Importance of hand germ contamination in health-care workers as possible carriers of nosocomial infections

The importance of hands in the transmission of nosocomial infection has been world wide admitted. However, it is difficult to induce this behavior in health-care workers. The aim of the present work was to point out the importance of hand bacteria colonization, the influence of hand washing and of patient physical examination. One hundred health-care workers were randomly divided in two groups: Group A without hand washing previous to patient physical examination or handling (PPE); group B with hand washing previous to PPE. Direct fingerprint samples in Columbia agar before and after PPE were obtained. The colonies were counted and identified by conventional techniques, and antibiograms according to NCCLS were performed. Before PPE group A participants showed a high number of bacteria regarding group B participants (73.9 Vs 20.7; p < 0.001); 44 out of 50 participants were carriers of potentially pathogen bacteria. No group B participants were carriers of potential pathogen bacteria before PPE. The latter group showed an increase in number of bacteria after PPE (20.7 CFU (before) Vs 115.9 CFU (after); p < 0.001). Sixteen group B participants were contaminated after PPE with potential pathogens such as S. aureus (50% of them meticillin resistant); Escherichia coli, Pseudomonas aeruginosa and Enterococcus faecalis, half of them multiresistant. We can conclude on the importance of these results to implement educational programs and to provide the health-care workers with the proper commodities to fulfill this practice.

Clean your hands: hand hygiene in the community - guidance

This�leaflet is part of an extension of the cleanyourhands campaign, aimed at preventing the spread of healthcare associated infections (HCAIs) in community healthcare settings including primary care and dental services, residential and nursing homes (including independent sector homes), hospices and independent clinics/hospitals. It describes the campaign and outlines the campaign resources.

The significance of hand wash compliance on the transfer of dermal lipids in contact lens wear

Aim: The aim of this study was to assess the impact of hand washing regimes on lipid transference to contact lenses. The presence of lipids on contact lenses can affect visual acuity and enhance spoilation. Additionally, they may even mediate and foster microbial transfer and serve as a marker of potential dermal contamination. Methods and materials: A social hand wash and the Royal College of Nursing (RCN) hand wash were investigated. A 'no-wash regime' was used as control. The transfer of lipids from the hand was assessed by Thin Layer Chromatography (TLC). Lipid transference to the contact lenses was studied through fluorescence spectroscopy (FS). Results: Iodine staining, for presence of lipids, on TLC plates indicated the 'no-wash regime' score averaged at 3.4 ± 0.8, the social wash averaged at 2.2 ± 0.9 and the RCN averaged at 1.2 ± 0.3 on a scale of 1-4. The FS of lipids on contact lenses for 'no washing' presented an average of 28.47 ± 10.54 fluorescence units (FU), the social wash presented an average of 13.52 ± 11.12. FU and the RCN wash presented a much lower average 6.47 ± 4.26. FU. Conclusions: This work demonstrates how the method used for washing the hands can affect the concentration of lipids, and the transfer of these lipids onto contact lenses. A regime of hand washing for contact lens users should be standardised to help reduce potentially transferable species present on the hands. © 2011 British Contact Lens Association.

Infection control practices among a cohort of Brazilian dentists

Objective: To evaluate infection control practices among dentists in private and public practice. Design: Survey and cross-sectional analysis. Setting: Sertaozinho city, Brazil. Participants: All dentists who were currently working at the study city, and agreed to participate, resulting in a study population of 135 dentists. Methods: Participants were personally interviewed and variables were submitted to X(2) or Fisher`s exact test. Results: Hand washing before and after each patient was reported by 86.7% of dentists, but private practitioners used liquid soap and paper towels more often than their public colleagues (p<0.001). Most of the study population (97.8%) used gloves routinely during clinical sessions, but 8.2% reused them. Dry-heat was the main method employed for sterilisation of heat-stable devices by 80.0% of dentists, but adequate temperature and time of exposure was accomplished by only 32.1% of public and 70.0% of private professionals (p<0.001). Heat-sensitive devices were disinfected with an adequate substance by 60.0% of both affiliation dentists (p=0.908). Conclusions: There is a large gap between infection control recommendations and practices observed among the study population, and the situation is worse in public services. To reverse that situation, infection control issues must be openly debated by professional associations, dental schools and health authorities.

Prevalence and risk factors for intestinal protozoa infection in elderly residents at Long Term Residency Institutions in Southeastern Brazil

This study determined the prevalence of intestinal protozoa in Long Term Residency Institutions for the Elderly (ILPI) in elders, nurses and food handlers, identifying the risk factors associated with the infections. Stool samples taken from the elderly (n = 293), nurses (63) and food handlers (19) were studied. Questionnaires were used with questions related to sociodemographic variables, health, behavior and health characteristics. Stool samples were examined using the techniques of Faust and Ziehl Neelsen, and the prevalence of G. duodenalis, Cryptosporidium spp., E. histolytica/dispar in the elderly was 4.0%, 1.0% and 0.3% respectively. Nurses and food handlers showed 4.8% and 5.2% positivity only for G. duodenalis, respectively. The origin of the individuals and contact with domestic animals has been associated with infection by G. duodenalis in the elderly, and contact with domestic animals was considered a risk factor for infection. The last stool examinations were related to Cryptosporidium spp.. None of the variables were associated with E. histolytica/dispar. The frequency of hand washing was significantly associated with G. duodenalis among nurses. The frequency of positive samples of G. duodenalis, Cryptosporidium spp., E. histolytica/dispar showed that ILPIs environments are conducive to this occurring due to contact between the elderly, nurses and food handlers, which are often poorly trained in hygiene procedures and food handling.

Evaluation of inflammatory response induced by different types of daily contact lenses

Dissertação de mestrado em Genética Molecular

El lavado de manos: ¿una recomendación atendida?

Objective: to determine the incidence of hand washing in parents as a preventive factor in the spread of viral respiratory infections in children under two years assigned to an urban pediatric basic health area affected by catarrhal symptoms during the influenza vaccination campaign. Material and methods: from 230 children under two years included in the basic health area attending the Well Child program, 51 consulted during the influenza vaccination campaign (October 2011) by catarrhal symptoms. Results: fifty-one children were included, 23 male and 28 female. From the clinical point of view, 33 cases were afebrile and only 18 had fever, runny nose 100%. The clinic diagnosis in 44 cases was nasopharyngitis, acute bronchitis in 5 cases and obstructive bronchiolitis in 2 cases. No family history in 19, however 32 cases had a family member with catarrhal symptoms. As for the performance of hand washing as a preventive measure, 34 cases said they did not comply with this measure, only 17 cases did, despite the recommendations. Conclusions: while recognizing the importance of hand washing as a preventive measure for respiratory infections and being included among the recommendations offered in the well child program, only 33% of the population of our study reported washing hands. This recommendation should also be included in consultations on demand during the influenza season to encourage compliance.

Foodborne norovirus outbreak: the role of an asymptomatic food handler

Background: In July 2005 an outbreak of acute gastroenteritis occurred on a residential summer camp in the province of Barcelona (northeast of Spain). Forty-four people were affected among residents and employees. All of them had in common a meal at lunch time on 13 July (paella, round of beef and fruit). The aim of this study was to investigate a foodborne norovirus outbreak that occurred in the residential summer camp and in which the implication of a food handler was demonstrated by laboratory tests. Methods: A retrospective cohort study was designed. Personal or telephone interview was carried out to collect demographic, clinical and microbiological data of the exposed people, as well as food consumption in the suspected lunch. Food handlers of the mentioned summer camp were interviewed. Ten stool samples were requested from symptomatic exposed residents and the three food handlers that prepared the suspected food. Stools were tested for bacteries and noroviruses. Norovirus was detected using RT-PCR and sequence analysis. Attack rate, relative risks (RR) and its 95% confidence intervals (CI) were calculated to assess the association between food consumption and disease. Results: The global attack rate of the outbreak was 55%. The main symptoms were abdominal pain (90%), nausea (85%), vomiting (70%) and diarrhoea (42.5%). The disease remitted in 24-48 hours. Norovirus was detected in seven faecal samples, one of them was from an asymptomatic food handler who had not eaten the suspected food (round of beef), but cooked and served the lunch. Analysis of the two suspected foods isolated no pathogenic bacteria and detected no viruses. Molecular analysis showed that the viral strain was the same in ill patients and in the asymptomatic food handler (genotype GII.2 Melksham-like). Conclusions: In outbreaks of foodborne disease, the search for viruses in affected patients and all food handlers, even in those that are asymptomatic, is essential. Health education of food handlers with respect to hand washing should be promoted.

Infecção do trato urinário associada à sondagem vesical numa unidade de terapia intensiva

A descriptive, quantitative approach and non-participant observation study, which was aimed at analyzing the association between knowledge and practice of inclusion and maintenance of urinary catheter by nursing professionals in the occurrence of urinary tract infection, performed in the ICU of Onofre Lopes University Hospital in Natal / RN. The original sample was composed of 42 nursing staff professional, five (5) nurses and 37 nursing technicians, 27 of them were outsourced (FUNPEC and IEL fellows) and 10 servers UFRN. Data collection was performed using two instruments, the first observation procedures used in the insertion and manipulation of indwelling urinary catheter (IUC) and the second with a questionnaire that addressed the characterization data of respondents, knowledge and conduct the insertion and manipulation of the IUC. The results were tabulated in Microsoft Excel and analyzed using SPSS software, version 15.0. We found the prevalence of institutional staff members on outsourcing - IEL and FUNPEC - (64.3%) were female (69.0%), aged 21 to 35 years (59.5%) and with mid-level education (88.1%). As to knowledge, we found that the nurses had levels of good to excellent and the nursing technicians, to regulate the poor. The nurses made a mistake when choosing IUC (40.0%) and washing hands (30.0%) and technicians on hand washing (74.4%) and the contents of the tray (34.7%). In relation to the conduct of insertion of IUC, the nurses made a mistake when choosing SVD (66.7%) and washing hands (57.1%). Regarding the handling of IUC/drainage system, the technicians were wrong more about washing their hands (56.0%). Analyzing the misconduct to the categorization of knowledge, we saw that the nursing staff who had missed more had inadequate knowledge (ρ = 0.001). At the end we found the risk of a patient to acquire UTI is higher in two and a half times when there is a large number of mismatches, patient spends more time using the IUC and hospitalized in the ICU. As regards the study hypotheses, we accept the alternative hypothesis and reject the null hypothesis proposed at the start of this research, where the number of gaps in knowledge and behavior increases the incidence of urinary tract infection.

Validação de instrumentos para avaliação do conhecimento e da habilidade acerca da higienização simples das mãos

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Avaliação de desinfetantes de superfície utilizados em Odontologia

Desinfecção de superfície é um procedimento realizado nas áreas externas do equipamento odontológico e demais itens do consultório. O objetivo deste trabalho foi analisar a ação de quatro desinfetantes utilizados em Odontologia: álcool etílico a 77°GL, composto fenólico (Duplofen), iodóforo (PVP-I) e solução de álcool etílico a 77°GL com 5% de clorexidina para desinfecção de superfície. Foram analisados quatro pontos em cada equipamento (carter, pia de lavagem de mãos, encosto de cabeça da cadeira e superfície frontal externa do refletor), utilizando-se a técnica de spray-wipe-spray. de cada ponto, foram coletadas amostras utilizando-se placas de superfície contendo ágar Mitis Salivarius bacitracina sacarose, ágar Sabouraud Dextrose com cloranfenicol, ágar MacConkey e ágar-sangue para contagem de estreptococos do grupo mutans, leveduras do gênero Candida, bactérias gram-negativas e contagem total de microrganismos, respectivamente (ufc/placa). Os resultados foram analisados estatisticamente utilizando-se teste t de Student para comparação entre as médias de ufc/placa. O desinfetante que demonstrou ser mais efetivo na redução microbiana foi a solução alcoólica de clorexidina, principalmente para bactérias gram-positivas. O iodo e o composto fenólico mostraram ser bastante eficazes na redução microbiana. O álcool etílico a 77°GL foi o menos eficaz dos quatro desinfetantes analisados, mas apesar de não ser indicado como desinfetante de superfície, mostrou, no presente trabalho, redução microbiana estatisticamente significativa após o processo de desinfecção.

Research on staphylococcus spp in biofilm formations in water pipes and sinsibility to antibiotics

Water from dental equipment presents risks for surgeon-dentists as well as for patients because it might work as a means of dissemination/ transmission of microoganisms. The objective of this study was to verify the quality of the water used in dental equipment by means of microbiological analysis, accomplishing the count of Staphylococcus spp.There have been collected, 160 samples of water from reserviors, taps used for hand washing, air-water syringes, and high-speed handpieces, in 40 dental offices in the city of Barretos, São Paulo. The rules concerning bacteriotogicaI analysis in cfu/mL from Standard Methods for the Examination of Water and Wastewater have been followed. The analysis of the results has made it possible to verify that out of the total of samples, 28% did not meet the standards of potability established by the American Dental Association: Regarding the origin of analyzed S. aureus., the most contaminated sites were high-speed handpicces in private offices (761%) and in, ental care plan offices (71%), followed by air-water syringe in dental care plan offices (64%). For S. epidermitis samples, the most contaminated sites were high-speed handpieces in SUS (Brazilian Government Health System) dental offices (22%) and in dental care plan offices (14%) The most contaminated sites were dental offices that saw Patients under dental care plans, Concerning tested antibiotics, the ones that presented better results as to sensibility to strain S. epidermidis were vancomycin and ciprofloxacin (100%) and, as to sensibility to strain S. aureus, it was ciprofloxacin (97%).

Developed and studies on technical and economical viability of an environmental efficient urinal

This work introduces an innovative urinal for public convenience, that promotes at the same time water reuse and personal higiene, in a safe and economical way . Furthermore it demonstrates the latest technology and its technical and economical viabillity of utilization in new and already existing buildings facilities. This new model of personal higiene equipment offers as main benefits the improved economy with subsequent decrease in drinkable water consumption, sanitary safety, low cost and easy installation due to its simplicity and to the fact that it can be installed in already existing facilities. The proposal is constituted by a higienic, ecological and smart system for flushing of public urinals. It is a conjugated system of lavatory and urinal that reuses hands higienization water from the lavatory for flushing purpose. The proposed urinal can be operated manually or automatically by means of a presential sensor. The system promotes drinkable water economy by a rational utilization by avoiding the use of waste water from hand washing in place of clean water for flushing. The proposed equipment increases the economy of clean water in a simple and economical way and it can be installed in any type of public lavatory facilitie such as schools, public buildings, hospitals, commercial buildings, bus terminals, airports, stadiums, parking buildings and shopping centers. Additional benefits of the proposed system is the suggestion of hands washing before and after the use of the urinal without contamination risks from focet handling.and render more attractive the installation for a rational use of clean water in commercial and industrial buildings. Pay-back has shown to be very attractive for a number of internal return rates and also very attractive from the point of view of environmental protection.

Avaliação da utilização da técnica de lavagem das mãos pelo profissional de enfermagem em Unidade de Terapia Intensiva Neonatal

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Análise genômicae suscetibilidade de Pseudomonas aeruginosa isoladas de rede de água de consultórios odontológicos da cidade de Barretos-SP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)