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Hospital como reservatório e transmissor de microrganismos
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O papel do Hospital como reservatório e transmissor de microrganismos é complexo e, muitas vezes, subestimado.
O ambiente hospitalar e as pessoas que com este contactam funcionam como reservatórios e fontes, como transmissores, especialmente durante a prestação de cuidados de saúde e como recetores de microrganismos, tornando-se então um novo reservatório. As superfícies inanimadas, os equipamentos médicos, o ar e a água propiciam a transmissão de microrganismos, particularmente de microrganismos multi-resistentes aos antimicrobianos (MMR), que devido à sua capacidade adaptativa sobrevivem durante longos períodos de tempo no ambiente hospitalar, perpetuando a cadeia de infeção. Atualmente, os doentes recebem cuidados de saúde numa variedade de configurações, incluindo Unidades de Cuidados Continuados (UCC), lares/residenciais de idosos e em diferentes hospitais que podem, da mesma forma, funcionar como reservatórios ou fontes externas de microrganismos. A cadeia de infeção hospitalar funciona assim como um processo cíclico, em que cada ponto pode ser interpretado como o início da cadeia tendo como consequências a transmissão cruzada de microrganismos, com consequente colonização e/ou infeção de novos doentes e do meio hospitalar em particular.
Existem, contudo, oportunidades de ação que ao interferirem com um dos elos do ciclo suspendem a cadeia de infeção. Isto pode ser alcançado com a adoção de medidas de controlo e prevenção de infeções, uma vez que grande percentagem de Infeções Associadas aos Cuidados de Saúde (IACS) é evitável. A prevenção deve figurar assim, como um fator chave na prestação de cuidados de saúde garantindo a segurança, não só do doente, mas também do profissional de saúde (PS).
The role of the Hospital as reservoir and as transmitter of pathogens is complex and often underestimated. The Hospital environment and the people who contact with it can act as: a reservoir and source; a transmitter, particularly during treatment; a receptor for microorganisms, thus becoming a new reservoir. The health environment may induce transmission of several important health care-associated pathogens, including multidrug-resistant (MDR) bacteria. Some characteristics of individual species or strains could determine the degree of infection risk for patients, particularly when the MDR survive long term in the hospital environment. Nowadays, patients receive healthcare treatments in a variety of settings, including long-term care facilities (LTCFs), nursing homes, and in different hospitals, which can also function as reservoirs or external sources of microorganisms. The chain of hospital infection should be understood as a cyclic process, and each stage may be considered as the starting point. Possible outcomes of this process are cross-transmission of microorganisms that lead to colonization or infection of new patients and healthcare area further contamination. However there are opportunities to intervene focused on breaking the chain of infection by eliminating or interfering with at least one its links. Through effective infection prevention and control measures this can be achieved, since a large percentage of Health Care Associated Infections (HCAI) is preventable. Therefore, prevention should be seen as a fundamental key factor when delivering healthcare services, guaranteeing the safety of the patient and the healthcare workers.
The role of the Hospital as reservoir and as transmitter of pathogens is complex and often underestimated. The Hospital environment and the people who contact with it can act as: a reservoir and source; a transmitter, particularly during treatment; a receptor for microorganisms, thus becoming a new reservoir. The health environment may induce transmission of several important health care-associated pathogens, including multidrug-resistant (MDR) bacteria. Some characteristics of individual species or strains could determine the degree of infection risk for patients, particularly when the MDR survive long term in the hospital environment. Nowadays, patients receive healthcare treatments in a variety of settings, including long-term care facilities (LTCFs), nursing homes, and in different hospitals, which can also function as reservoirs or external sources of microorganisms. The chain of hospital infection should be understood as a cyclic process, and each stage may be considered as the starting point. Possible outcomes of this process are cross-transmission of microorganisms that lead to colonization or infection of new patients and healthcare area further contamination. However there are opportunities to intervene focused on breaking the chain of infection by eliminating or interfering with at least one its links. Through effective infection prevention and control measures this can be achieved, since a large percentage of Health Care Associated Infections (HCAI) is preventable. Therefore, prevention should be seen as a fundamental key factor when delivering healthcare services, guaranteeing the safety of the patient and the healthcare workers.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, Universidade de Lisboa, Faculdade de Farmácia, 2017
Palavras-chave
Hospital Reservatório Transmissão cruzada MMR IACS Mestrado Integrado - 2017