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1.
Enferm. foco (Brasília) ; 11(2): 83-88, jul. 2020.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1104176

ABSTRACT

Objetivo: Conhecer a percepção da equipe multiprofissional acerca dos cuidados relacionados às medidas de prevenção a pneumonia associada à ventilação mecânica. Método: Tratou-se de um estudo descritivo, qualitativo em que participou a equipe multiprofissional atuante em UTI. Resultados: Totalizaram 20 profissionais. Verificou-se que a equipe multiprofissional conhece algumas medidas preventivas, no entanto a enfermagem percebe o fisioterapeuta como protagonista neste processo. Conclusões: A pesquisa permitiu identificar a maneira como cada membro da equipe percebe a sua atuação e a atuação do outro. (AU)


Objective: To know the perception of the multidisciplinary team about the care related to the prevention measures against ventilator-associated pneumonia. Method: This was a descriptive and qualitative study in which the multiprofessional team working in Intensive Care Unit participated. Results: Totaled 20 professionals. It was found that the multiprofessional team knows some preventive measures, however nursing refers to the physical therapist as a protagonist in this process. It was also noticed that the nurse has a fundamental role in maintaining care before the multiprofessional team. Conclusions: The study showed that the multiprofessional team demonstrates knowledge about the preventive measures related to ventilator-associated pneumonia, as well as the professionals seek to act continuously to improve the quality of care, aiming to ensure patient safety. (AU)


Objetivo: Conocer la percepción del equipo multidisciplinario sobre la atención relacionada con las medidas de prevención contra la neumonía asociada al ventilador. Método: Este fue un estudio descriptivo y cualitativo en el que participó el equipo multiprofesional que trabajaba en la Unidad Intensiva. Resultados: totalizaron 20 profesionales. Se encontró que el equipo multiprofesional conoce algunas medidas preventivas, sin embargo, la enfermería se refiere al fisioterapeuta como protagonista en este proceso. También se notó que la enfermera tiene un papel fundamental en el mantenimiento de la atención ante el equipo multiprofesional. Conclusiones: El estudio mostró que el equipo multiprofesional demuestra conocimiento sobre las medidas preventivas relacionadas con la neumonía asociada al ventilador, así como que los profesionales buscan actuar continuamente para mejorar la calidad de la atención, con el objetivo de garantizar la seguridad del paciente. (AU)


Subject(s)
Cross Infection , Patient Care Team , Nursing , Infection Control
2.
Enferm. foco (Brasília) ; 11(2): 176-181, jul. 2020. tab
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1116005

ABSTRACT

Objetivo: Identificar os fatores associados ao desenvolvimento de Infecção do Trato Urinária Associada ao Cateter (ITU-AC) e mortalidade entre pacientes com cateter urinário. Metodologia: Estudo de coorte, prospectivo, com amostragem por conveniência envolvendo 790 pacientes com idade superior a 12 anos, em uso de cateter durante hospitalização. Os dados coletados do prontuário e fichas de notificação de infecção hospitalar foram analisados pelo programa SPSS. Resultados: Contribuíram para o desenvolvimento da ITU-AC a permanência com o cateter urinário por período >20 dias (OR 26,5; p<0,001), ser cateterizado mais de uma vez (OR 8,92; p<0,001) e hospitalização >30 dias (OR 26,8; p<0,001). Pacientes que desenvolveram ITU-AC apresentaram chance maior de mortalidade (OR 2,7; p<0,001). Conclusão:Frequência da inserção do dispositivo urinário, períodos prolongados de hospitalização e de permanência com o cateter contribuíram para o desenvolvimento de ITU-AC, e as chances de mortalidade foram aumentadas entre pacientes com essa infecção. (AU)


Objective: To identify factors associated with the development of Catheter-related Urinary Tract Infection (CR-UTI) and mortality among patients using urinary catheter. Methodology: Prospective cohort study in a convenience sample of 790 patients older than 12 years using catheter during hospitalization.[A1] The data collected from medical records and hospital infection notification were analyzed using the SPSS program. Results: Permanence with the urinary catheter >20 days (OR 26.5; p<0.001), being catheterized more than once (OR 8.92; p<0.001) and hospitalization >30 days (OR 26.8; p<0.001) contributed to the development of CR-UTI. Patients who developed CR-UTI presented a greater chance of mortality (OR 2.7; p<0.001). Conclusion: Frequency of urinary device insertion, prolonged periods of hospitalization and of permanence with the catheter contributed to the development of CR-UTI, and the chances of mortality were increased among patients with this infection. (AU)


Objetivo: Identificar los factores asociados con el desarrollo de Infección del Tracto Urinario Asociada con el Catéter (ITU-AC) y la mortalidad entre los pacientes que usan catéter urinario. Metodología: Estudio de cohorte, prospectivo con una muestra de conveniencia de 790 pacientes mayores de 12 años, que usan catéter durante su hospitalización. Los datos recopilados de los registros médicos y los formularios de notificación de infección nosocomial fueron analizados por el programa SPSS. Resultados: Contribuyendo al desarrollo de la (ITU-AC) la permanencia con el catéter urinario por un plazo >20 días (OR 26,5; p <0,001), tener recibido catéter más de una vez (OR 8,92; p<0,001) y hospitalización >30 días (OR 26,8; p<0,001). Los pacientes que desarrollaron (ITU-AC) presentaron una mayor posibilidad de mortalidad (OR 2,7; p<0,001). Conclusión: Frecuencia de inserción del dispositivo urinario, períodos prolongados de hospitalización y de permanencia con el catéter contribuyeron al desarrollo de (ITU-AC), y las posibilidades de mortalidad aumentaron entre los pacientes con esta infección. (AU)


Subject(s)
Urinary Tract Infections , Urinary Catheterization , Infection Control , Catheter-Related Infections , Nursing Care
3.
Enferm. actual Costa Rica (Online) ; (38): 230-244, Jan.-Jun. 2020. tab, graf
Article in Spanish | LILACS (Americas), BDENF | ID: biblio-1090098

ABSTRACT

Resumen Identificar el efecto del uso de protectores puerto desinfectantes en los conectores sin aguja en la disminución de las bacteriemias asociadas a catéter venoso central. Se realizó una revisión rápida de la literatura a través de una búsqueda de artículos en idiomas inglés y español en Pubmed, Medline, Cochrane Library y Science Direct, de diciembre del año 2018 a febrero del año 2019. Esta revisión se centró en identificar ensayos: clínicos aleatorizados, cohorte longitudinal, revisiones sistemáticas y meta-análisis. Los criterios de inclusión fueron: usuarios hospitalizados, desinfección pasiva con protectores puerto desinfectantes y reporte de disminución de las bacteriemias asociadas a catéter venoso central con su uso. Un total de 2479 artículos se identificaron como potencialmente relevantes; después de eliminar los duplicados, quedaron 1622 artículos, los cuales fueron evaluados según título y resumen. Posteriormente, 59 artículos fueron analizados en texto completo; se seleccionaron 3 artículos correspondientes a tres revisiones sistemáticas, de las cuales dos realizaron metaanálisis. La evidencia disponible sugiere que estudios no aleatorizados han demostrado que el uso de los protectores puerto desinfectantes con alcohol isopropílico al 70% en los conectores sin aguja, puede generar una reducción de las bacteriemias asociadas al catéter venoso central y podría considerarse como una medida costo efectiva; no obstante, se requieren estudios aleatorizados que confirmen estos resultados.


Abstract Identify the effect of the use of disinfectant port protectors on needleless connectors in the reduction of bacteraemias associated with central venous catheters. A quick review of the literature was carried out through a search of articles in English and Spanish in Pubmed, Medline, Cochrane Library and Science Direct; from December 2018 to February 2019. It focused on identifying randomized clinical trials, longitudinal cohort, reviews and meta-analysis. The inclusion criteria were: hospitalized users, passive disinfection with disinfectant port protectors and report of decrease in bacteraemias associated with central venous catheter with its use. A total of 2479 articles were identified as potentially relevant, after eliminating duplicates, 1622 articles were evaluated according to inclusion criteria were: hospitalized users, passive disinfection with disinfectant port protectors and report of decrease in bacteraemias associated with central venous catheter with its use. The available evidence suggests that non-randomized studies have shown that the use of disinfectant port protectors with 70% isopropyl alcohol in needleless connectors can lead to a reduction in bacteraemias associated with central venous catheters and could be considered as a cost measure. effective, however, randomized studies are required to confirm these results.


Resumo Identificar o efeito do uso de protetores de porta desinfetantes nos conectores sem agulha na redução de bacteremias associadas aos cateteres venosos centrais. Uma rápida revisão da literatura foi realizada através de uma pesquisa de artigos em inglês e espanhol no Pubmed, Medline, Cochrane Library e Science Direct; de dezembro de 2018 a fevereiro de 2019. Concentrou-se na identificação de ensaios clínicos randomizados, coorte longitudinal, revisões sistemáticas e metanálise. Os critérios de inclusão foram: usuários hospitalizados, desinfecção passiva com protetores de porta desinfetantes e relato de diminuição de bacteremias associadas ao cateter venoso central com seu uso. Um total de 2479 artigos foi identificado como potencialmente relevante; após eliminação de duplicatas, 1622 artigos foram avaliados de acordo com o título e o resumo, depois 59 artigos foram analisados ​​em texto completo, foram selecionados 3 artigos correspondentes a três revisões sistemáticas, dos quais dois realizaram meta-análise. As evidências disponíveis sugerem que estudos não randomizados demonstraram que o uso de protetores de porta desinfetantes com álcool isopropílico a 70% em conectores sem agulha pode levar a uma redução nas bacteremias associadas aos cateteres venosos centrais e pode ser considerado como uma medida de custo. estudos eficazes, no entanto, são necessários para confirmar esses resultados.


Subject(s)
Humans , Disinfection , Infection Control , Bacteremia , 2-Propanol , Central Venous Catheters , Anti-Infective Agents
4.
Gastroenterol. latinoam ; 31(1): 9-20, mayo 2020. tab, ilus
Article in Spanish | LILACS (Americas), Inca | ID: biblio-1103076

ABSTRACT

The outbreak of COVID-19 disease has recently spread from its original place in Wuhan, Hubei province, China, to the entire world, and has been declared to be a pandemic by the World Health Organization in March 2020. All countries in America, in particular Chile, show an important increase in COVID-19 cases and deaths. The clinical manifestations of COVID-19 are a broad spectrum, from asymptomatic mild disease, to severe respiratory failure, shock, multiorgan dysfunction and death. Thus, high clinical suspicion and appropriate structure risk stratification are needed. Health care teams in endoscopy units, are at an increased risk of infection by COVID-19 from inhalation of droplets, mucosae contact, probably contamination due to contact with stools. Endoscopic aerosolized associated infections have also been reported. Different societies' recommendations, have recently placed digestive endoscopy (especially upper) among the high risk aerosol generating procedures (AGPs). In addition, live virus has been found in patient stools. On top of this, the infected health professionals may transmit the infection to their patients. Health care infection prevention and control (HCIPC), has been shown to be effective in assuring the safety of both health care personnel and patients. This is not limited to the correct use of personal protective equipment (PPE), but is based on a clear, detailed and well communicated HCIPC strategy, risk stratification, use of PPE, and careful interventions in patients with moderate and high risk of COVID-19. A conscientious approach regarding limited resources is important, as the simultaneous outbreak in all countries heavily affects the availability of health supplies. The Chilean Gastroenterology Society (SChGE) and Digestive Endoscopy Association of Chile (ACHED) are joining to provide continued updated guidance in order to assure the highest level of protection against COVID-19, for both patients and health care workers. This guideline will be updated online as needed.


El brote de la enfermedad denominada COVID-19, se ha extendido desde su origen en Wuhan, provincia de Hubei, China, a todo el mundo. La Organización Mundial de la Salud lo declaró pandemia en marzo de 2020. Todos los países de América, en especial Chile, presentan incremento de casos y fallecidos. Las manifestaciones clínicas de COVID-19 van desde una enfermedad leve, hasta insuficiencia respiratoria severa, shock, disfunción orgánica y muerte. Se necesita una alta sospecha clínica y una adecuada estratificación del riesgo. El equipo de salud en las unidades de endoscopia, tiene un mayor riesgo de COVID-19 que otras unidades clínicas y de apoyo diagnóstico, dada la mayor exposición a inhalación de gotas, contacto posible con mucosas y contaminación por contacto con deposiciones. Recomendaciones de diferentes sociedades colocan la endoscopia digestiva (especialmente la esofagogastroscopia o endoscopia digestiva alta, EDA) entre los procedimientos generadores de aerosoles (PGA) de alto riesgo. Además, se han encontrado virus viables en las deposiciones de los pacientes. Potencialmente, los profesionales de la salud infectados podrían contagiar a los pacientes. Se ha demostrado que la prevención y control de infecciones asociadas a la atención de salud (IAAS), son efectivos para garantizar la seguridad tanto del personal de salud, como de los pacientes. Esto no es solamente el correcto uso del equipo de protección personal (EPP), sino que se basa en una clara estrategia de IAAS, bien comunicada, con estratificación de riesgo, uso de EPP e intervenciones correctas en pacientes con riesgo moderado y alto. Es relevante un enfoque sobre los limitados recursos, dado la simultaneidad del brote en todos los países, que afecta la disponibilidad de insumos. La Sociedad Chilena de Gastroenterología (SChGE) y la Asociación Chilena de Endoscopia Digestiva (ACHED) publican esta guía actualizada para apoyar las buenas prácticas contra COVID-19, tanto para pacientes como para el equipo de salud. Esta guía podrá tener actualizaciones según avance la información disponible.


Subject(s)
Humans , Pneumonia, Viral/prevention & control , Endoscopy, Digestive System/standards , Coronavirus Infections/prevention & control , Betacoronavirus , Pneumonia, Viral/epidemiology , Risk Factors , Infection Control/methods , Practice Guidelines as Topic , Coronavirus Infections/epidemiology , Pandemics , Hospital Units/standards
5.
Guatemala; MSPAS, Unidad de Gestión de Riesgos; 03 abr 2020. 13 p. ilus.
Non-conventional in Spanish | LILACS (Americas), LIGCSA | ID: biblio-1096349

ABSTRACT

Detalla el procedimiento para homogenizar el equipo de protección personal (EPP) que se recomienda utilizar en las acciones relacionadas con la obtención de muestras a analizar para detectar la presencia del virus, así como establecer las especificaciones y características que deben llenar los diferentes elementos a emplear, priorizando la seguridad del personal de salud involucrado.


Subject(s)
Humans , Pneumonia, Viral/prevention & control , Coronavirus Infections/prevention & control , Personal Protective Equipment/supply & distribution , Betacoronavirus , Infection Control/standards , Hand Hygiene/methods , Guatemala
6.
REME rev. min. enferm ; 24: e-1296, fev.2020.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1096478

ABSTRACT

Objetivo: avaliar o controle da tuberculose em 44 municípios paulistas segundo aspectos do contexto externo, político-organizacional e técnicooperacional dos sistemas locais de saúde. Método: estudo operacional de análise de agrupamento utilizando indicadores operacionais e de desfecho de casos novos de tuberculose para os anos de 2014 e 2015; e teste de hipótese para proporção para identificação de associação dos grupos com porte populacional, índice de Gini, cobertura de Programa de Agentes Comunitários de Saúde e Estratégia Saúde da Família e despesas per capita em atenção básica e vigilância epidemiológica. Resultados: o primeiro grupo formado (n=19) apresentou resultados satisfatórios dos indicadores operacionais e desfecho; o segundo (n=5) teve desempenho regular (resultado satisfatório de desfecho e insatisfatório para o tratamento diretamente observado) e esteve associado ao índice de Gini baixo e menor proporção de PACS; o terceiro (n=20) grupo, de desempenho insatisfatório, esteve associado a índice de Gini mais alto e porte populacional pequeno. Conclusão: os achados destacaram a relação entre aspectos socioeconômicos e o desempenho das ações de controle da tuberculose.(AU)


Objective: to evaluate tuberculosis control in 44 municipalities in São Paulo according to aspects of the external, political-organizational and technicaloperational context of local health systems. Method: operational study of cluster analysis using operational and outcome indicators of new cases of tuberculosis for the years 2014 and 2015; and hypothesis test for proportion to identify association of groups with population size, Gini index, coverage of Community Health Agents Program and Family Health Strategy and per capita expenditure in primary care and epidemiological surveillance. Results: the first group (n=19) presented satisfactory results of operational indicators and outcome; the second (n=5) had regular performance (satisfactory outcome and unsatisfactory for directly observed treatment) and was associated with low Gini index and lower proportion of PACS; the third (n=20) group, with poor performance, was associated with a higher Gini index and small population size. Conclusion: the findings highlighted the relationship between socioeconomic aspects and the performance of tuberculosis control actions.(AU)


Objetivo: evaluar el control de la tuberculosis en 44 municipios de São Paulo de acuerdo con los aspectos del contexto externo, políticoorganizativo y técnico-operativo de los sistemas locales de salud. Método: estudio operativo de análisis de conglomerados utilizando indicadores operativos y de desenlace de nuevos casos de tuberculosis para los años 2014 y 2015; y prueba de hipótesis para proporciones para identificar la asociación de grupos con el tamaño de la población, el índice de Gini, el alcance del Programa de Agentes Comunitarios de Salud (PACS) y la Estrategia de Salud Familiar y los gastos per cápita en atención primaria y vigilancia epidemiológica. Resultados: el primer grupo formado (n = 19) presentó resultados satisfactorios para indicadores operativos y desenlace; el segundo (n = 5) presentó rendimiento regular (resultado satisfactorio de desenlace e insatisfactorio para el tratamiento observado directamente) y se asoció con un índice de Gini bajo y una menor proporción de PACS; el tercer grupo (n = 20), de rendimiento insatisfactorio, se asoció con un índice de Gini más alto y poblaciones de menor tamaño. Conclusión: los hallazgos realzaron la relación entre los aspectos socioeconómicos y el desempeño de las acciones de control de la tuberculosis.(AU)


Subject(s)
Humans , Outcome and Process Assessment, Health Care , Tuberculosis , Health Evaluation , Infection Control , Quality Indicators, Health Care , Epidemiological Monitoring
7.
Article in English | WPRIM (Western Pacific) | ID: wprim-810949

ABSTRACT

BACKGROUND: Statistical data of undiagnosed people living with human immunodeficiency virus (PLHIV) are of great importance to human immunodeficiency virus (HIV) infection control. This study estimated the total number of PLHIV using nationwide claims data.METHODS: This study used data of the incident HIV cases identified by the National Health Insurance System between 2009 and 2015. The number of patients with acquired immune deficiency syndrome (AIDS) was identified by diagnoses or prescription records. The estimated number of PLHIV and the time to diagnosis were calculated from the incident numbers of HIV and AIDS cases using the HIV Modeling Tool of the European Center for Disease Prevention and Control.RESULTS: Between 2009 and 2015, a total of 7,033 PLHIV and 2,899 AIDS patients were diagnosed. In 2009, the number of incident HIV cases was 873 (460 AIDS patients), increasing to 995 (337 AIDS patients) in 2015. Besides, the estimated number of prevalent cases was 10,753 in 2009, compared to 14,880 in 2015. Patients visiting health facilities accounted for 42.9% (4,616/10,753) in 2009 and 64.1% (9,544/14,880) in 2015. In 2009, there were 8,363 (77.8%) undiagnosed HIV cases, experiencing a decline to 6,215 (41.8%) in 2015. It took a mean of 6.96 years to diagnose after HIV infection.CONCLUSION: This study estimates the total burden of HIV infection in Korea for the first time using an internationally recognized HIV modeling tool. Claims data can be used to estimate the number of undiagnosed cases by identifying the total number of PLHIV and AIDS patients visiting health facilities.


Subject(s)
Acquired Immunodeficiency Syndrome , Diagnosis , Health Facilities , HIV Infections , HIV , Humans , Infection Control , Korea , National Health Programs , Prescriptions
11.
Arq. odontol ; 56: 1-10, jan.-dez. 2020. tab, graf
Article in Portuguese | LILACS (Americas), BBO | ID: biblio-1103340

ABSTRACT

Objetivo: Avaliar a taxa de infecção e eventos adversos no pós-operatório de cirurgias orais menores, em uma instituição pública de atenção odontológica, entre 2017 e 2018. Métodos: Após realização dos procedimentos cirúrgicos, um formulário foi preenchido com dados relacionados ao paciente e à cirurgia. Trinta dias após, os egressos cirúrgicos foram contactados, via telefone e questionados quanto à ocorrência de eventos adversos (dor, secreção, sangramento e deiscência de sutura) e sobre uso de antibióticos. Realizou-se a análise descritiva dos dados (distribuição de frequências e percentuais) e cálculo da taxa de infecção global. Resultados:Foram incluídos 3.745 procedimentos cirúrgicos. A média de idade dos pacientes da amostra foi de 42,7 anos, com ligeiro predomínio do sexo masculino (51,3%). A clínica de cirurgia teve a maior concentração de procedimentos cirúrgicos realizados (53,8%), a prevalência média anual de eventos adversos no pós-operatório foi de 1,7% e a dor foi o evento adverso mais informado (4,0%). A maioria dos pacientes (64,2%) não recebeu nenhum tipo de prescrição antibiótica (profilático, terapêutico ou ambos) e a taxa de infecção no pós-operatório apresentou prevalência média total de 1,1%. Conclusão: As taxas de eventos adversos e a de infecção das feridas cirúrgicas encontradas foram baixas, demonstrando que o serviço atua de forma comprometida com os padrões de biossegurança, zelando pelos cuidados com o paciente.


Aim: To evaluate the rate of infection and adverse events in the postoperative stage of dental surgeries in a public dental care institution between 2017 and 2018. Methods: After performing the surgical procedures, a form was filled with data related to the patient and the surgery. Thirty days later, the patients were contacted via telephone, inquiring about the occurrence of adverse events (pain, discharge, bleeding, suture dehiscence) and antibiotic use. Descriptive data analysis (frequency and percentage distribution) and global infection rate were calculated. Results: This study included 3,745 surgical procedures. The mean age of the patients was 42.7 years, with a slight predominance of males. The surgery clinic presented the highest concentration of executed surgical procedures (53.8%); the average annual incidence of postoperative adverse events was 1.7%; and pain was the most commonly reported adverse event (4.0%). Most patients (64.2%) received no type of antibiotic prescription (prophylactic, therapeutic, or both) and the postoperative infection rate presented a total average incidence of 1.1%. Conclusion: The rates of adverse events and the infection of surgical sites were low, demonstrating that the service acts in a manner committed to the standards of biosafety, thus ensuring patient care.


Subject(s)
Postoperative Complications , Surgical Wound Infection , Infection Control , Oral Surgical Procedures , Health Management , Pain, Postoperative , Anti-Bacterial Agents
12.
Braz. dent. sci ; 23(2,supl): 1-7, 2020.
Article in English | LILACS (Americas), BBO | ID: biblio-1100311

ABSTRACT

A new coronavirus disease has affected the whole world, starting from Wuhan, China at the end of 2019. The disease, caused by the pathogen of SARS-CoV-2, commonly called COVID-19, has soon passed into the history of epidemics as the most effective pandemic recently. Dentistry has also been significantly affected by the pandemic process, which had a restrictive effect on almost all aspects of social life. Dental treatments are healthcare services that have been applied very carefully in terms of the risk control of cross-infection prior to this pandemic where disinfection and sterilization rules continue to be controlled at the highest level. However, hand instruments used in most dental treatments and generating aerosol has raised concerns, particularly in diseases such as COVID-19, which increase the risk of droplet contamination. This working order is an important risk factor not only for healthcare professionals but also for the contamination of patients and the environment. In addition, the continuing pandemic process and the dynamics of the process require revision of the protocols. For this reason, each country has prepared protocols in order to maintain the dental treatments in the pandemic process in accordance with their own health care conditions and policies. This process caused the dental professionals to reconsider their routine working practices and prospectively, new protocols are recommended for dental applications. This article aims to provide a perspective evaluating the current situation and discuss additional measures to be considered during the pandemic and thereafter.(AU)


Uma nova doença por coronavírus afetou o mundo inteiro, a partir de Wuhan, China, no final de 2019. A doença, causada pelo patógeno da SARS-CoV-2, comumente chamada COVID-19, logo passou para a história das epidemias como a pandemia mais eficaz. A odontologia também foi significativamente afetada pelo processo de pandemia, que teve um efeito restritivo em quase todos os aspectos da vida social. Os tratamentos dentários são serviços de saúde que foram sempre aplicados com muito cuidado em termos de controle de risco de infecção cruzada mesmo antes desta pandemia, onde as regras de desinfecção e esterilização continuam a ser controladas ao mais alto nível. No entanto, as turbinas usadas na maioria dos tratamentos odontológicos que geram aerossóis têm suscitado preocupações, principalmente em doenças como a COVID-19, pelo aumento do risco de contaminação por gotículas. Essa mecânica de trabalho é um importante fator de risco não apenas para os profissionais de saúde, mas também para a contaminação dos pacientes e do ambiente. Além disso, o processo continuado da pandemia e sua dinâmica exigem revisão dos protocolos. Por esse motivo, cada país elaborou protocolos para manter os tratamentos dentários no processo de pandemia, de acordo com suas próprias condições e políticas de saúde. Esse processo levou os profissionais de odontologia a reconsiderar suas práticas de trabalho de rotina e, prospectivamente, novos protocolos são recomendados para aplicações odontológicas. Este artigo tem como objetivo fornecer uma perspectiva para avaliar a situação atual e discutir medidas adicionais a serem consideradas durante e após a pandemia.(AU)


Subject(s)
Infection Control , Coronavirus Infections , Coronavirus , Disease Transmission, Infectious , Betacoronavirus
13.
Braz. dent. sci ; 23(2,supl): 1-9, 2020. graf
Article in English | LILACS (Americas), BBO | ID: biblio-1100337

ABSTRACT

Background: The global issue that urges the public health emergency is the outbreak of the Novel Corona Virus strain (COVID-19). Dentists being are highly prone to airborne transmission during dental treatment due to aerosols generated by various dental procedures on patients with COVID-19. Taking this fact into consideration, the present survey research was mainly aimed at evaluating the knowledge, attitude, and practice of dentists in preventing the disease transmission of Novel Coronavirus (COVID-19). Material and methods: The present study is prospective research, where the online survey questionnaire was distributed among 300 dentists in Andhra Pradesh and Telangana states in India, who were randomly recruited for the study. The participants were recruited based on the clinical experience ranging from less than five years to more than ten years, who were working in both the private and government sectors. 15 close-ended questions were formulated and validated. The questionnaire consisted of the necessary demographic details of the participants and equally distributed into three sections that contained questions that assessed the knowledge, attitude, and practice of dentists in preventing the disease transmission of Novel Coronavirus (COVID-19). Results: The results revealed that dentists have an adequate knowledge and awareness on COVID-19 transmission and most of the dentists felt that dentists have a major role in preventing the disease transmission. Majority of the participants raised the importance of awareness programs have to be conducted on various measures in preventing COVID-19 transmission among dental fraternity and in public. Conclusions: From the survey research it can be concluded that dentists have an adequate knowledge and awareness on COVID-19 disease. Majority of them are trying their level best in the present situation to prevent COVID-19 transmission. (AU)


Histórico: A questão global que instiga a emergência de saúde pública é o surto do Novel Corona Virus (COVID-19). Os dentistas são altamente propensos à transmissão aérea durante o tratamento dentário devido aos aerossóis gerados por vários procedimentos odontológicos em pacientes com COVID-19. Levando esse fato em consideração, a presente pesquisa teve como objetivo principal avaliar o conhecimento, a atitude e a prática dos dentistas na prevenção da transmissão da doença pelo novo coronavírus (COVID-19). Material e métodos: O presente estudo é uma pesquisa prospectiva, na qual o questionário online de pesquisa foi distribuído entre 300 dentistas, que foram recrutados aleatoriamente para o estudo, nos estados de Andhra Pradesh e Telangana, na Índia. Os participantes foram recrutados com base na experiência clínica que variava de menos de cinco anos até mais de dez anos, que trabalhavam nos setores privado e público. Quinze perguntas fechadas foram formuladas e validadas. O questionário consistiu nos detalhes demográficos dos participantes e três seções com distribuição igualitária, as quais continham perguntas que avaliavam o conhecimento, a atitude e a prática dos dentistas na prevenção da transmissão da doença pelo novo coronavírus (COVID-19). Resultados: Os resultados revelaram que os dentistas têm um conhecimento e conscientização adequados sobre a transmissão do COVID-19 e a maioria considerou que os dentistas têm um papel importante na prevenção da transmissão da doença. A maioria dos participantes levantou a importância de que programas de conscientização devem ser conduzidos sobre várias medidas para impedir a transmissão do COVID-19 entre a comunidade odontológica e com o público. Conclusões: A partir da pesquisa realizada pode-se concluir que os dentistas possuem conhecimento e conscientização adequados sobre a doença de COVID-19. A maioria deles está contribuindo da melhor maneira possível na situação atual para impedir a transmissão do COVID-19. (AU)


Subject(s)
Infection Control , Coronavirus Infections , Dentists
14.
Article in English | WPRIM (Western Pacific) | ID: wprim-785399

ABSTRACT

BACKGROUND: As the spread of carbapenemase-producing Enterobacteriaceae poses a critical threat to public health, rapid detection of carbapenemase genes is urgently required for prompt initiation of appropriate antimicrobial therapy and infection control. We evaluated the performance of Xpert Carba-R v.2 (Cepheid, USA) compared with that of culture-based conventional PCR.METHODS: Using the results of 5,479 consecutive clinical rectal swabs, discrepant analysis (enriched culture followed by PCR) was performed for all discordant samples (N=100), which were Carba-R v.2-positive and culture-negative.RESULTS: Among the samples, 206 carbapenemase genes (3.6%) were detected by Carba-R v.2. The sensitivity and specificity were 95.0% and 98.1%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) were 49.0% and 99.9%, respectively. Following discrepant analysis, the PPV increased to 73.5% and the low PPV (8.1%) of the 86 non-KPC improved to 48.8%. Among the 105 discrepancies, NDM was the most frequently observed (N=56), followed by KPC (N=26), VIM (N=10), IMP (N=8), OXA-48 (N=5). The threshold cycle values between discordant vs. concordant and resolved groups were significantly different (P<0.001).CONCLUSIONS: Carba-R v.2 is a rapid and sensitive method for detecting carbapenemase-encoding genes compared with culture-based conventional PCR. Most of our discrepant results were non-KPC genes. Thus, the clinical significance of the non-KPC positive cases detected by Carba-R v.2 should be investigated. This assay would be useful for deciding whether to isolate pre-exposed patients in hospital settings, based on the high specificity and NPV.


Subject(s)
Enterobacteriaceae , Humans , Infection Control , Korea , Methods , Polymerase Chain Reaction , Public Health , Sensitivity and Specificity
15.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-816605

ABSTRACT

BACKGROUND: Rapid and accurate detection of Mycobacterium tuberculosis (MTB) is of primary importance for infection control and selection of anti-tuberculosis drugs. However, most clinical laboratories report MTB complex (MTC) without reporting MTB because MTC comprising MTB, Mycobacterium bovis, Mycobacterium africanum, Mycobacterium microti, Mycobacterium caprae and Mycobacterium pinnipedii have 99.9% similarity at the nucleotide level and identical 16S rRNA sequences. This study was conducted to analyze the species frequency of MTC isolates obtained from clinical specimen.METHODS: Of 310 MTC isolates obtained from clinical samples in a tertiary care hospital from February 2017 to August 2018, MolecuTech Real TB-Taq (YD Diagnostics, Korea) real-time PCR was performed, specifically to detect MTB. For DNA showing MTB negative results by MTB-specific real-time PCR or pyrazinamide-resistant strains, PCR-based MTC typing, spoligotyping, and exact tandem repeat D gene sequencing were performed.RESULTS: All the 310 MTC isolates were identified to be MTB. Two MTB strains of East-African-Indian 4-Vietnam genotype, which have not been reported in Korea, were also found.CONCLUSION: There was no zoonotic tuberculosis in this study. Since we investigated only 310 MTC isolates detected in only one medical institution, multi-center study is needed to accurately know the prevalence of zoonotic tuberculosis in Korea.


Subject(s)
DNA , Genotype , Goats , Infection Control , Korea , Mycobacterium bovis , Mycobacterium tuberculosis , Mycobacterium , Prevalence , Real-Time Polymerase Chain Reaction , Sequence Analysis , Tandem Repeat Sequences , Tertiary Healthcare , Tuberculosis
16.
Article in English | WPRIM (Western Pacific) | ID: wprim-816604

ABSTRACT

BACKGROUND: The weather has well-documented effects on infectious disease and reports suggest that summer peaks in the incidences of gram-negative bacterial infections among hospitalized patients. We evaluated how season and temperature changes affect bloodstream infection (BSI) incidences of major pathogens to understand BSI trends with an emphasis on acquisition sites.METHODS: Incidence rates of BSIs by Staphylococcus aureus, Enterococcus spp., Escherichia coli, Klebsiella pneumoniae, Acinetobacter spp., and Pseudomonas aeruginosa were retrospectively analyzed from blood cultures during 2008–2016 at a university hospital in Seoul, Korea according to the acquisition sites. Warm months (June–September) had an average temperature of ≥20℃ and cold months (December–February) had an average temperature of ≤5℃.RESULTS: We analyzed 18,047 cases, where 43% were with community-onset BSI. E. coli (N = 5,365) was the most common pathogen, followed by Enterococcus spp. (N = 3,980), S. aureus (N = 3,075), K. pneumoniae (N = 3,043), Acinetobacter spp. (N = 1,657), and P. aeruginosa (N = 927). The incidence of hospital-acquired BSI by Enterococcus spp. was weakly correlated with temperature, and the median incidence was higher during cold months. The incidence of community-onset BSI by E. coli was higher in warm months and was weakly correlated with temperature.CONCLUSION: We found seasonal or temperature-associated variation in some species-associated BSIs. This could be a useful information for enhancing infection control and public health policies by taking season or climate into consideration.


Subject(s)
Acinetobacter , Climate , Climate Change , Communicable Diseases , Enterococcus , Escherichia coli , Gram-Negative Bacterial Infections , Humans , Incidence , Infection Control , Klebsiella pneumoniae , Korea , Pneumonia , Pseudomonas aeruginosa , Public Health , Retrospective Studies , Seasons , Seoul , Staphylococcus aureus , Tertiary Care Centers , Weather
17.
Rev. Esc. Enferm. USP ; 53: e03508, Jan.-Dez. 2019. tab, graf
Article in English, Portuguese | LILACS (Americas), BDENF | ID: biblio-1020384

ABSTRACT

RESUMO Objetivo Avaliar a estrutura e a adesão às medidas de precauções-padrão e específicas dos profissionais de saúde em Unidade de Terapia Intensiva de hospital de ensino, no Distrito Federal. Método Estudo descritivo, transversal e prospectivo. Utilizou-se de questionário estruturado mediante observações que registraram as práticas dos profissionais com Equipamentos de Proteção Individual e indicações de precauções. Foi aplicado o teste Qui-quadrado, e calculado o p-valor . Resultados Participaram do estudo 52 profissionais, e foram observados 445 procedimentos assistenciais em 36 sessões de auditoria. A média da taxa de adesão ao uso de equipamentos foi de 72,72%, sendo 94,91% às luvas, 91,43% ao avental, 80% à máscara e 24,56% aos óculos de proteção. Quando não havia indicação e não foi utilizado o Equipamento de Proteção Individual, a média da taxa foi de 68,01%, sendo 30,77% em relação às luvas, 87,58% ao avental, 57,58% à máscara, e 96,13% aos óculos. As precauções de contato foram indicadas desnecessariamente em 35% dos pacientes. Conclusão Verificou-se boa adesão ao uso de luvas, avental e máscara, baixa adesão ao uso de óculos de proteção e uso desnecessário de máscaras e precauções de contato admissionais.


RESUMEN Objetivo Evaluar la estructura y la adhesión a las medidas de precauciones estándar y específicas de los profesionales sanitarios en Unidad de Cuidados Intensivos de hospital de enseñanza, en el Distrito Federal. Método Estudio descriptivo, transversal y prospectivo. Se utilizó un cuestionario estructurado mediante observaciones que registraron las prácticas de los profesionales con Equipos de Protección Individual e indicaciones de precauciones. Se aplicó la prueba de Chi cuadrado y se calculó el p-valor. Resultados Participaron en el estudio 52 profesionales y se observaron 445 procedimientos asistenciales en 36 sesiones de auditoría. El promedio de la tasa de adhesión al uso de equipos fue del 72,72%, siendo el 94,91% a los guantes, el 91,43% al delantal, el 80% a la mascarilla y el 24,56% a los anteojos de protección. Cuando no había indicación y no fue utilizado el Equipo de Protección Individual, el promedio de la tasa fue del 68,01%, siendo el 30,77% con relación a los guantes, el 87,58% al delantal, el 57,58% a la mascarilla y el 96,13% a los anteojos. Las precauciones de contacto fueron indicadas innecesariamente al 35% de los pacientes. Conclusión Se verificó buena adhesión al uso de guantes, delantal y mascarilla, baja adhesión al uso de anteojos de protección y uso innecesario de mascarillas y precauciones de contacto de ingreso.


ABSTRACT Objective To evaluate the structure and adherence to the standardized and specific precautionary measures of health professionals in the Intensive Care Unit of a teaching hospital in the Federal District of Brazil. Method A descriptive, cross-sectional and prospective study. A structured questionnaire was used via observations which recorded the practices of professionals with Individual Protection Equipment and indications of precautions. The chi-square test was applied, and the p-value was calculated. Results A total of 52 professionals participated in the study, and 445 care procedures were observed in 36 audit sessions. The average adhesion rate for equipment use was 72.72%, with 94.91% for gloves, 91.43% for aprons, 80% for masks and 24.56% for safety glasses. When there was no indication and no personal protective equipment was used, the average rate was 68.01%, with 30.77% for gloves, 87.58% for aprons, 57.58% for masks, and 96.13% for safety glasses. Contact precautions were unnecessarily indicated for 35% of patients. Conclusion Good adherence to using gloves, aprons and masks were observed, but there was poor adherence to using safety glasses and unnecessary use of masks and admission contact precautions.


Subject(s)
Humans , Professional Practice , Universal Precautions , Infection Control , Health Personnel , Intensive Care Units , Cross-Sectional Studies , Prospective Studies , Patient Safety , Hospitals, Teaching
18.
Nursing (Säo Paulo) ; 22(258): 3363-3370, nov.2019.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1053418

ABSTRACT

Objetivo: analisar através da literatura as estratégias da educação permanente que contribuem para a mudança de condutas de prevenção e controle de infecção em assistência à saúde pela equipe multidisciplinar. Método: Revisão integrativa com busca nas bases de dados LILACS, MEDLINE e BDENF. Elaborou-se um instrumento de coleta de dados que sinaliza as características para análise dos estudos. Resultados: Incluíram-se 12 artigos e foram agrupados por similaridade didática de acordo com as estratégias implementadas quanto à prevenção e controle em assistência à saúde. Conclusão: Ficou evidente que a utilização de diversas estratégias da educação permanente, na assistência à saúde, traz melhorias à medida que estimulam os profissionais no aperfeiçoamento, qualificação e na atualização de conceitos e ações práticas, contribuindo também para o desenvolvimento da reflexão crítica, trazendo mudança comportamental, favorecendo desta forma o crescimento pessoal e profissional e a interação da equipe multidisciplinar, propiciando assim a melhora na qualidade da assistência.(AU)


Objective: analyze through the literature the strategies of the permanent education that contribute in the change of conduits of prevention and control of infection in health care by the multidisciplinary team. Method: Integrative revision with search in LILACS, MEDLINE and BDENF databases. Elaborated an instrument of data collection that signals the characteristics for analysis of the studies. Results: Were included 12 articles and grouped by didactic similarity according to the strategies implemented regarding prevention and control in health care. Conclusion: It was evident that the use of several strategies of permanent education in health care, brings improvements as they stimulate professionals in the improvement, qualification and updating of concepts and practical actions, also contributing to the development of critical reflection, bringing change behavioral, thus favoring personal and professional growth and the interaction of the multidisciplinary team, thus improving the quality of care.(AU)


Objetivo: analizar a través de la literatura las estrategias de la educación permanente que contribuyen en el cambio de conductas de prevención y control de infección en asistencia a la salud por el equipo multidisciplinario. Método: Revisión integrativa con búsqueda en las bases de datos LILACS, MEDLINE y BDENF. Elaboró un instrumento de recolección de datos que señaliza las características para el análisis de los estudios. Resultados: Se incluyeron 12 artículos y fueron agrupados por similitud didáctica de acuerdo con las estrategias implementadas en cuanto a la prevención y control en asistencia a la salud. Conclusión: Es evidente que la utilización de diversas estrategias de la educación permanente en la asistencia a la salud, trae mejoras a medida que estimulan a los profesionales en el perfeccionamiento, calificación y actualización de conceptos y acciones prácticas, contribuyendo también al desarrollo de la reflexión crítica, trayendo cambio comportamental, favoreciendo de esta forma el crecimiento personal y profesional y la interacción del equipo multidisciplinario propiciando así la mejora en la calidad de la asistencia.(AU)


Subject(s)
Humans , Cross Infection/prevention & control , Infection Control , Delivery of Health Care , Education, Continuing , Health Personnel
19.
Rev. pediatr. electrón ; 16(2): 3-7, ago. 2019.
Article in Spanish | LILACS (Americas) | ID: biblio-1021327

ABSTRACT

Los pacientes inmunocomprometidos presentan un riesgo aumentado de colonización e infecciones por microorganismos multirresistentes (MOR), entre ellos Enterococcus spp resistentes a vancomicina (ERV) y bacterias productoras de betalactamasas de espectro extendido (BLEE), las cuales son causa importante de morbimortalidad. OBJETIVO: Describir la prevalencia de MOR en Servicio de Oncología del Hospital Roberto del Río. MÉTODO: Se realizó un estudio descriptivo retrospectivo de los niños hospitalizados en el servicio de oncología desde enero a diciembre del 2016 a los cuales se les realizó vigilancia de portación de ERV y BLEE. RESULTADOS: De los 97 pacientes hospitalizados, se identificó un 8% de portación de ERV, un 13,7% de BLEE y un 6,8% presentó portación de ambos microorganismos. DISCUSIÓN: Entre enero 2012 a diciembre del 2013 se observó en nuestro centro que un 52% de los pacientes hospitalizados en oncología estaban colonizados por ERV, la disminución significativa de la portación podría deberse a la mejor adherencia de normas de prevención de infecciones asociadas a la atención en salud (IAAS), programa de uso racional de antimicrobianos y a la nueva infraestructura del servicio.


The inmunosupressed patients are at increased risk of colonization and infection with vancomycin resistant Enterococci (VRE) and extended- spectrum b-lactamase producing Enterobacteriaceae (ESBL), which can cause substantial morbidity and mortality. OBJECTIVE: Describe the prevalence of VRE and ESBL in the Oncology Unit of Roberto del Río Hospital. METHODS: Descriptive and retrospective study of hospitalized children since January to December 2016 in the Oncology Unit, that underwent VRE and ESBL colonization surveillance. RESULTS: From the 97 hospitalized patients, there were 8% of VRE colonization, 13.7% of ESBL and 6.8% of colonization from both microorganism. DISCUSSION: Between January 2012 and December 2013, we observed that 52% of hospitalized patients in the Oncology Unit were colonized by VRE. The significant decrease in colonization may be due to better fulfillment of healthcare-associated infections (HAI) normative, antibiotics stewardship and new infraestructure of our unit.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , beta-Lactamases/metabolism , Cross Infection/epidemiology , Gram-Positive Bacterial Infections/epidemiology , Vancomycin-Resistant Enterococci/enzymology , Cross Infection/microbiology , Cross Infection/prevention & control , Prevalence , Retrospective Studies , Oncology Service, Hospital , Infection Control , Gram-Positive Bacterial Infections/microbiology , Gram-Positive Bacterial Infections/prevention & control , Hospitals, Pediatric
20.
Acta méd. costarric ; 61(1): 6-12, ene.-mar. 2019. tab
Article in Spanish | LILACS (Americas) | ID: biblio-983713

ABSTRACT

Resumen Justificación: la inmunoprofilaxis del personal sanitario conlleva múltiples propósitos que engloban tanto la protección de los pacientes como de los funcionarios mismos, y redunda en un claro beneficio para el empleador. En particular, la protección de pacientes inmunocomprometidos y con bajo potencial de desarrollar respuestas vacunales efectivas es de suma importancia. Programas de inmunización sistemática del personal de salud pueden reducir el riesgo de enfermedad, minimizar el impacto de accidentes laborales con materiales infecciosos y mantener la fuerza de trabajo indemne en los centros médicos durante los brotes estacionales de algunas infecciones. Objetivos: concatenar los esquemas de vacunación recomendados actualmente para los funcionarios que laboran en centros de salud y ofrecer una guía adaptada a la realidad epidemiológica nacional. Métodos: se efectuó una revisión no sistemática de bibliografía médica publicada en Internet entre 1990 y 2018, concerniente a vacunación de empleados sanitarios. De igual manera, se compararon los respectivos esquemas de inmunización vigentes en América y Europa. Conclusiones: la trasmisión de enfermedades infecciosas en los centros sanitarios es un problema de salud pública frecuentemente no reconocido, pero sustancial, que pone en riesgo tanto a los usuarios como al personal de estas instituciones. La inmunización de los trabajadores sanitarios es una estrategia fundamental para prevenir y contener la diseminación de agentes infecciosos a nivel hospitalario. Esta medida puede crear "inmunidad de rebaño" para proteger a pacientes y funcionarios que no se hayan vacunado o no puedan generar inmunidad suficiente contra determinados patógenos. Además, la vacunación de los empleados de salud constituye un punto de referencia para motivar las inmunizaciones en los demás segmentos de la población.


Abstract Background: Immune prophylaxis in health care personnel induces multiple positive effects that include protection for patients, as well as for employees and results with a clear benefit for the employers. Especially in immunological compromised patient groups and individuals who present a diminished potential to develop immunity to vaccination, contagion prevention is of highest importance. Systematic immunization programs can help to lower disease risks, minimize impact of occupational accidents related to handling of contagious materials and maintain the intactness of workforce in medical centers during periods of seasonal infection outbreaks. Objectives: this article resumes the present recommended schemes for vaccination of health care personnel and concludes them in a guideline adapted to the country´s epidemiologic reality. Methods: a non-systematic revision of medical literature related to immunization of health care personnel, published online between 1990 and 2018, was realized. In the same manner, a comparison of active vaccination schemes existing in Europe and the United States of America has been executed. Conclusion: the transmission of infectious diseases in health care installations represents a frequently ignored problem which substantially elevates the infection risk of patients as well as of health care personnel. The vaccination of health care personnel represents the easiest to imply and most effective strategy to inhibit this kind of transmission of infectious diseases. As well, this measure can create a "herd immunity" protecting patients and health care personnel who are not vaccinated or in conditions where they can not develop sufficient immunity against infectious agents. Furthermore, the immunization of the health care workers represents a reference and an example of motivation to other parts of the population.


Subject(s)
Humans , Vaccines/administration & dosage , Cross Infection/prevention & control , Immunization , Infection Control , Health Personnel , Accident Prevention , Immunization Schedule
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