As cortinas que separam os leitos dos pacientes em muitos hospitais servem para proteger sua privacidade, mas podem ameaçar sua saúde: geralmente carregam bactérias resistentes que podem contaminar os doentes, de acordo com um estudo divulgado nesta sexta-feira (12).
The patients may have been exposed to blood-borne illnesses due to “lapses in infection control in sterilization,” according to the surgery center.
Artigo do JAMA sobre um assunto recorrente. Há ou não benefícios em descontaminação do trato gastrointestinal em pacientes submetidos à ventilação mecânica?
Original Article from The New England Journal of Medicine — A Candida auris Outbreak and Its Control in an Intensive Care Setting
Candida auris é o mais novo “enfant terrible” dos germes multirresistentes.
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Número sobe para 10% em países de renda média e baixa. Documento do Banco Mundial, OMS e OCDE traz panorama da assistência à saúde em todo o mundo: ‘práticas inadequadas ocorrem em países ricos e pobres’.
Background: Carbapenem-resistant Klebsiella pneumoniae infections are increasingly prevalent in North American hospitals. We describe an outbreak of carbapenem-resistant K. pneumoniae containing the blaOXA-232 gene transmitted by contaminated duodenoscopes during endoscopic retrograde cholangiopancreatography (ERCP) procedures. Methods: An outbreak investigation was performed when 9 patients with blaOXA-232 carbapenem-resistant K. pneumoniae infections were identified at a tertiary care hospital. The investigation included 2 case-control studies, review of duodenoscope reprocessing procedures, and culture of devices. Carbapenem-resistant Enterobacteriacieae (CRE) isolates were evaluated with polymerase chain reaction analysis for carbapenemase genes, and isolates with the blaOXA-232 gene were subjected to whole-genome sequencing and chromosome single-nucleotide polymorphism analysis. On recognition of ERCP as a key risk factor for infection, targeted patient notification and CRE screening cultures were performed. Results: Molecular testing ultimately identified 17 patients with blaOxa-232 carbapenem-resistant K. pneumoniae isolates, including 9 with infections, 7 asymptomatic carriers who had undergone ERCP, and 1 additional patient who had been hospitalized in India and was probably the initial carrier. Two case-control studies established a point-source outbreak associated with 2 specific duodenoscopes. A field investigation of the use, reprocessing, and storage of deuodenoscopes did not identify deviations from US Food and Drug Administration or manufacturer recommendations for reprocessing. Conclusions: This outbreak demonstrated the previously underappreciated potential for duodenoscopes to transmit disease, even after undergoing high-level disinfection according to manufacturers’ guidelines.
A Randomized Trial to Determine Whether Wearing Short-Sleeved White Coats Reduces the Risk for Pathogen Transmission – Volume 39 Issue 2 – Amrita R. John, Heba Alhmidi, Melany I. Gonzalez-Orta, Jennifer L. Cadnum, Curtis J. Donskey