves, since the patients in the ICU are all bedridden. However, hygiene measures are extremely necessary to contain outbreaks of infection. On the other hand, due to emergencies in these units, there is often no time for such procedures. Since a total sanitation measure and it is important to know the minimum measures necessary for the decrease of infections. In this context, the objective xiii of this work is to propose and analyze a model that describes the dynamics of transmission of infection within an ICU, considering patients and health professionals, as well as to propose an optimization model aiming to determine the minimum hygienic measures are needed to minimize the number of infected patients. A Variable Neighborhood Search Metaheuristic was proposed to solve the optimization model. For validation of the models were carried out computational simulations. These simulations showed that hygiene and contact with environment influences the transmission of Acinetobacter baumannii bacteria and that the proposed optimization methodology is able to determine minimum measures for the control of infections.
Originated in the 1970s, Hospital Infections come every time more taking colossal proportions, causing death in about 30% of patients in Intensive Care Units (ICU). Patients diagnosed with infections remain long hospitalized, generating a very high cost for hospitals. In the hospital environment, Acinetobacter baumannii is the main responsible for such infections due to their ease of survival in dry and humid, and can survive both in the human body and in the environments that health workers contact (computers, medical equipment, etc.). The main vectors of this bacterium are the health agents themselves, since the patients in the ICU are all bedridden. However, hygiene measures are extremely necessary to contain outbreaks of infection. On the other hand, due to emergencies in these units, there is often no time for such procedures. Since a total sanitation measure and it is important to know the minimum measures necessary for the decrease of infections. In this context, the objective xiii of this work is to propose and analyze a model that describes the dynamics of transmission of infection within an ICU, considering patients and health professionals, as well as to propose an optimization model aiming to determine the minimum hygienic measures are needed to minimize the number of infected patients. A Variable Neighborhood Search Metaheuristic was proposed to solve the optimization model. For validation of the models were carried out computational simulations. These simulations showed that hygiene and contact with environment influences the transmission of Acinetobacter baumannii bacteria and that the proposed optimization methodology is able to determine minimum measures for the control of infections.
Descrição
Palavras-chave
Otimização, Equações Diferencias, Infecção Hospitalar, Metaheurística, Variable Neighborhood Search (VNS)