Formação do biofilme em ferida cutânea e seu comportamento diante das intervenções: revisão integrativa / Biofilm formation in cutaneous wounds and its behavior in the face of interventions: an integrative review

RESUMO Objetivo identificar na literatura a formação do biofilme e o seu comportamento diante das intervenções em feridas cutâneas. Métodos revisão integrativa, realizada nas bases de dados Cumulative Index to Nursing and Allied Health Literature , Literatura Latino-Americana e do Caribe em Ciências da Saúde, EMBASE, Scopus, The Cochrane Library Collaboration , MEDLINE/PubMed e Science Direct, sem delimitação temporal. Foram selecionados 19 estudos. Avaliação das informações ocorreu de forma descritiva, confrontando com os achados pertinentes. Resultados os estudos da amostra foram publicados no idioma inglês e contemplaram três tipos de pesquisa de biofilme: dois clínicos, seis in vitro e 11 in vivo (animal). Incluíram-se três temas: criação de modelo biofilme (n=4), avaliação do biofilme (n=3), comportamento do biofilme diante de intervenções para o seu manejo (n=12). Conclusão efeitos prejudiciais do biofilme na cicatrização de feridas foram confirmados. Diversas intervenções foram capazes de reduzir e eliminar o biofilme nos modelos in vitro e in vivo . Contribuições para a prática constatou-se que avaliação clínica da lesão não permite identificar o biofilme, inclusive quando presente encontra-se abaixo da superfície da lesão. Este achado suscita reflexão por parte dos enfermeiros a respeito das intervenções adotadas para a remoção do biofilme.

ABSTRACT Objective to identify in the literature the biofilm formation and its behavior when faced with interventions in cutaneous wounds. Methods an integrative review, carried out in the Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Health Sciences Literature, EMBASE, Scopus, The Cochrane Library Collaboration, MEDLINE/PubMed and Science Direct databases, without temporal delimitation. Nineteen studies were selected. The information was evaluated descriptively, comparing it with the pertinent findings. Results the sample studies were published in English and included three types of biofilm research: two clinical, six in vitro and 11 in vivo (animal). Three themes were included: biofilm model creation (n=4), biofilm assessment (n=3), biofilm behavior before interventions for its management (n=12). Conclusion the detrimental effects of biofilm on wound healing have been confirmed. Several interventions were able to reduce and eliminate biofilm in in vitro and in vivo models. Contributions to practice it was found that clinical evaluation of the lesion does not allow the identification of biofilm, even when present; it is below the surface of the lesion. This finding raises reflection on the part of nurses regarding the interventions adopted for the removal of biofilm.

Escala de Avaliação do Odor de Feridas Neoplásicas: Construção e Evidência de Validade de Conteúdo / Odor scale for neoplastic wounds: construction and evidence of content validity

Objetivo: Construir e obter a evidência de validade de conteúdo da Escala de Avaliação do Odor de Feridas Neoplásicas. Método: Estudo conduzido em 2019 em duas etapas: construção da escala a partir de revisão de literatura e validação a partir da avaliação de 17 juízes que responderam a um questionário por meio de ferramenta online. Foi aplicado o cálculo de índice de Validade de Conteúdo (IVC) para a análise dos dados. Resultados: As principais mudanças indicadas foram: retirada do swab para avaliar a carga microbiana e a inclusão do exsudato sanguinolento como item relevante na avaliação do odor. O IVC da escala foi de 0,91, indicando que 91% dos juízes consideraram a escala um instrumento relevante para avaliar o odor das feridas neoplásicas. Conclusão: A escala desenvolvida foi aprovada como instrumento de análise clínica que poderá auxiliar os profissionais na avaliação mais consistente do odor das feridas neoplásicas.(AU)

Objective: To build and obtain evidence of content validity of the Neoplastic Wound Odor Rating Scale. Materials and method: Two-step study: construction of the scale based on a literature review and validation based on the evaluation of 17 judges who answered a questionnaire through an online tool. The Content Validity Index (CVI) calculation was applied for data analysis. Results: The main changes indicated were: removal of the swab to assess the microbial load and the inclusion of bloody exudate as a relevant item in the odor assessment. The scale's CVI was 0.91, indicating that 91% of the judges considered the scale a relevant instrument to assess the odor of neoplastic wounds. Conclusion: The developed scale was approved as a clinical analysis instrument that can help professionals to more consistently assess the odor of neoplastic wounds.(AU)

Objetivo: Construir y obtener evidencia de la validez de contenido de la Escala de calificación de olores de heridas neoplásicas. Materiales y método: Estudio de dos pasos: construcción de la escala a partir de una revisión de la literatura y validación a partir de la evaluación de 17 jueces que respondieron un cuestionario a través de una herramienta online. Se aplicó el cálculo del Índice de Validez de Contenido (IVC) para el análisis de datos. Resultados: Los principales cambios indicados fueron: extracción del hisopo para evaluar la carga microbiana y la inclusión de exudado sanguinolento como elemento relevante en la evaluación de olores. El CVI de la escala fue de 0,91, lo que indica que el 91% de los jueces consideró la escala un instrumento relevante para evaluar el olor de las heridas neoplásicas. Conclusión: La escala desarrollada fue aprobada como un instrumento de análisis clínico que puede ayudar a los profesionales a evaluar de manera más consistente el olor de las heridas neoplásicas.(AU)

Antibacterial activity of 3, 3', 4'-Trihydroxyflavone from Justicia wynaadensis against diabetic wound and urinary tract infection

ABSTRACT The present investigation was designed to study the effect of an active compound isolated from Justicia wynaadensis against multi drug resistant organisms (MDRO's) associated with diabetic patients. The drug resistant pathogens implicated in wound and urinary tract infection of diabetic patients were isolated and identified by molecular sequencing. Solvent-solvent fractionation of crude methanol extract produced hexane, chloroform, ethyl acetate and methanol-water fraction, among which chloroform fraction was found to be potent when compared with other three fractions. Further, chloroform fraction was subjected to preparatory HPLC (High-Performance Liquid Chromatography), that produced four sub-fractions; chloroform HPLC fraction 1 (CHF1) through CHF4. Among the sub-fractions, CHF1 inhibited the pathogens effectively in comparison to other three sub-fractions. The purity of CHF1 was found to be >95%. Therefore, CHF1 was further characterized by NMR and FTIR analysis and based on the structure elucidated, the compound was found to be 3,3',4'-Trihydroxyflavone. The effective dose of this bioactive compound ranged from 32 µg/mL to 1.2 mg/mL. Thus, the present study shows that 3,3',4'-Trihydroxyflavone isolated from J. wynaadensis is an interesting biopharmaceutical agent and could be considered as a source of antimicrobial agent for the treatment of various infections and used as a template molecule for future drug development.

Prevalence of and risk factors associated with the presence of Staphylococcus aureus in the chronic wounds of patients treated in primary health care settings in Brazil

Abstract INTRODUCTION: Wounds can be colonized by methicillin-resistant Staphylococcus aureus (MRSA). METHODS: We evaluated the prevalence of S. aureus and MRSA in the wounds of patients treated at Basic Health Units in Brazil and identified risk factors associated with their presence. RESULTS: The prevalence rates of S. aureus and MRSA were 51.5% and 8.7%, respectively. There was a correlation between the presence of S. aureus in wounds and nostrils (p<0.01). A positive association was detected between S. aureus infection and previous benzylpenicillin use (p=0.02). No associations were observed for MRSA. CONCLUSIONS: Multidrug-resistant pathogens are present in primary healthcare settings in Brazil.

Antimicrobial activity of Melaleuca sp. oil against clinical isolates of antibiotics resistant Staphylococcus aureus

PURPOSE: To extract the Melaleuca sp. oil and to assess its in vitro inhibitory effect against Staphylococcus aureus isolates obtained from lower limb wounds and resistant to several antibiotics. METHODS: A total of 14 test-tubes containing Mueller-Hinton broth were used to determine the Minimum Inhibitory Concentration (MIC). The following concentrations of the Melaleuca sp. oil were added to the first 11 tubes: 8; 4; 2; 1; 0.5; 0.2; 0.1; 0.05; 0.025; 0,0125 and 0.00625%. The 12th and 13th tubes, with and without oil, were used as the positive and negative controls, respectively. The experimental study was carried out in triplicate at 37ºC for 18 hours. The Minimum Bactericidal Concentration (MBC), able of killing all the microorganisms, was also determined. Two S. aureus isolates were obtained from lower limb wounds of female patients and the identification of the microorganisms (Staphylococcus aureus) and the test for susceptibility to the antimicrobial agents were carried out by automation using the apparatus MicroScan(r). After identification, the isolates were preserved in liquid Trypticase Soy medium, and inoculated for determination of the MIC and MBC. RESULTS: The MIC was 0.2% and the MBC was 0.4%. CONCLUSION: The Melaleuca sp. oil showed antimicrobial properties in vitro against strains isolated from lower limb wounds which were resistant to multiple antibiotics. .

Genetic site determination of antibiotic resistance genes in escherichiacoli isolated from different sources of human infection

This study includes isolation of Escherichia coli from different sources of human infections [urine, stool, burns, wounds, and cerebrospinal fluid]. In addition to these, a few samples were taken from sewage water. Eighty-three isolates of E. coli were obtained from 264 samples. According to the resistance to antibiotics, isolates were classified into 41 groups. The isolates varied in their resistance to tested antimicrobials. Isolate E48 was resistant to all antimicrobials under study, while isolate E37 was resistant only to three antimicrobials. All isolates showed resistance of 97.59% to Chm and less sensitivity to Amk [2.40%]. The transformation was conducted successfully by plasmid DNA of isolate E48 and failed by plasmid isolate E38. The results cleared that the genes responsible for resistance to Amk, Chm, Cln, Dox, Kan, Lin, Pac, Tet, Tob, and Tri were located on the plasmid DNA, while the genes responsible for resistance to Cef, Cph, Cip, Gen, Gul, Nal, Nit, Pip, and Rif were located on the chromosome. It appeared from the electrophoresis run DNA samples on gel that E. coli K12JM83 strain obtained two plasmids through the transformation process

Detection of resistance to linezolid in Staphylococcus aureus infecting orthopedic patients.

Context: In today's medical scenario, the human race is battling the most intelligent enemy who has unending alternatives to combat with the potent elements they have produced against it. Aim: To study the resistance to linezolid among Staphylococcus aureus isolated from pus samples of orthopedic patients. Settings and Design: Pus samples were collected from dirty wounds of orthopedic patients undergoing long antimicrobial treatment programs. The sampling period was from July 2010 to June 2011. The samples were collected from different orthopedic hospitals of Nagpur (central India) representing a mixed sample of patients. Materials and Methods: One hundred pus samples were screened for S. aureus, by growth on mannitol salt agar (MSA), Baird-Parker agar (BPA), deoxyribonuclease test, tube coagulase test, and HiStaph latex agglutination test. Fifty-one S. aureus isolates were obtained which were further subjected to antimicrobial susceptibility testing by Kirby-Bauer disc diffusion method (DDM). Minimal inhibitory concentrations (MICs) were determined by an automated system, the VITEK 2 system. Also, Ezy MIC strip method was carried out in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines. Results and Conclusion: Twelve linezolid-resistant S. aureus (LRSA) isolates were recovered from 51 S. aureus cultures tested for susceptibility to linezolid using the DDM, VITEK 2 system, and Ezy MIC strip method. The emergence of resistance suggests nosocomial spread and abuse of antibiotic.

Length of exposure to the hospital environment is more important than antibiotic exposure in healthcare associated infections by methicillin-resistant Staphylococcus aureus: a comparative study

OBJECTIVES: Both total antimicrobial use and specific antimicrobials have been implicated as risk factors for healthcare-associated methicillin-resistant Staphylococcus aureus (HCA-MRSA) infection. The aims of this study were: (I) to explore predictors of a new HCA-MRSA infection in comparison with a new healthcare-associated methicillin-sensitive Staphylococcus aureus (HCA-MSSA); (II) to thoroughly assess the role of recent antibiotic use qualitatively and quantitatively. METHODS: The time-period for our study was from October 1997 through September 2001. Through applying strict criteria, we identified two groups of inpatients, one with a new HCA-MRSA infection and one with a new HCA-MSSA infection. We recorded demographic, clinical and antibiotic use-related data up to 30 days before the positive culture date. RESULTS: We identified 127 and 70 patients for each group, respectively. Two logistic regression models were carried out to assess the role of antimicrobial use (qualitatively and quantitatively). In model I, duration of hospital stay, presence of chronic wounds, aminoglycoside and fluoroquinolone use retained statistical significance. In model II, duration of hospital stay and history of intubation during the last month stood out as the only significant predictors of a subsequent HCA-MRSA infection. No significant differences in outcome were noted. CONCLUSIONS: The length of exposure to the hospital environment may be the best predictor of a new HCA-MRSA infection. Use of aminoglycosides and fluoroquinolones may also stand independently along with presence of chronic ulcers and surgical procedures. No independent association between quantitative antibiotic use and subsequent HCA-MRSA infection was documented.

[Molecular detection and identification of virulence factors of Pseudomonas aeruginosa isolated from wound and burn infections]

In recent decades, Pseudomonas aeruginosa has emerged as one of the most important nosocomial pathogens. Due to the clinical importance this bacterium, various methods have been developed to rapidly and accurately identify it. The aim of this research was to detect P. aeruginosa isolated from wound and burn infections on the basis of the amplification of the oprl, oprL and toxA genes, and to determine the prevalence of nanl and exoS genes among them. A total of 150 P. aeruginosa isolates was collected from patients with burn and wound infections of Imam-Khomaini, Tohid and Motahari hospitals in Tehran. The isolates were identified as P. aeruginosa using specific biochemical tests. Chromosomal DNA of the isolates was extracted with phenol chloroform method and used for PCR of oprl, oprL, toxA, exoS and nanl genes by specific primers. Among 150 P. aeruginosa isolates all carried the oprl and oprL genes; 98 [65.3%] 142 [94.7%] and 19 [12.66%] of the isolates were positive for exoS, toxA and nanl genes respectively. The presence of nanl gene in wound isolates [30%] was significantly higher [p<0.05] than in burn isolates [4%].Our results indicated that simultaneous use of oprl, oprL and toxA genes provide sufficient sensitivity to detect P. aeruginosa in clinical samples. The high prevalence of exoS in isolates suggests invasive phenotype of wound and burn isolates. The high prevalence of nanl in wound isolates suggests a possible role of this gene in those infections

[Searching for Penicillium marneffei in the soil of Qazvin city]

Penicillium marneffei is a dimorphic fungus that produces disseminated infections in immune-deficient people and AIDS patients. This fungus is endemic to Southeastern Asia with its reservoir in Southeast Asian bamboo rats. Also, it has been isolated from rats of a region in India. This study was conducted to search for Penicillium marneffei fungus in the soil of Qazvin city from the spring of 2007 to spring of 2008. Samples were taken from different locations of the city and cultured on Sabouraud dextrose agar after preliminary processing in laboratory. A suspension from colonies suspected of penicillium marneffei species was prepared and injected into peritoneum of rats. Penicillium marneffei fungus was not found in soil of the city however, other fungi including Cladosporium spp., Aspergillus spp., Penicillium spp., Rhizopus spp., Alternaria spp., Mucor spp., Chrysosporium spp., Acremonium spp., Fusarium spp., Ulocladium spp., Drechselera spp., Scopulariopsis spp., and yeasts were cultured from the soil specimens. No Penicillium marneffei positive cultures were obtained from lung cultures of rats inhabiting the city. Although Penicillium marneffei fungus was not isolated from the city soil yet further researches on other locations of Iran are required to determine the presence or absence of this fungus

Extended spectrum beta- lactamase [EBSL] in E. coli isolated from a tertiary hospital in Enugu state, Nigeria

The frequency of extended spectrum beta - lactamase [ESBL] producing E. coil in a tertiary hospital in Enugu, Enugu State, Nigeria was studied. Clinical specimens were collected from patients attending the Medical Microbiology Laboratory unit of the University of Nigeria Teaching Hospital [UNTH], Enugu. Isolates of E. coil were obtained from various specimen types namely, urine [19]; blood [25], wound [52], and sputum [32]. Susceptibility studies were carried out using agar diffusion method by Kirby and Bauer, while ESBL detection on these isolates was carried out on Mueller Hinton agar using the double disc diffusion method. The frequency of ESBL producing E. coli among the clinical isolates was 11.4% [15] and ESBL producing organisms were isolated more frequently from blood [6] followed by wound [5], urine [3] and sputum [1]. Urgent measures to avert the further spread of ESBL producing organisms in Enugu, Enugu State, Nigeria is a compelling necessity

Effect of antimicrobial fibers on the resistant strains of staphylococcus isolated from wounds

Some needs of patients can be provided by application of antimicrobial fibers in fabrics preparation. The aim of this study was to assess the antimicrobial effect of a particular kind of these fibers. The antimicrobial fibers were produced by Isfahan Poly Acryl company. We studied three resistant Staphylococcus aureus strains, one Staphylococcus epidermidis strain and one standard Staphylococcus aureus strain [ATCC6538p=PTCC1112]. At first sensitivity of sample strains to the controlling effect of pure antimicrobial agent was proved, and then their MIC was determined with agar dilution method. In the next stage, the effect of antibacterial activity of antibacterial fibers on these strains was studied before and after washing. The effect of antimicrobial pure agent of fibers was compared with the effect of penicillin G as the first selected antibiotic for treatment of Staphylococcus originated infections. Antimicrobial fibers containing 30%, 60% and 100% antimicrobial agent had significant effects on Staphylococcus strains after 24 hours. In spite of the high MIC of penicillin G on these bacteria [32-64 microg/ml], the antibacterial pure agent of fibers with a MIC about 10-4 microl/ml inhibited the bacteria growth. The results confirmed the antibacterial activity of examined fibers in preventing and controlling nosocomial infections resulted from Staphylococcus sp. We hope that clinical trial in the near future would provide the possibility of using these fibers in clinical experiences

Ineficiência da Thuja occidentalis no tratamento dos poxvirus aviários / Thuja occidentalis ineficiency in avian poxviruses treatment

Medicações à base de Tuia (Thuja occidentalis) são comuns em tratamentos homeopáticos e fitoterápicos, na medicina humana e veterinária. Suas propriedades imunoestimulantes e antivirais são descritas e sua utilização empírica no tratamento das poxviroses aviárias é recomendada por criadores e veterinários. Para avaliar o potencial terapêutico da Tuia sobre estas infecções, dois grupos (controle e teste) de dez aves jovens foram inoculados por escarificação, com uma amostra de campo de poxvírus aviário. As aves inoculadas foram examinadas diariamente, quanto ao início e evolução das lesões, registrando-se o número e tamanho destas, até a cicatrização. Após o surgimento das lesões, o grupo teste recebeu a tintura alcoólica diluída na água de consumo. A análise experimental indicou que, nas condições empregadas, a utilização da Tuia não favoreceu a regressão ou restrição no desenvolvimento das lesões de pele promovidas pela infecção experimental.

O cuidado de enfermagem na coleta de material microbiológico de feridas: comparação de duas técnicas / The nursing care in the microbiologic material collection of wounds: comparison between two techniques

O exame microbiológico de feridas constitui um método de auxílio na identificação e monitorização de feridas infectadas, contribuindo para o tratamento e recuperação do cliente que as possui. Decorrente dessa necessidade resulta uma atividade de cuidado indireto ao cliente, sob a responsabilidade do enfermeiro. Questionando-se os passos desse procedimento técnico e a resolutividade da técnica de swab quanto aos resultados referentes ao quantitativo e qualitativo de microrganismos coletados, elegeu-se o método de investigação clinica e técnica de medida biofisiológica "in vitro", com o objetivo de testar a implementação das técnicas de coleta de material microbiológico de feridas: por "swab" e por irrigação-aspiração, sendo esta última adaptada pelo pesquisador e considerada como sua intervenção no campo da pesquisa. Formulou-se uma hipótese substantiva cuja decorrente hipótese nula previu a inexistência de diferença significativa entre o quantitativo e qualitativo das amostragens de microrganismos presentes nas lesões dos clientes obtidas com a aplicação das técnicas alvo da testagem. A amostra intencional foi composta por 20 clientes com feridas crônicas internados no Hospital Dr. Roberto Arnizaut Silvares (HRAS) de São Mateus - ES, em 2002. Anterior à coleta das amostras, as feridas eram limpas utilizando solução salina a 0,9% morna com a técnica de irrigação sob pressão, utilizando-se agulha 25X8 (21G) e seringa de 20ml e após este passo a coleta do material se deu, primeiramente, pela técnica de irrigação-aspiração onde se instilava no leito das feridas, aproximadamente 5ml de soro fisiológico e posteriormente aspirava-se com uma seringa de 3ml a quantidade de 1ml desta solução e em seguida o "swab" que foi umedecido e rodado em seu eixo durante 5 segundos, de um único ponto do leito das feridas. Após a coleta do material microbiológico pelas duas técnicas os mesmos foram enviados ao laboratório de microbiologia do HRAS, onde foram analisados qualitativam

Methicillin resistance among isolates of Staphylococcus aureus: antibiotic sensitivity pattern & phage typing.

Out of 3988 clinical specimens from hospital admitted patients 230 strains of Staphylococcus aureus were isolated, 45 strains (19.56%) were Methicillin resistance Staphylococcus aureus (MRSA). All MRSA strains were beta lactamase producers. Multidrug resistance was observed among MRSA strains more commonly than in methicillin sensitive strains of Staphylococcus aureus (MSSA). Maximum strains were resistant to penicillin (100%), co-trimoxa zole (97%) & chloramphenicol (93.33%). As least resistant to gentamicin & ciprofloxacin shown by MRSA, these drugs can be used in few situations after susceptibility test. All strains of MRSA were sensitive to vancomicin (100%). Majority of strains (34 out of 45) showed MIC values of 4 ug/ml. Twenty eight out of 44 strains were non typable using routine phages. Study revealed that MRSA with associated multidrug resistance is common in this region. There is need to develop local set of MRSA phages for improvement of typability.

Antibiogram of aerobic pyogenic isolates from wounds and abscesses of patients at Rawalpindi

During the years 1996-1998 pus specimens from wounds and abscesses of patients were cultured on to MacConkey and blood agar plates in microbiology section, pathology laboratory of Rawalpindi Medical College. Organisms were isolated from 220 samples. Staphylococcus aureus was the most common Pathogen [49%] followed by E.coli [25.9%] Klebsiella [9.5%], Pseudomonas aeruginosa [8.6%], Proteus sp [4%] and acinetobactor sp [2.7%]. Quinolones, aminoglycosides and cephalosporins were found to be the most effective antimicrobial in vitro while amoxicillin, minocycline and trimethoprim-Sulphamethaxazole were least effective

Avaliaçäo de três técnicas de limpeza do sítio cirúrgico infectado utilizando soro fisiológico para a remoçäo de microrganismos / Evaluation of three techniques for cleaning infected surgical site with psysiological serum for the removal of microorganisms

Percebemos que na literatura estrangeira existem muitas pesquisas referentes à limpeza de feridas mas que, no Brasil, este tipo de estudo näo é muito comum. Há uma tendência em se desenvolver pesquisas sobre os diferentes tipos de coberturas que devem ser utilizados nas lesöes, porém näo se tem atribuído a mesma importância à técnica de limpeza. Com a divulgaçäo dos estudos internacionais, atualmente percebe-se uma orientaçäo no sentido de se adotar a técnica de limpeza de feridas por meio da irrigaçäo sob pressäo utilizando-se agulha 19 Gauges (G) e seringa de 35 ml que proporciona uma pressäo conhecida de 4 a 8 "psi", considerados valores ideais para limpeza. No Brasil, entretanto, não há padronizaçäo deste material (seringa de 35 ml e agulha 19G), sendo necessário fazer adaptaçöes. Esta pesquisa foi elaborada com o objetivo de comparar a reduçäo de microrganismos nas feridas infectadas submetidas à limpeza com soro fisiológico por meio da execuçäo de três técnicas diferentes: por remoçäo mecânica tradicional, por técnica de irrigaçäo com agulha 25x8 (21 G) e seringa de 20 ml e por técnica de irrigaçäo com agulha 40x12 (18G) e seringa de 20 ml. Foram estudados três grupos de feridas infectadas de pacientes internados no Hospital Universitário Regional do Norte do Paraná (HURNP), divididos de acordo com técnica de limpeza que seria realizada na lesäo. Vale ressaltar que a primeira técnica a ser aplicada foi estabelecida por sorteio e as seguintes foram intercaladas. Foram colhidas culturas primeiramente do grupo I (remoçäo mecânica) e grupo II (seringa de 20 ml e agulha 40x12), e em uma segunda etapa, do grupo III (seringa de 20 ml e agulha 25x8). As culturas eram realizadas por "swab" tanto antes como após a limpeza com soro fisiológico e aplicaçäo de uma das técnicas acima mencionadas. Todo material colhido foi encaminhado ao laboratório de microbiologia do HURNP, onde foi desenvolvida uma técnica de análise microbiológica quantitativa pelo método de "swab", para possibilitar a comparaçäo do número de bactérias tanto antes como após o procedimento de limpeza. O trabalho teve, também, a colaboraçäo de um docente do Departamento de Física da Universidade Estadual de Londrina para a realizaçäo de experimentos que elucidassem o valor da pressäo que o conjunto seringa e agulha proporcionava aos jatos de soros fisiológicos para irrigaçäo da ferida. Os resultados foram surpreendentes pois os experimentos comprovaram que com a seringa de 20 ml e...

Estudo da sensibilidade do S aureus aos antimicrobianos nas feridas ortopédicas / Sensibility study of S aureus to antimicrobians at orthopedic wounds

Com o intuito de traçar o perfil de sensibilidade do Staphylococcus aureus aos antimicrobianos nas feridas ortopédicas, realizou-se um estudo retrospectivo em nossa instituição, de outubro de 1996 a janeiro de 1998. O agente era sensível em 100 por cento à vancomicina seguina pela oxacilina (64,91 por cento), doxiciclina (59,64 por cento), cloranfenicol (56,14 por cento) e sulfametoxazol-trimetoprima (54,38 por cento). Os autores discutem os resultados e comentam sobre o aumento do número das infecções atualmente e suas implicações nas indicações cirúrgicas