RESUMO
Three clusters of Chryseobacterium meningosepticum infections in a tertiary health center in July 2006 and January 2007 involving 8 newborns and 5 older children were investigated. The index patient was from the neonatal intensive care unit, and the older patients were from other pediatric wards. Cultures were obtained from the environment and from health care workers' hands as part of an outbreak investigation. C meningosepticum was isolated from hand cultures obtained from a senior resident and from environmental cultures obtained from powdered infant formula, an electrical button, a computer keyboard, phone, a doorknob, and an Ambu bag. Antibiogram typing and enterobacterial repetitive intergenic consensus sequence polymerase chain reaction indicated that all of the isolates were epidemiologically related. Nine patients improved on antimicrobial treatment, and 4 premature infants died after the infection. C meningosepticum is a well-known etiologic agent for nosocomial infections involving newborns and immunocompromised patients. Wet and dry environmental surfaces and equipment may act as a source or play a role in disseminating the microorganism. Outbreaks may be controlled with strong emphasis on infection control measures.
Assuntos
Chryseobacterium/classificação , Chryseobacterium/isolamento & purificação , Infecção Hospitalar/epidemiologia , Surtos de Doenças , Infecções por Flavobacteriaceae/epidemiologia , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Análise por Conglomerados , Infecção Hospitalar/tratamento farmacológico , Impressões Digitais de DNA , DNA Bacteriano/genética , Microbiologia Ambiental , Feminino , Infecções por Flavobacteriaceae/tratamento farmacológico , Genótipo , Mãos/microbiologia , Pessoal de Saúde , Unidades Hospitalares , Humanos , Lactente , Recém-Nascido , Masculino , Testes de Sensibilidade Microbiana , Técnica de Amplificação ao Acaso de DNA Polimórfico , Turquia/epidemiologiaRESUMO
OBJECTIVES: The aim of the study is to assess the effect of ring wearing and ring types on hand contamination and efficacy of alcohol-based hand disinfection among nurses working in intensive care settings. METHODS: Hand cultures were obtained from 84 nurses providing direct patient care in intensive care units of a pediatric hospital. Colony counts were compared depending on ring wearing and the type of ring worn. Twenty-eight nurses were asked to a wear plain wedding ring, 28 to wear rings with stones and 28 not to wear any rings, starting 15 days before and continuing throughout the study. Cultures were obtained by using sterile gloves containing phosphate-buffered-saline solution (PBS) after an alcohol-based hand disinfectant was used and bacteria were identified with standard laboratory tests. RESULTS: The nurses wearing rings had more Gram-positive, Gram-negative and total bacterial colonization on their hands than the nurses without rings despite using an alcohol-based rub (p=0.001). When comparing the two groups with rings (plain wedding rings and rings with stones), colony counts of Gram-positive, Gram-negative and total bacteria did not differ (p>0.05). CONCLUSIONS: Ring wearing increases the bacterial colonization of hands and alcohol-based hand disinfection might not significantly reduce contamination of the ring-wearing hands. The type of ring did not cause any significant difference on the bacterial load. Wearing rings could increase the frequency of transmission of potential nosocomial pathogens.