Prevalência de portadores de Neisseria meningitidis em profissionais de Saúde recém-admitidos em um hospital escola.
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Data
2008
Autores
Pacheco, Luciana Maria de Medeiros [UNIFESP]
Orientadores
Pereira, Luiz Alberto Amador [UNIFESP]
Tipo
Dissertação de mestrado
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Introdução: Os profissionais de saúde estão expostos a vários riscos no desenvolvimento de suas atividades, no ambiente hospitalar, especialmente os biológicos. As doenças infectocontagiosas são as principais fontes de transmissão de microrganismos de pacientes para profissionais, através de diferentes vias. A doença meningocócica, cuja transmissão é respiratória, causa pânico na população, inclusive entre estes profissionais, devido ao seu caráter epidêmico e letalidade elevada. Objetivos: Determinar a prevalência de portadores de Neisseria meningitidis em profissionais de saúde recém-admitidos em um hospital escola e verificar a colonização da nasofaringe destes profissionais expostos ao microrganismo 12 meses após a admissão, bem como a aplicação das medidas de prevenção e uso de quimioprofilaxia preconizadas. Métodos: Estudo de painel de medidas repetidas, onde os indivíduos selecionados foram avaliados, através de coleta de cultura de nasofaringe, antes da exposição e, num segundo momento, doze meses após a exposição já definida anteriormente. Participaram da pesquisa 117 profissionais de saúde aprovados em concurso púbico e lotados no hospital entre janeiro de 2004 e dezembro de 2005. A análise descritiva das variáveis qualitativas foi apresentada em valores absolutos e relativos e as quantitativas através das medidas de tendência central e de distribuição do conjunto de medidas registradas. Foi utilizado o teste de McNemar para comparar a distribuição de duas variáveis correlacionadas. Resultados: Os 117 profissionais de saúde avaliados apresentaram uma média de idade de 34 anos e 86% eram da categoria de enfermagem. Apenas 3% eram portadores de Neisseria meningitidis no exame admissional. Distribuídos nos setores do hospital, 76% foram selecionados para enfermarias, pronto atendimento e unidade semi-intensiva. Cerca de 66% dos profissionais trabalharam anteriormente em serviços de saúde e 46,1% exerciam, concomitantemente à admissão no hospital, a mesma atividade em outras unidades. Apenas 19% referiram contato recente com pacientes com doença meningocócica e 90% foram orientados a usar máscara ao prestarem assistência a pacientes com esta doença. No intervalo estudado, somente 4% destes profissionais utilizaram rifampicina como quimioprofilaxia, sendo que 68% tiveram contato com pacientes internados com doença meningocócica neste período. Apesar da orientação sobre o uso de máscara, 32% não a utilizaram. Não houve registro de nenhum resultado positivo para Neisseria meningitidis, na cultura realizada nestes profissionais, após um ano de exposição ao microrganismo, no ambiente hospitalar. Conclusões: Não houve colonização dos profissionais de saúde pela Neisseria meningitidis, o que nos permite corroborar as medidas de precaução, padronizadas universalmente, para prevenção da doença meningocócica no ambiente hospitalar
Introduction: Healthcare professionals are frequently exposed to a variety of hazards and risks whilst carrying out their activities in hospital environments, especially with regards to biological risks. The contagious diseases are the main source of transmission of infectious agents from patients to professionals through a wide and different variety of ways. The meningococcal disease, which is transmitted from respiratory secretions, causes panic in the population including these very professionals due to epidemic and lethal character. Objectives: To determine the prevalence of carriage of Neisseria meningitidis amongst the healthcare professionals whom have been recently admitted in a hospital and to verify the colonization in the nasopharynx of these very professionals exposed to the agent 12 months after their admission as well as the use of preventive measures. Methods: A panel study of repeated measurements where the selected individuals had been evaluated through the collection of cultures from the nasopharynx before exposure and, in a second instance, 12 months after the exposure previously defined. Between January 2004 and December 2005, 117 healthcare professionals, whom were successfully approved in a public admission exam and were duly assigned to a hospital, have participated in the study. The descriptive analysis of the qualitative variables was presented in absolute and relative values and the qualitative variables were presented through the measures of central tendency and distribution tendency from the set of registered measures. The McNemar Test was used in order to compare the distribution of the two correlated variables. Results: The evaluated 117 healthcare professionals presented an average age of 34 years of age and 86% were from the Nursing Category. Only 3% were carriers of N. meningitidis at the admission exam. When distributed throughout the hospital sections, 76% were selected for wards, emergency wards and semi intensive units. Approximately 66% of the professionals had previous experience in the health settings and 46.1% performed, concomitantly to the admission in the hospital, the same activity in other units. Only 19% mentioned recent contact with patients suffering from meningococcal disease and 90% were duly orientated to use a mask whenever assisting patients suffering from this disease. During the studied interval, only 4% of these professionals used rifampicin as chemoprophylaxis although 68% had actually had contact with interned patients with meningococcal disease within the said period. Independently from the orientation regarding the use of masks, 32% of them did not use it. There were no registrations of a positive result for Neisseria meningitidis in the culture carried out on these professionals after one year of exposure to the agent within the hospital environment. Conclusion: There was no colonization in the healthcare professionals by N. meningitidis thus we may corroborate the universally standardized preventive measures for the meningococcal disease in a hospital environment.
Introduction: Healthcare professionals are frequently exposed to a variety of hazards and risks whilst carrying out their activities in hospital environments, especially with regards to biological risks. The contagious diseases are the main source of transmission of infectious agents from patients to professionals through a wide and different variety of ways. The meningococcal disease, which is transmitted from respiratory secretions, causes panic in the population including these very professionals due to epidemic and lethal character. Objectives: To determine the prevalence of carriage of Neisseria meningitidis amongst the healthcare professionals whom have been recently admitted in a hospital and to verify the colonization in the nasopharynx of these very professionals exposed to the agent 12 months after their admission as well as the use of preventive measures. Methods: A panel study of repeated measurements where the selected individuals had been evaluated through the collection of cultures from the nasopharynx before exposure and, in a second instance, 12 months after the exposure previously defined. Between January 2004 and December 2005, 117 healthcare professionals, whom were successfully approved in a public admission exam and were duly assigned to a hospital, have participated in the study. The descriptive analysis of the qualitative variables was presented in absolute and relative values and the qualitative variables were presented through the measures of central tendency and distribution tendency from the set of registered measures. The McNemar Test was used in order to compare the distribution of the two correlated variables. Results: The evaluated 117 healthcare professionals presented an average age of 34 years of age and 86% were from the Nursing Category. Only 3% were carriers of N. meningitidis at the admission exam. When distributed throughout the hospital sections, 76% were selected for wards, emergency wards and semi intensive units. Approximately 66% of the professionals had previous experience in the health settings and 46.1% performed, concomitantly to the admission in the hospital, the same activity in other units. Only 19% mentioned recent contact with patients suffering from meningococcal disease and 90% were duly orientated to use a mask whenever assisting patients suffering from this disease. During the studied interval, only 4% of these professionals used rifampicin as chemoprophylaxis although 68% had actually had contact with interned patients with meningococcal disease within the said period. Independently from the orientation regarding the use of masks, 32% of them did not use it. There were no registrations of a positive result for Neisseria meningitidis in the culture carried out on these professionals after one year of exposure to the agent within the hospital environment. Conclusion: There was no colonization in the healthcare professionals by N. meningitidis thus we may corroborate the universally standardized preventive measures for the meningococcal disease in a hospital environment.
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Citação
PACHECO, Luciana Maria de Medeiros. Prevalência de portadores de Neisseria meningitidis em profissionais de Saúde recém-admitidos em um hospital escola. 2008. 77 p. Dissertação (Mestrado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2008.