Infecção hospitalar em pacientes cirúrgicos de Hospital Universitário

Medeiros, Aldo da Cunha; Neto, Tertuliano Aires; Filho, Antônio Medeiros Dantas; Pinto, Francisco Edilson Leite; Uchôa, Raquel Araújo Costa; Carvalho, Mariana Rêgo de

doi:10.1590/s0102-86502003000700003

Cited by 21 publications

(24 citation statements)

References 5 publications

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“…In another study, an incidence of 115 (3.70%) SSIs was observed when analyzing 3,120 participants in the period from 1999 to 2002. [23][24][25][26][27][28][29] The risk factors related to the development of a SSI in the postoperative period in the hospital setting which stood out in this study were cholecystectomy surgeries, acute cholecystitis diseases and cholelithiasis, and the period of hospitalization until discharge, which are corroborated in the research scientific studies. 8,21,[25][26] However, cholecystectomy and the diagnosis of acute cholecystitis were not significant or differential elements that could certify that the patients who presented these factors suffered more SSIs in the hospital setting than those who did not undergo this surgical intervention, nor were they diagnosed with the disease, 33 these results did not compromise the achievement of the objectives proposed by this research statistically.…”

Section: Discussionsupporting

confidence: 61%

Fatores De Risco Para Infecção Do Sítio Cirúrgico Em Cirurgias Potencialmente Contaminadas

Martins¹,

Amante

Virtuoso

et al. 2018

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RESUMO Objetivo: associar os fatores de risco do período pós-operatório de cirurgias potencialmente contaminadas, com a ocorrência da infecção do sítio cirúrgico no período pós-operatório hospitalar e domiciliar. Método: período de coleta de dados foi de fevereiro a junho de 2015, com 84 pacientes acompanhados nos três primeiros dias de pós-operatório e sete dias após a alta hospitalar, através de questionários elaborados para avaliação do sítio cirúrgico, das condições clínicas do paciente e da análise de prontuário. Para verificação dos fatores de risco influenciáveis e classificação das infecções do sítio cirúrgico, utilizou-se um questionário com variáveis que foram analisadas de forma descritiva através da frequência simples, porcentagem e medidas de posição e dispersão. Para a associação e nível de significância dos fatores de risco foram realizados testes estatísticos. Resultados: nenhum dos pacientes entrevistados desenvolveu infecção profunda do sítio cirúrgico ou de órgão/espaço, sendo que sete desenvolveram infecção do sítio cirúrgico superficial no pós-operatório hospitalar e 41 em domicílio. Os fatores de risco analisados não foram significativos para o desenvolvimento das infecções. Conclusões: recomenda-se que as instituições implantem um serviço de vigilância e acompanhamento pós-alta, a fim de que se melhore a confiabilidade das taxas de incidência das infecções do sítio cirúrgico; melhorar a qualidade dos cuidados com os pacientes; compreensão epidemiológica e identificação dos fatores de risco. Além disso, propõe-se facilitar o processo de referência e contra referência através de capacitações da Estratégia de Saúde da Família para identificação destes fatores de risco, atuando em rede.

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Section: Discussionsupporting

confidence: 61%

Fatores De Risco Para Infecção Do Sítio Cirúrgico Em Cirurgias Potencialmente Contaminadas

Martins¹,

Amante

Virtuoso

et al. 2018

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“…by Medeiros et al 16 . However, the infection rate found by the present study (22.1%) was similar to that reported (23.6%) by Villas Boas & Ruiz 17 .…”

Section: Discussionmentioning

confidence: 90%

Decreased calorie and protein intake is a risk factor for infection and prolonged length of stay in surgical patients: A prospective cohort study

Assis¹,

Silveira

Beghetto

et al. 2016

Rev. Nutr.

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Objective The aim was to assess whether postoperative calorie and protein intakes increase the risk of infection and prolonged length of stay in a tertiary care university hospital in Southern Brazil. Methods This is a prospective cohort study approved by the hospital's Research Ethics Committee. The sample consisted of adult patients undergoing elective surgery. The exclusion criteria included patients who could not undergo nutritional assessment and those with a planned hospital stay of fewer than 72 hours. Nutritional status was assessed on admission and every seven days thereafter until hospital discharge or death. Demographic and clinical data, as well as information regarding independent and outcome variables, were collected from the patient's records. Food intake assessment was conducted by researchers six times a week. Calorie and protein intakes were considered adequate if equal to or greater than 75% of the prescribed amount, and length of stay was considered prolonged when above the average for specialty and type of surgery. Data was analyzed using Poisson regression. Results Of the 519 study patients, 16.2% had adequate nutritional therapy. Most of these patients were men with ischemic heart disease and acquired immunodeficiency syndrome. After adjusting for confounders, inadequate nutritional therapy increased risk of infection by 121.0% (RR=2.21; 95%CI=1.01-4.86) and risk of prolonged length of stay by 89.0% (RR=1.89; 95%CI=1.01-3.53). Conclusion Most patients did not have adequate nutritional therapy. Those with inadequate nutritional therapy had a higher risk of infection and longer length of stay.

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“…From 593,344 surgical operations performed in the United States from 1986 to 1996, 15,525 (3%) were followed by infection. From 551 infected patients who died 77% of the deaths were due to severe infection that had led to multiple organ failure (MOF) 12 . Since MOF was recognized it has been one of the most frequent causes of mortality in surgical patients, especially in those cared for in Intensive Care Unit (ICU) 13 .…”

Section: Discussionmentioning

confidence: 99%

Bacterial translocation in rats nonfunctioning diverted distal colon

Júnior

Brandt²,

Medeiros

et al. 2007

Acta Cir. Bras.

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Purpose:To investigate whether the alterations of the diverted colon segment mucosa, evidenced in fecal colitis, would be able to alter Bacterial Translocation (BT). Methods: Sixty-two Wistar male rats ranging from 220 to 320 grams of weight, were divided in two groups: A (Colostomy) and B (Control), with 31 animals each one. In group A, all animals underwent end colostomy, one stoma, in ascending colon; and in the 70 th POD was injected in five rats, by rectal routediverted segment -2ml of a 0.9% saline solution in animals (A1 subgroup); in eight it was inoculated, by rectal route, 2ml of a solution containing Escherichia coli ATCC 25922 (American Type Culture Collection), in a concentration of 10 8 Colony Forming Unit for milliliters (CFU/ml) -A2 Subgroup; in ten animals the same solution of E. coli was inoculated, in a concentration of 10 11 CFU/ml (A3 Subgroup); and in eight it was collected part of the mucus found in the diverted distal colonic segment for neutral sugars and total proteins dosage (A4 subgroup). The animals from the group B underwent the same procedures of group A, but with differences in the colostomy confection. In rats from subgroups A1, A2, A3, B1, B2, and B3 2ml of blood were aspirated from the heart, and fragments from mesenteric lymphatic nodule, liver, spleen, lung and kidney taken for microbiological analysis, after their death. This analysis consisted of evidencing the presence of E. coli ATCC 25922 CFU. Mann-Whitney and ANOVA Tests were applied as analytic techniques for association of variables. Results: The occurrence of BT was evidenced only in those animals in which inoculated concentration of E. coli ATCC 25922, reached levels of 10 11 CFU/ml, i.e. in Subgroups A3 and B3, although, being significantly greater (80%) in those animals without colostomy (subgroup B3) when compared to the ones with colostomy (20%) from the subgroup A3 (P <0.05). Lung, liver and mesenteric lymphatic nodules were the tissues with larger percentile of bacterial recovery, so much in subgroup A3, as in B3. Blood culture was considered positive in 60% of the animals from subgroup B3 and in 10% of those from subgroup A3 (p <0.05). There was greater concentration of neutral sugars, in subgroup A4 -mean 27.3mg/ml -, than in subgroup B4 -mean 8.4mg/ml -(P <0.05). Conclusion: The modifications in the architecture of intestinal mucosa in colitis following fecal diversion can cause alterations in the intestinal barrier, but it does not necessarily lead to an increased frequency of BT. Key words: Bacterial Translocation. Colitis. Rats, Wistar. RESUMO Objetivo: Investigar se as alterações do cólon desfuncionalizado, evidenciadas na colite de derivação fecal, seriam capazes de permitir Translocação Bacteriana (TB), ou se a mucosa intestinal atrofiada permitiria a passagem de bactérias para órgãos à distância. Métodos: Foram utilizados 62 ratos Wistar, machos, pesando entre 220 e 320 gramas, divididos em dois grupos: A (Colostomia) e B (Controle), contendo cada um 31 animais. No grupo A, os animais foram ...

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Infecção hospitalar em pacientes cirúrgicos de Hospital Universitário

Cited by 21 publications

References 5 publications

Fatores De Risco Para Infecção Do Sítio Cirúrgico Em Cirurgias Potencialmente Contaminadas

Fatores De Risco Para Infecção Do Sítio Cirúrgico Em Cirurgias Potencialmente Contaminadas

Decreased calorie and protein intake is a risk factor for infection and prolonged length of stay in surgical patients: A prospective cohort study

Bacterial translocation in rats nonfunctioning diverted distal colon

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