RESUMO
We described a health care-associated Serratia marcescens outbreak of wound and soft tissue infection lasting approximately 11 months at Ankara University Ibni Sina Hospital. After identification of S marcescens strains from the clinical and environmental samples, and their susceptibility testing to antimicrobial agents, pulsed-field gel electrophoresis (PFGE) was performed to detect molecular epidemiologic relationships among these isolates. The strains which were isolated from the saline bottles used for wound cleansing in the wound care unit were found to be 100% interrelated by PFGE to the strains from the samples of the outbreak patients. Reuse of the emptied bottles has no longer been allowed since the outbreak occurred. Besides, more efficient and frequent infection control training for hospital staff has been conducted.
Assuntos
Infecção Hospitalar/epidemiologia , Surtos de Doenças , Infecções por Serratia/epidemiologia , Serratia marcescens/isolamento & purificação , Infecções dos Tecidos Moles/epidemiologia , Infecção dos Ferimentos/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Infecção Hospitalar/microbiologia , Contaminação de Medicamentos , Eletroforese em Gel de Campo Pulsado , Feminino , Genótipo , Hospitais Universitários , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Tipagem Molecular , Infecções por Serratia/microbiologia , Serratia marcescens/classificação , Serratia marcescens/genética , Cloreto de Sódio , Infecções dos Tecidos Moles/microbiologia , Turquia/epidemiologia , Infecção dos Ferimentos/microbiologiaRESUMO
BACKGROUND: The risk of occupational acquisition of bloodborne pathogens via exposure to blood and body fluids is a serious problem for health care workers in Turkey. Because there are no systematic recording programs in Turkey, national data concerning frequency of exposures are not readily available. OBJECTIVE: To determine the risk factors of exposure to blood and body fluids among health care workers (HCWs). METHODS: This study was conducted in the hospitals of Ankara University School of Medicine. A structured survey form was administered by person-to-person interview. RESULTS: The study included 988 HCWs: 500 nurses (51%), 212 residents (21%), 152 nurse assistants (15%), and others (13%). Six hundred thirty-four (64%) of the HCWs had been exposed to blood and body fluids at least once in their professional life (0.85 exposure per person-year). The most frequent cause of the sharps injuries was recapping the needle (45%). Of the injured HCWs, 60 (28%) were not using any personal protective equipment, and 144 (67%) did not seek any medical advice for injury. CONCLUSIONS: Systematic control measures, including an effective and goal-oriented education program targeting HCWs, prospective record keeping, and instillation of a special unit for the health of HCWs should be implemented in the hospital setting.
