Microbiological evaluation of the effectiveness of concurrent disinfection of the patient unit in intensive care
DOI:
https://doi.org/10.26694/repis.v8i1.2296Palavras-chave:
Cross Infection, Colony Count, Microbial, Disinfection, Intensive Care Units, Housekeeping, HospitalResumo
Introduction: The health environment can act as a reservoir for microorganisms. For microbiological control, it is necessary to effectively disinfect and to monitor the quality of this process. Aim: To evaluate, through microbial analysis, the effectiveness of concurrent disinfection of the patient care unit of patients receiving intensive care. Outlining: Cross sectional, descriptive, and observational. Microbiological cultures were performed in the patient's unit, before and after concurrent disinfection using 70% ethyl alcohol. The analysis of the cultures was performed by standard methodology. Results: 42 surfaces were investigated. At the time of pre-disinfection, contamination was identified on 26 (62.0%) surfaces, with the touch screen panels of the mechanical ventilators (6040 CFU/mL - 85.7%) being the ones with the highest microbial quantity (6040 CFU/mL - 85.7%), followed by bedside lockers (2380 CFU/mL - 57.1%) and the bed side rails (650 CFU/mL - 42.9%). After disinfection, 65.3% (17) of the surfaces achieved a total reduction in colony count. Implications: The importance of carrying out concurrent disinfection, with 70% ethyl alcohol, on inanimate surfaces with a high degree of contact with hands in the intensive care unit, for the reduction of the microbial load and promotion of a biologically safe environment for the patient was evidenced.
Referências
Cordeiro ALAO, Oliveira MMC, Fernandes JD, Barros CSMA, Castro LMC. Contaminação de equipamentos em unidade de terapia intensiva. Acta Paul Enferm. [Internet]. 2015 Mar-Apr [cited 2019 Jan 17]; 28(2):160-165. Available from: http://dx.doi.org/10.1590/1982--0194201500027
Costa DM, Johani K, Melo DS, Lopes LKO, Lopes Lima LKO, Tipple AFV, et al. Biofilm contamination of high-touched surfaces in intensive care units: epidemiology and potential impacts. Lett Appl Microbiol. [Internet]. 2019 Feb [cited 2019 Mar 14]; 68(4):269—276. Available from: http://dx.doi.org/10.1111/lam.13127
Ferreira LL, Azevedo LMN, Salvador PTCO, Morais SHM, Paiva RM, Santos VEP. Cuidado de enfermagem nas Infecções Relacionadas à Assistência à Saúde: Scoping review. Rev Bras Enferm [Internet]. 2019 Mar-Apr [cited 2020 Jan 01]; 72(2):498-505. Available from: https://doi.org/10.1590/0034-7167-2018-0418
Centers for Diase Control and Prevention (CDC). Antibiotic resistance threats in the United States, 2013. [Internet]. 2019 [cited 2019 Jan 17]; Available from: http://www.cdc.gov/drugresistence/threat-report-2013/index.html
Ferreira AM, Andrade D, Rigotti MA, Almeida MTG, Guerra OG, Junior AGS. Avaliação da desinfecção de superfícies hospitalares por diferentes métodos de monitoramento. Rev. Latino-Am. Enfermagem [Internet]. 2015 May-Jun [cited 2019 Fev 20]; 23(3):466-74. Available from: https://doi.org/10.1590/0104-1169.0094.2577
Barbosa ASAA, Carneiro GS, Repullio LF, Silveira M, Silva SMUR, Moreno FRV. Eficácia do álcool etílico e quaternário de amônio na desinfecção de equipamentos médicos hospitalares. Rev Epidemiol Control Infec [Internet]. 2018 Out-Dez [cited 2019 Jan 18]; 8(4):409-414. Available from: https://online.unisc.br/seer/index.php/epidemiologia/article/view/11394
Agência Nacional de Vigilância Sanitária (ANVISA) (BR). Segurança do paciente em serviços de saúde: limpeza e desinfecção de superfícies/Agência Nacional de Vigilância Sanitária. Brasília: Anvisa [Internet]. 2012 [cited 2019 Jan 15]; Available from: https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/publicacoes/manual-de-limpeza-e-desinfeccao-de-superficies.pdf
Casini B, Tuvo B, Totaro M, Aquino F, Baggiani A, Privitera G. Evaluation of the Cleaning Procedure Efficacy in Prevention of Nosocomial Infections in Healthcare Facilities Using Cultural Method Associated with High Sensitivity Luminometer for ATP Detection. Pathogens [Internet]. 2018 Aug [cited 2019 Mar 28]; 7(3):1-9. Available from: https://doi.org/10.3390/pathogens7030071
Brixner B, Renner JDP, Krummenauer EC. Contaminação ambiental da UTI pediátrica: fator de risco para aquisição de infecções oportunistas? Rev Epidemiol Control Infec [Internet]. 2016 Abr [cited 2019 Apr 20]; 6(1):24-28. Available from: https://online.unisc.br/seer/index.php/epidemiologia/article/view/6819
Gil AC, Bordignon APP, Castro EAR, Castro ST, Rafael RMR, Pereira JAA. Avaliação microbiológica de superfícies em terapia intensiva: reflexões sobre as estratégias preventivas de infecções nosocomiais. Rev enferm UERJ [Internet]. 2018 Abr [cited 2019 Mar 18]; 26:e26388. Available from: https://doi.org/10.12957/reuerj.2018.26388
Raro OHF, Gallo SW, Ferreira CAS, Oleiveira SD. Carbapenem-resistant Acinetobacter baumannii contamination in an intensive care unit. Rev. Soc. Bras. Med. Trop [Internet]. 2017 Mar-Apr [cited 2020 Oct 01]; 50(2):167-172. Available from: https://doi.org/10.1590/0037-8682-0329-2016
Deasy EC, Moloney EM, Boyle MA, Fleming TE, O’Donnell MJ, Coleman DC. Minimizing microbial contamination risk simultaneously from multiple hospital washbasins by automated cleaning and disinfection of U-bends with electrochemically activated solutions. J Hosp Infec [Internet]. 2018 Feb [cited 2019 Abr 12]; 100(3):e98-e104. Available from: https://doi.org/10.1016/j.jhin.2018.01.012
Furlan MCR, Ferreira AM, Barcelos LS, Rigotti MA, Sousa AFL, Junior AGS, et al. Evaluation of disinfection of surfaces at an outpatient unit before and after an intervention program. BMC Infec Dis [Internet]. 2019 Apr [cited 2020 Mai 01]; 19(355). Available from: https://doi.org/10.1186/s12879-019-3977-4
Gonçalves LR, Luz PCT, Azevedo ALO. Avaliação microbiológica de incubadoras: antes e depois a limpeza em uma maternidade de Teresina – PI. R. Interd [Internet]. 2016 Abr-Jun [cited 2019 Out 10]; 9(2):57-64. Available from: https://dialnet.unirioja.es/servlet/articulo?codigo=6771895
Mendes JR, Brasileiro MSE. Proposta de protocolo para descontaminação de equipamentos em unidade de terapia Intensiva. Rev Enfer Centro-Oeste Mineiro [Internet]. 2017 [cited 2019 Jan 09]; 7:e.2346. Available from: https://doi.org/10.19175/recom.v7i0.2346
Rigotti MA, Ferreira AM, Nogueira MCL, Almeida MTG, Guerra OG, Andrade D. Avaliação de três técnicas de fricção de superfície para remoção de matéria orgânica. Texto & Contexto Enfermagem [Internet]. 2015 Dec [cited 2019 Out 28]; 24(4):1061-1070. Available from: https://doi.org/10.1590/0104-0707201500003690014
Weldegebreal F, Admassu D, Meaza D, Mulatu A. Non-critical healthcare tools as a potential source of healthcare-acquired bacterial infections in eastern Ethiopia: A hospital-based cross-sectional study. SAGE Open Med [Internet]. 2019 Jul-Dec [cited 2019 Jan 17]; 7:1–10. Available from: https://doi.org/10.1177/2050312118822627
Dresch F, Birkheuer CF, Rempel C, Maciel MJ. Contaminação de superfícies localizadas em unidades de terapia intensiva e salas de cirurgia: uma revisão sistemática da literatura. Rev Epidemiol Control Infec [Internet]. 2018 Ago [cited 2019 Apr 01]; 8(1): 85-91. Available from: https://online.unisc.br/seer/index.php/epidemiologia/article/view/9897
Johani K, Abualsaud D, Costa DM, Hu H, Whiteley G, Deva A, et al. Characterization of microbial community composition, antimicrobialresistance and biofilm on intensive care surfaces. J Infec Public Health [Internet]. 2018 May-Jun [cited 2019 Jan 17]; 11:418-424. Available from: https://doi.org/10.1016/j.jiph.2017.10.005
Adams CE, Smith J, Watson V, Robertson C, Dancer SJ. Examining the relationship between surface bioburden and frequently touched sites in Intensive Care. J Hosp Infec [Internet]. 2017 Nov [cited 2019 Dez 01]; 95(1):76-80. Available from: https://doi.org/10.1016/j.jhin.2016.11.002
Villacís JE, Lopez M, Passey D, Santillán MH, Verdezoto G, Trujillo F, et al. Efficacy of pulsed-xenon ultraviolet light for disinfection of high-touch surfaces in na Ecuadorian hospital. BMC Infectious Diseases [Internet]. 2019 Jun-Jul [cited 2019 Jan 15]; 19(575). Available from: https://doi.org/10.1186/s12879-019-4200-3
Lima LKOL, Pinto JCG, Misael LS, Castro RB, Coelho DD, Benevides DVL, Sousa ERM. Avaliação da contaminação cruzada por Acinetobacter spp. em uma unidade de terapia intensiva. Rev Epidemiol Control Infec [Internet]. 2019 Jul-Set [cited 2020 Jan 15]; 9(3):241-247. Available from: https://online.unisc.br/seer/index.php/epidemiologia/article/view/12510
Ambrogi V, Cavalié L, Mantion B, Gliglia MJ, Cointault O, Dubois D, Prère MF, Levitzki N, Kamar N, Malavaud S. Transmission of metallo β-lactamase-producing Pseudomonas aeruginosa in a nephrology-transplant intensive care unit with potential link to the environment. J Hosp Infect [Internet]. 2016 Out [cited 2019 Fev 13]; 92(1):27-9. Available from: https://doi.org/10.1016/j.jhin.2015.09.007
Rutala WA, Weber DJ. Disinfectants used for environmental disinfection and new room decontamination technology. Am J Infec Control [Internet]. 2013 May [cited 2020 Oct 12]; 41(5):S36-S41. Available from: https://doi.org/10.1016/j.ajic.2012.11.006