RESUMO
OBJECTIVE: The study aimed to investigate an outbreak caused by Enterobacter cloacae in a neonate intensive care unit. DESIGN: A descriptive study of an outbreak of sepsis in high-risk neonates was used. SETTING: The study was set in a tertiary care university teaching hospital. PATIENTS: The patients were 11 neonates infected with Enterobacter cloacae whose symptoms and signs of sepsis developed during a 16-hour period. All but one neonate received parenteral nutrition. Isolates from blood cultures, in-use parenteral nutrition solutions, and control aliquots of parenteral nutrition solution were typed by pulsed-field gel electrophoresis. RESULTS: Enterobacter cloacae was found in the refrigerated aliquots of parenteral nutrition solution, in blood cultures from infected newborns, and from in-use parenteral nutrition solutions. All these strains of Enterobacter cloacae had the same antibiotic susceptibility pattern and the same genomic DNA profile. The strain isolated from the one patient who did not receive parenteral nutrition presented a different susceptibility profile and genotype. CONCLUSION: The source of the nosocomial sepsis was the parenteral nutrition solution in 10 neonates. This contamination apparently occurred during preparation of the parenteral solution.
Assuntos
Enterobacter cloacae/isolamento & purificação , Infecções por Enterobacteriaceae/etiologia , Nutrição Parenteral Total/efeitos adversos , Choque Séptico/etiologia , Surtos de Doenças , Eletroforese em Gel de Campo Pulsado , Enterobacter cloacae/genética , Infecções por Enterobacteriaceae/epidemiologia , Infecções por Enterobacteriaceae/microbiologia , Feminino , Genoma Bacteriano , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino , Testes de Sensibilidade Microbiana , Fatores de Risco , Choque Séptico/microbiologiaRESUMO
During 1993 and 1994, a recycling program on Standard Precautions was conducted for the nursing personnel at the Women's Health Centre (CAISM). In 1995, an evaluation was obtained through direct observation of these sectors regarding the adoption of these measures, the adequate use, access and availability of gloves and boxes for the disposal of perforating, sharp material. Sixty observations and 232 procedures were reported. One hundred sixty four procedures (71%) adopted these measures and 68 procedures (29%) did not. It was evident that the need to wash hands and not to use needles twice should be emphasized.