Nasal colonization by gram-negative bacteria in dental surgeons: interfaces between prevention and control measures

The work conditions of dental surgeons (DS), associated with low compliance to precautionary standards, often lead to the colonization and dissemination of infectious agents. To assess the epidemiological and microbiological aspects of nasal colonization by Gram-negative bacteria in DS while teaching (dentistry teachers). The data were collected by application of a questionnaire and a nasal swab. The biochemical identification, the susceptibility profile and the detection of ß-lactamases were carried out in Vitek 2 compact®. 41 (77.3%) DS participated in the study, nine of them (22.0%) presented nasal colonization by Enterobacteriaceae, the participants were predominantly men (27/65.9%), over 50 years of age (24/58.5%). All of them confirmed using procedure gloves and a surgical mask while attending patients, with frequent (95.5%) hand washing although a statistical difference was found regarding personal habits (p=0.03). Enterobacter aerogenes (60.0%) was the most prevalent species, followed by Citrobacter koseri (20.0%). The intrinsic production of AmpC ß-lactamase by E. aerogenesspecies, which is multiresistant to antimicrobials, was present in the nasal cavity of 14.6% of the DS. There were high levels of nasal colonization by Enterobacteriaceae in teaching DS (22.0%), 14.6% had been colonized by multiresistant microorganisms and the results were associated with inadequate personal habits.

Contaminação de torniquetes para punção intravenosa periférica / Contamination of tourniquets for peripheral intravenous puncture

Objetivo: Identificar a presença de contaminação em torniquetes para punção intravenosa periférica e caracterizar o perfil dos Staphylococcus spp. e leveduras isolados. Métodos Estudo transversal que inseriu análise de 18 torniquetes para punção intravenosa periférica em uso no hospital. Os torniquetes foram imersos em caldo BHI por 24h e cultivados em meios seletivos para isolamento e identificação de Staphylococcus spp. e leveduras. O método disco-difusão foi empregado para analisar o perfil de suscetibilidade dos Staphylococcus spp. aos antimicrobianos. Resultados Treze (72,2%) torniquetes apresentaram crescimento de algum micro-organismo sendo 11 (52,4%) Staphylococcus coagulase-negativo, dois (9,5%) Staphylococcusaureus, quatro (19%) Rodothorulamucilaginosa, três (14,3%) Candidaalbicans. 61,5% dos Staphylococcus spp. apresentaram resistência a oxacilina. Os profissionais da equipe não relataram protocolos para limpeza, desinfecção ou substituição controlada destes materiais na instituição. Conclusão Foi identificada a contaminação de torniquetes por micro-organismos patogênicos com perfil de resistência aos antibióticos muito utilizados em instituições hospitalares.

Objectives: To identify the presence of contamination on tourniquets for peripheral intravenous puncture and to characterize the profile of the Staphylococcus spp. and the isolated yeasts. Methods Cross-sectional study in which 18 tourniquets for peripheral intravenous puncture in use at a hospital were analyzed. The tourniquets were immersed in BHI broth for 24h and cultivated in selective media for isolation and identification of Staphylococcus spp. and yeasts. The disk-diffusion method was employed to analyze the susceptibility profile of the Staphylococcus spp. to the antimicrobial agents. Results The growth of some microorganism was identified on 13 (72.2%) tourniquets: 11 (52.4%) coagulase-negative Staphylococcus, two (9.5%) Staphylococcus aureus, four (19%) Rodothorula mucilaginosa, three (14.3%) Candida albicans. 61.5% of the Staphylococcus spp. were oxacillin-resistant. The team professionals did not mention protocols for cleaning, disinfection or controlled replacement of these materials at the institution. Conclusion The contamination of tourniquets by pathogenic microorganisms was identified, with a resistance profile to the antibiotics that are frequently used in hospitals.