Potentially pathogenic bacteria isolated from neglected air and surfaces in hospitals

Hospital infections (HI) are a serious public health problem in many countries. Several studies have identified strains correlating to surgical site infections, many with multi-resistance. The goals of this study was to quantify, to identify and to verify the resistance profile of microorganisms collected at two hospitals settings, and to alert health professionals how environmental contamination can influence hospital infection rates. For air sampling in operating rooms, intensive care unit and materials sterilization center, the impaction method (Spin Air, IUL®) and passive sedimentation were used. For the isolation of bacteria on surfaces and uniforms contact plates (RODAC®) were used. Identification of the microorganisms was performed using Vitek® 2 Systems. The antibiograms were conducted according to the disk diffusion method recommended by CLSI. The surgical center of hospital B presented more than 500 CFU/m3 in aerial microbial load. In the aerial microbiota of the sampled areas of both hospitals, M. luteus, S. haemolyticus and S. hominis spp hominis were the prevalent microorganisms, with a percentage greater than 30%. On the surfaces and uniforms there was a prevalence of M. luteus (40%) and S. hominis spp hominis (20%) among others, and some of the resistant strains were isolated from environments with microbial load within the recommended limits.

Assessment of some medical malpractice cases during surgical procedures in Yemen

This research aims to study some cases of medical malpractice and provides guidance for medical persons to minimize or even avoid medical malpractice among Yemenis. This first study in Yemen was done on hundred cases of medical malpractice during surgery that were collected randomly through the last ten years [1996-2005] from many places in Yemen. All cases were aging from 3 to 70 years old. The gender of patient was 54 males and 46 females. This study showed highly significant increase of number of cases between ages 21- 30, 41- 50 and 51-60 in both sexes as compared to other groups of age, while ages 11-20 and 31-40 showed significant increase in number of malpractice cases versus age 61-70 years. No significant difference between females and males among the studied cases. There was very highly statistical significant increase of number of malpractices that done by one physician when compared to that done by two or three physicians. There was very highly significant increase in number of malpractice cases in public hospital versus other hospitals and in private hospitals versus academic hospitals. Positive cases of medical malpractice were very highly significantly decreased as compared to negative one in public and private hospitals and no significant difference between positive and negative cases in academic hospitals. There was very highly significant increase in number of malpractice cases among specialists as compare to university staff and consultant. There was no statistical significant difference between university staff and consultants. There was also very highly significant increase in number of negative cases among university staff and specialists, but significant increase of negative cases as compared to positive cases was seen among consultants. This study proved that the general surgery showed very highly significant increase in number of malpractice cases versus other groups. Urology showed significant increase in number of malpractice cases versus internal medicine and neurosurgery. It was demonstrated very highly significant increase in number of malpractice cases during intra-operative and post-operative stages versus other stages. Appendicectomy and cholecystectomy showed very highly significant increase in number of malpractice cases versus other types of operations. There was no statistical significant difference between the distribution of criminal and civil cases among the studied cases. A statistical significant difference was shown between the final outcome in number of deaths and complete recovery when compared with cases of permanent deformity

Responsabilidade legal do médico - civil penal e administrativa / Legal responsability of the professional of healht - civil, penal, and administrative

O artigo informa sobre as responsabilidades dos profissionais de saúde em razão de sua conduta profissional, sinalizando a interpretação dos tribunais judiciais brasileiros sobre o assunto. Nesse contexto, a matéria é dividida em três tópicos distintos: implicações do Direito Civil, implicações do Direito Penal e implicações administrativas. No âmbito do Direito Civil, a atividade médica pode gerar a propositura de ações indenizatórias, em razão de uma conduta culposa que tenha gerado danos ao paciente, dependendo a condenação da comprovação de existência do nexo de casualidade. Ao lado da responsabilidadde civil dos profissionais de saúde, a atuação médica pode ensejar a instauração de inquéritos policiais e processos penais para apuração de eventual crime. O objetivo, nesse campo, é o de impor ao profissional uma penalidade pelo desvalor da ação ou da omissão. A penalidade pode ser de restrição da liberdade de ir e vir(prisão),monetária(multa) ou de outra natureza, chamada de pena alternativa (como a de prestar gratuitamente serviços à coletividade). O terceiro tópico tratado deriva dos Códigos de Ética Profissional, que regulam as profissões liberais. Ao lado das responsabilidades civil e penal , o profissional da área da saúde pode, em razão de sua conduta (omissiva ou comissiva), sujeitar-se a processo ético. Nesse caso, as penalidades possíveis são: advertência confidêncial, em aviso reservado, censura confidencial, em aviso reservado, censura pública, em publicação oficial, suspensão do exercício profissional até 30 dias, ou cassação do exercício profissional. Todas as disciplinas legislativas citadas poderão incidir em razão de um único ato médico, sujeitando-se o profissional a três processos distintos, ação de indenização na esfera civil, visando ao ressarcimento dos danos ocasionados, processo criminal, para a averiguação da prática de determinado crime, e processo ético administrativo, para a apuração de eventual transgressão de norma ética profissional.