Staphylococcus aureus e Staphylococcus aureus resistente à meticilina em trabalhadores de um hospital universitário: colonização e crenças em saúde

Abstract

Fortaleza CR, Melo EC, Fortaleza CMCB. Nasopharyngeal colonization with methicillin-resistant staphylococcus aureus and mortality among patients in an intensive care unit. Rev Latino-am Enfermagem 2009 setembro-outubro; 17(5):677-82. Nasopharyngeal colonization with Methicillin-resistant Staphylococcus aureus (MRSA) is common in critically ill patients, but its effect on patient prognosis is not fully elucidated. A retrospective cohort study was carried out enrolling 122 patients from an intensive care unit who were screened weekly for nasopharyngeal colonization with MRSA. The outcomes of interest were: general mortality and mortality by infection. Several exposure variables (severity of illness, procedures, intercurrences and MRSA nasopharyngeal colonization) were analyzed through univariate and multivariable models. Factors significantly associated with mortality in general or due to infection were: APACHE II and lung disease. The performance of surgery predicted favorable outcomes. MRSA colonization did not predict mortality in general (OR=1.02; 95%CI=0.35-3.00; p=0.97) or by infectious causes (OR=0.96; 95%CI=0.33-2.89; p=0.96). The results suggest that, in the absence of severity of illness factors, colonization with MRSA is not associated with unfavorable outcomes. DESCRIPTORS: Staphylococcus aureus; intensive care units; mortality COLONIZACIÓN NASAL POR EL STAPHYLOCOCCUS AUREUS RESISTENTE A LA METICILINA Y MORTALIDAD EN PACIENTES DE UNA UNIDAD DE TERAPIA INTENSIVA La colonización nasofaríngea por el Staphylococcus aureus resistente a la meticilina (Methicillin-resistant S.aureus-MRSA) es común en pacientes críticamente enfermos, pero su efecto sobre el pronóstico no está completamente esclarecido. Fue realizado un estudio de Cohorte retrospectivo con 122 pacientes de una Unidad de Terapia Intensiva que realiza semanalmente exámenes para constatar la colonización nasofaríngea por MRSA. Lo encontrado de interés fue: mortalidad general y mortalidad por causas infecciosas. Diversas variables de exposición (gravedad, procedimientos ocurrencias y colonización nasofaríngea por MRSA) fueran analizadas en modelos univariados y multivariados. Los factores asociados significativamente a la mortalidad en general o por causas infecciosas fueran: APACHE II y enfermedad pulmonar. La realización de cirugía predijo mejor el pronóstico. La colonización por MRSA no predijo la mortalidad en general (OR=1.02; IC95%=0.35-3.00; p=0.97) o por causas infecciosas (OR=0.96; IC95%=0.33-2.89; p=0.96). Los resultados sugieren que, en la ausencia de factores de gravedad, la colonización por MRSA no se asocia al peor pronóstico. A colonização de nasofaringe por Staphylococcus aureus, resistente à meticilina (Methicillin-resistant S.aureus-MRSA), é comum em pacientes criticamente doentes, mas seu significado prognóstico não é inteiramente conhecido. Realizou-se estudo de coorte retrospectivo com 122 pacientes de uma unidade de terapia intensiva que realizaram triagem semanal para colonização por MRSA. Os desfechos de interesse foram: mor...

Colonization of nursing professionals by Staphylococcus aureus

“…Therefore, the index obtained in this study (7.1%) was considered elevated, although low when compared to other similar studies 12.7% (9) and 12% (17) . A study conducted over twenty years ago in the same institution of the present study, among nursing professionals from various sectors, investigated the colonization in different anatomical sites (nasal cavity, oropharynx and hands) and found the prevalence of carriers of S. aureus in one or more of the anatomical sites studied to be 40.6% (18) .…”

“…Regarding the prevalence of MRSA, the highest was found in Curitiba (12.7%) (9) and the lowest was found in Santo André (4.1%) (15) . The results encountered in the present study, when compared to the others, proved to be of an intermediate value, i.e.…”

“…A recent study showed that, contrary to expectations, colonization is more persistent in the throat than in the anterior nares (8) . Although the studies chose the nasal vestibule as the site of choice for the investigation of MRSA carriers, there is evidence that the oral cavity is also a reservoir, which makes the dispersion of droplets produced by talking, coughing and sneezing relevant (9) . The transmission of MRSA from professionals to family members has been documented (10) and, in Brazil, research conducted at a university hospital showed that the incidence of nasal colonization among nursing professionals in critical care units was 38.23% (52/136) (11) .…”

“…Knowledge of the carrier status and decolonization reduce the risk of subsequent infections. Some authors (9,16) and liver transplantation units. In these locations, the decolonization of colonized professionals is considered relevant as well as performing surveillance cultures of the team.…”

Prevalência de Staphylococcus Aureus Meticilina Resistente em Profissionais de Enfermagem

“…Esta ocorrência pode ser explicada por Cruz (2008), na qual a longa jornada de trabalho pode favorecer erros e desatenção, assim como maior tempo de exposição ao ambiente insalubre.…”