Are there clinical signs and symptoms of infection to indicate the presence of multidrug-resistant bacteria in venous ulcers?

The selection of topical and systemic therapies for the treatment of venous ulcers with signs of infection is challenging and should be accompanied by specific precautionary measures to protect against cross-contamination in the presence of multidrug-resistant microorganisms. However, there are still no clinical indicators for this situation, and confirmation of resistant strains occurs through culture and sensitivity, which can take up to 14 days. During this period, protective measures may no longer be taken, contributing to the spread of these pathogens. This study aimed to analyze the relationship between clinical signs and symptoms of infection in venous ulcers and the presence of antimicrobial-resistant Staphylococcus aureus and/or Pseudomonas spp. A cross-sectional study was developed including 69 patients with 98 venous ulcers. Clinical observation protocol was applied to detect infection indicators established by the European Wound Management Association and microbiological analysis of samples of the lesions. Fisher's exact test and χ2 were used for analyses (P < 0.05). Two indicators of infection predominated (f >70%): discoloration of the opaque type and/or dark brick red and increased exudate volume; 31 (31.6%) ulcer samples showed positive culture for the bacteria studied. There was no relationship between signs and symptoms of infection and the presence of multidrug-resistant microorganisms. Taking into account the percentage of lesions with resistant strains, for safe care, contact precautionary measures should be implemented in the treatment rooms, in addition to standard precautions.

[Potentially infectious residues at hemotherapy services and interfaces with infectious diseases]. / Resíduos potencialmente infectantes em serviços de hemoterapia e as interfaces com as doen,cas infecciosas.

The aim was to identify the processing of potentially infectious residues and of piercing and cutting residues at hemotherapy units and their possible relation with workers' health. No service presented a structured plan for managing health service residues or for the occupational safety program. We found an occupational accident rate of 32.82% and that 9.16% of the workers did not have a complete plan of vaccination against hepatitis B. In-service training in handling residues and in occupational health are not standardized. The rate of serum conversion for HBV and HCV after occupational exposure was 11.63%. We concluded that the processing of potentially infectious residues and of piercing and cutting residues at the examined hemotherapy units has exposed workers to the acquisition of infectious diseases.