Contaminação por enterobactérias resistentes a antimicrobianos isoladas em celulares e mãos em hospital veterinário
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Data
2021-07-05
Autores
Hespanha, Ana Carolina Valentim
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
As infecções nosocomiais representam sério problema de saúde pública, levando ao aumento da mortalidade e morbidade dos pacientes afetados. Os telefones celulares são alvo de investigações sobre sua importância na disseminação de patógenos, devido ao seu uso descontrolado e presença em todos os ambientes do dia a dia, incluindo hospitais veterinários. Nesse sentido, o objetivo deste trabalho é avaliar a presença de Escherichia coli (E. coli), Proteus mirabilis (P. mirabilis) e Klebsiella pneumoniae (K. pneumoniae), importantes bactérias associadas à infecção hospitalar, em telefones celulares da equipe cirúrgica de pequenos animais do Hospital Veterinário da Universidade Estadual Paulista – Câmpus Jaboticabal. Para isso, foram coletadas amostras de telefones celulares dos cirurgiões, auxiliares, enfermeiros e anestesistas e dos responsáveis pelos pacientes, bem como também de suas mãos, mesa cirúrgica e do paciente. As bactérias foram isoladas e identificadas através do teste de reação em cadeia de polimerase (PCR), a diversidade genética por Eletroforese em gel de Campo Pulsado (PFGE) e a suscetibilidade à antimicrobianos através de antibiograma. Adicionalmente, os pacientes foram acompanhados por 4 semanas quanto à sinais de infecção nosocomial na ferida operatória. Oito amostras foram positivas para E. coli e Proteus mirabilis, provenientes da mão do anestesista, mão do tutor, mão do cirurgião, celular do cirurgião, celular do enfermeiro, celular do anestesista e duas mesas cirúrgicas. O teste de sensibilidade antimicrobiana demonstrou que todos os isolados eram resistentes à múltiplos antimicrobianos. A eletroforese de campo pulsado demonstrou alta diversidade genética entre os isolados. A identificação de E.coli e Proteus mirabilis multirresistentes em aparelhos celulares da equipe cirúrgica representa grande preocupação e, apesar de não diretamente correlacionado, o isolamento dessas bactérias no interior da área limpa do centro cirúrgico evidenciou a possibilidade de transmissão nosocomial a partir dos aparelhos celulares à pacientes susceptíveis.
Nosocomial infections represent a serious public health problem, leading to increased mortality and morbidity for affected patients. Cell phones are the target of investigations about their importance in the spread of pathogens, due to their uncontrolled use and presence in all day-to-day environments, including veterinary hospitals. In this sense, the objective of this work is to evaluate the presence of Escherichia coli (E.coli), Proteus mirabilis (P. mirabilis) and Klebsiella pneumoniae (K. pneumoniae), important bacteria associated with hospital infection, on cell phones of the small animal surgical team at the Veterinary Hospital of Paulista State University - Campus Jaboticabal. For this, samples of cell phones were collected from surgeons, assistants, nurses and anesthetists and those responsible for patients, as well as from their hands, operating table and the patient. The bacteria were isolated and identified through the polymerase chain reaction (PCR) test, genetic diversity by Pulsed Field Gel Electrophoresis (PFGE) and susceptibility to antimicrobials through antibiogram. Additionally, the patients were followed up for 4 weeks for signs of nosocomial infection in the surgical wound. Eight samples were positive for E. coli and Proteus mirabilis, from the hand of the anesthetist, hand of the tutor, hand of the surgeon, cell of the surgeon, cell of the nurse, cell of the anesthetist and two surgical tables. The antimicrobial susceptibility test demonstrated that all isolates were resistant to multiple antimicrobials. Pulsed field electrophoresis demonstrated high genetic diversity among the isolates. The identification of multi- resistant E.coli and Proteus mirabilis in cell phones of the surgical team is of great concern and, although not directly correlated, the isolation of these bacteria within the clean area of the operating room has evidenced the possibility of nosocomial transmission from cell phones susceptible patients.
Nosocomial infections represent a serious public health problem, leading to increased mortality and morbidity for affected patients. Cell phones are the target of investigations about their importance in the spread of pathogens, due to their uncontrolled use and presence in all day-to-day environments, including veterinary hospitals. In this sense, the objective of this work is to evaluate the presence of Escherichia coli (E.coli), Proteus mirabilis (P. mirabilis) and Klebsiella pneumoniae (K. pneumoniae), important bacteria associated with hospital infection, on cell phones of the small animal surgical team at the Veterinary Hospital of Paulista State University - Campus Jaboticabal. For this, samples of cell phones were collected from surgeons, assistants, nurses and anesthetists and those responsible for patients, as well as from their hands, operating table and the patient. The bacteria were isolated and identified through the polymerase chain reaction (PCR) test, genetic diversity by Pulsed Field Gel Electrophoresis (PFGE) and susceptibility to antimicrobials through antibiogram. Additionally, the patients were followed up for 4 weeks for signs of nosocomial infection in the surgical wound. Eight samples were positive for E. coli and Proteus mirabilis, from the hand of the anesthetist, hand of the tutor, hand of the surgeon, cell of the surgeon, cell of the nurse, cell of the anesthetist and two surgical tables. The antimicrobial susceptibility test demonstrated that all isolates were resistant to multiple antimicrobials. Pulsed field electrophoresis demonstrated high genetic diversity among the isolates. The identification of multi- resistant E.coli and Proteus mirabilis in cell phones of the surgical team is of great concern and, although not directly correlated, the isolation of these bacteria within the clean area of the operating room has evidenced the possibility of nosocomial transmission from cell phones susceptible patients.
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Palavras-chave
Cirurgia veterinária, Microbiologia, Eletroforese em gel, Infecção