The presence of bacteria in hospital environments is common and can lead to healthcare-related infections (HAI). These microorganisms are everywhere, including in our bodies. Therefore, strict protocols are adopted to prevent the spread of bacteria and infections by patients, professionals and visitors to hospitals.
“Especially now during the pandemic, with countless patients needing hospitalizations with invasive procedures, mechanical ventilation and the use of antibiotics, a scenario was formed that further favored the increase in the number of infections related to healthcare”, explains the Technical Reference District (RTD) of Infectology, Lívia Vanessa Ribeiro.
In addition, the doctor emphasizes that in intensive care environments this becomes even more critical due to the number of invasive devices used in patients, immunosuppression – decreased capacity of the immune system – caused by underlying diseases, the prolonged hospitalization itself and the nutritional status.
To prevent and with a view to reducing the occurrence of these cases, the RTD explains that there is a set of definitions standardized by the National Health Surveillance Agency (Anvisa) for the main infections related to health care.
“Furthermore, all hospitals have a Hospital Infection Control Center (NCIH), responsible for educational preventive actions and the development of protocols to assist the assistant teams in the adoption of safe and adequate standards and procedures to safeguard the health of patients, professionals and visitors, with the objective of preventing the hospital transmission of microorganisms and infections”, he reports.
Among the prevention actions are the correct hand hygiene of health professionals, the use of Personal Protective Equipment (PPE), the control of the use of antimicrobials, inspection of cleaning and disinfection of articles and surfaces.
Within the scope of the Health Department, the Risk Management in Health Services is the area responsible for receiving data and carrying out surveillance actions with the NCIHs of each hospital. To this end, the management maintains a constant partnership with the infection control professionals of the DF hospitals, through meetings, personalized guidance, technical support in the investigation of infection outbreaks and encouraging the implementation of projects to improve adherence to hygiene in hands.
In addition to preventing the main topographies of infection, which are associated with invasive devices: catheter-associated bloodstream infection, ventilator-associated pneumonia, and urinary catheter-associated infection.
Maternal and child Hospital
On July 8, a multidrug-resistant bacteria was detected in the Neonatal ICU of the Hospital Materno Infantil de Brasília Doutor Antônio Lisboa (Hmib). The Nosocomial Infection Committee was immediately called. Of the 25 babies hospitalized, six were detected with the bacterium Acinetobacter baumannii, resistant to most antibiotics. Therefore, all internal control measures were taken, coordinated by the Hospital Infection Commission.
The Hmib Hospital Infection Control Center, in addition to guiding the isolation of patients affected by the outbreak, has reinforced it with the ICU care teams – intensive care physicians, nurses and physiotherapists – and with other teams that provide support in these units – doctors from others specialties, radiology, nutrition and laboratory staff – greater rigor in hand hygiene and compliance with precautions established in the sector.
“This reinforcement is always accompanied by training and redefinition of assistance flows, guiding frequent hand hygiene, implant practice and good practices in the handling of invasive devices, especially catheters and probes”, says the RTD of Infectious Diseases.
After the initial identification of the bacteria, a regular surveillance system was set up and there was no record of new cases. The doctor explains that this surveillance is done by isolating the affected patients, preferably with the selection of exclusive teams to provide assistance to these patients and, even when they are discharged from the ICU, they must remain isolated until hospital discharge.
The Hmib, a reference in the care of high-risk babies and pregnant women, restricted the hospitalization of pregnant women whose profile characterizes the need for assistance in the Neonatal ICU. However, in cases where only the Hmib is a reference in the network, hospitalization was maintained normally, as in cases where newborns need surgical assistance immediately after birth.
*With information from the Health Department
EDITION: ROSUALDO RODRIGUES
Source: BRASILIA AGENCY*
Photo: Breno Esaki/Agência Saúde-DF