Contaminação de celulares em unidades de terapia intensiva e a segurança do paciente / Cell phone contamination in intensive care units and patient safety

Objetivo: Mapear o perfil microbiológico de contaminação dos celulares em profissionais de saúde que trabalham em Unidades de Terapia Intensiva de adulto. Métodos: Trata-se de uma revisão de escopo realizada no segundo semestrede 2019. As buscas foram feitas nas bases de dados Lilacs e Medline (PubMed), Cochrane Library e Google acadêmico com os descritores Cell Phone; Intensive Care Units; Health Personnel; Patient Safetye suas palavras-chaves correspondentes. Resultados: Houve predominância de Staphylococcus coagulase negativa e S. aureus, incluindo cepas resistente à meticilina- MRSA (Methicillin- resistant Staphylococcus aureus) e bactécias Gram negativas. Conclusão: A contaminação dos telefones celulares com bactérias presentes na pele e fossas nasais evidenciou a baixa adesão às medidas de controle de infecções, como higienização das mãos e desinfecção de objetos. Identificou-se que tal contaminação está aliada à falta de protocolos padronizados, o que contribui para o aumento de infecções relacionadas à assistência a saúde e compromete a segurança dos pacientes e dos próprios profissionais de saúde no ambiente hospitalar. Tal fato torna o controle de infecções hospitalares um grande desafio, sendo necessária a padronização de normas para o uso dos telefones celulares neste cenário, como também a realização de atividades educativas com os profissionais de saúde. (AU)

Objective: To map the microbiological profile of cell contamination in health professionals who work in adult intensive care units. Methods: This is a scope review carried out in the second half of 2019. The searches were performed in the Lilacs and Medline (PubMed), Cochrane Library and Google academic databases with the keywords Cell Phone; Intensive Care Units; Health Personnel; Patient Safety and its corresponding keywords. Results: There was a predominance of coagulase-negative Staphylococcus and S. aureus, including methicillin-resistant strains- MRSA (Methicillin-resistant Staphylococcus aureus) and Gram-negative bacteria. Conclusion: The contamination of cell phones with bacteria present on the skin and nasal cavities showed the low adherence to infection control measures, such as hand hygiene and disinfection of objects. It was identified that such contamination is coupled with the lack of standardized protocols, which contributes to the increase in infections related to health care and compromises the safety of patients and health professionals themselves in the hospital environment. This fact makes the control of nosocomial infections a great challenge, requiring the standardization of rules for the use of cell phones in this scenario, as well as the carrying out of educational activities with health professionals. (AU)

Objetivo: Mapear el perfil microbiológico de la contaminación de los celulares en profesionales de la salud que trabajan en unidades de cuidados intensivos para adultos. Métodos: Esta es una revisión de alcance realizada en el segundo semestre de 2019. Se realizaron búsquedas en las bases de datos académicas Lilacs y Medline (PubMed), Cochrane Library y Google con los descriptores Cell Phone; Unidades de cuidados intensivos; Personal sanitario; Seguridad del paciente y sus palabras clave correspondientes. Resultados: Predominó Staphylococcus coagulasa negativo y S. aureus, incluidas las cepas resistentes a meticilina MRSA (Staphylococcus aureus resistente a meticilina) y bacterias Gram negativas. Conclusión: La contaminación de los teléfonos celulares con bacterias presentes en la piel y las fosas nasales mostró una baja adherencia a las medidas de control de infecciones, como la higiene de manos y la desinfección de objetos. Se identificó que dicha contaminación se combina con la falta de protocolos estandarizados, lo que contribuye al aumento de infecciones relacionadas con la atención médica y compromete la seguridad de los pacientes y los profesionales de la salud en el entorno hospitalario. Este hecho hace que el control de las infecciones nosocomiales sea un gran desafío, que requiere la estandarización de las normas para el uso de teléfonos celulares en este escenario, así como la realización de actividades educativas con profesionales de la salud. (AU)

Congenital toxoplasmosis: perception of knowledge and primary prevention measures among healthcare professionals and pregnant women treated in public healthcare facilities / Toxoplasmose congênita: percepção do conhecimento e medidas de prevenção primária entre profissionais de saúde e gestantes atendidas em unidades públicas de saúde

AIMS: To evaluate knowledge about toxoplasmosis among pregnant women and healthcare professionals and to evaluate the knowledge acquired by pregnant women after health education actions. METHODSethods: Five hundred pregnant women and 141 healthcare professionals from health units in Niterói, state of Rio de Janeiro, answered a questionnaire, received information about toxoplasmosis and had access to an interactive educational model and to folders between 2013 and 2016. After 3 months, 145 pregnant women answered the questionnaire once again. RESULTS: Of 500 pregnant women, 226 (45.2%) reported having heard about toxoplasmosis. Among these, 23.5% had obtained information from friends and 19.0% from their doctors. About their exposure to risk factors, 6.8% had had contact with cat feces; 14.0% had had contact with soil without gloves; 23.4% had ingested undercooked meat; and 24.0% had drunk unfiltered water from the public supply system. The questionnaires of 145 pregnant women before and after the educational activities were compared and showed that contact with soil without gloves dropped significantly from 11.0% to 4.8% (p = 0.022) while consumption of unfiltered water fell from 26.9% to 20.0% (p < 0.001). Washing foods (62.1%), washing hands (62.1%) and consumption of well-cooked meat (61.4%) were the most widely cited preventive measures. Many mistakes were reported among healthcare professionals, and one nursing technician and 13 community healthcare agents (9.9%) had not heard about toxoplasmosis. CONCLUSIONS: Lack of knowledge about toxoplasmosis by most of the interviewed pregnant women, in addition to the misconceptions observed among healthcare professionals, leads to the conclusion that little importance has been given so far to primary prevention of toxoplasmosis during the prenatal period. Also, health professionals' inadequate knowledge could be detrimental to secondary prevention, which consists of early detection and treatment of toxoplasmosis during pregnancy. In this study, educational intervention contributed to improving knowledge about the transmission and prevention of toxoplasmosis by pregnant women and, to a lesser extent, to reducing exposure to some risk factors.

OBJETIVOS: Avaliar o conhecimento da toxoplasmose entre gestantes e profissionais de saúde e avaliar o conhecimento adquirido pelas gestantes após ações de educação em saúde. MÉTODOS: Quinhentas gestantes e 141 profissionais de saúde provenientes de Unidades de Saúde de Niterói-RJ de 2013 a 2016, foram entrevistados por meio de um questionário, receberam informações sobre a toxoplasmose, tiveram acesso a um modelo educativo interativo e folders. Após três meses, 145 gestantes responderam novamente ao questionário. RESULTADOS: Das 500 gestantes, 226 (45,2%) relataram que já tinham ouvido falar sobre toxoplasmose. Destas, 23,5% tiveram informações por amigos e 19,0% pelo médico. Sobre exposição aos fatores de risco, 6,8% relataram contato com fezes de gatos; 14,0% tiveram contato com o solo sem luvas; 23,4% ingeriam carne mal passada; e 24,0% bebiam água de abastecimento público sem filtrar. Ao comparar os questionários de 145 gestantes antes e após atividades educativas, o contato com o solo sem uso de luvas teve redução significativa de 11,0% para 4,8% (p=0,022) e o consumo de água sem filtro reduziu de 26,9% para 20,0% (p=0,001). Foram mais citados como medidas preventivas a lavagem dos alimentos (62,1%), a lavagem das mãos (62,1%) e o consumo de carne bem cozida (61,4%). Dentre os profissionais de saúde, muitos erros foram relatados e um técnico de enfermagem e 13 agentes comunitários de saúde (9,9%) não conheciam a toxoplasmose. CONCLUSÕES: A falta de conhecimento sobre a toxoplasmose pela maioria das gestantes entrevistadas, além de concepções equivocadas por parte dos profissionais de saúde, levam à conclusão de que vem sendo dada pouca importância para a prevenção primária da toxoplasmose durante o período pré-natal. Adicionalmente, algumas falhas no conhecimento dos profissionais podem prejudicar até mesmo a prevenção secundária, que consiste na detecção e tratamento precoce da toxoplasmose na gestação. Neste estudo, a intervenção educacional contribuiu para aumentar o conhecimento sobre a transmissão e a prevenção da toxoplasmose entre as gestantes e, em menor extensão, para reduzir a exposição a alguns fatores de risco.

Factors associated to toxoplasmosis-related knowledge among pregnant women attending public health services in the municipality of Niterói, Rio de Janeiro, Brazil, 2013-2015. / Fatores associados ao conhecimento sobre a toxoplasmose entre gestantes atendidas na rede pública de saúde do município de Niterói, Rio de Janeiro, 2013-2015.

OBJECTIVE: to analyze the factors associated to toxoplasmosis-related knowledge among pregnant women attending public health services in the municipality of Niterói, Rio de Janeiro, Brazil. METHODS: this is a cross-sectional study conducted with pregnant women assisted in eight health care units; data was collected using a standardized questionnaire, from April 2013 to February 2015. RESULTS: among the 405 pregnant women interviewed, 173 (42.7%) knew about toxoplasmosis and, of those, 24.3% knew about it through friends; the proportion of pregnant women with toxoplasmosis-related knowledge increased with age (p<0.001), education level (p<0.001) and the number of pregnancies (p=0.031); the history of abortion was also associated with toxoplasmosis-related knowledge (p=0.019). CONCLUSION: the variables 'age', 'education level', 'number of pregnancies' and 'abortion history' were important factors for toxoplasmosis-related knowledge among pregnant women assisted in the public health care sector of Niterói.

Ocorrência de toxoplasmose congênita, avaliação do conhecimento sobre toxoplasmose e do acompanhamento sorológico das gestantes e implantação de medidas de prevenção primária nos programas de prénatal da rede pública de saúde do município de Niterói-RJ / Occurrence of congenital toxoplasmosis, evaluation of toxoplasmosis-related knowledge and serological monitoring of pregnant women and implementation of primary prevention measures in pre-natal programs of public health in the city of Niterói-RJ

INTRODUÇÃO: Toxoplasma gondii pode ocasionar infecção fetal por via transplacentária, sendo a toxoplasmose congênita um grave problema de saúde pública. É fundamental no pré-natal o diagnóstico laboratorial precoce, bem como a transmissão de informações sobre a doença. OBJETIVOS: Avaliar o conhecimento sobre a toxoplasmose entre as gestantes e os profissionais de saúde e contribuir para a implantação da prevenção primária da toxoplasmose congênita nos Programas de pré-natal do município de Niterói-RJ. Metodologia: Participaram da pesquisa 500 gestantes e 141 profissionais de saúde provenientes de 17 módulos do Programa Médico de Família e de duas Policlínicas de Niterói-RJ, de 2013 a 2016. Todos assinaram o TCLE e responderam um questionário. Após esta etapa foram realizadas ações de educação e saúde, utilizando palestras, materiais educativos e um modelo educativo interativo. Após três meses, 145 gestantes responderam os questionários novamente. RESULTADOS: Das 500 gestantes, 226 (45,2%) conheciam a toxoplasmose. Destas, 23,5% tiveram informações por amigos e 19,0% pelo médico. Do total de gestantes, 6,8% relataram contato com fezes de gatos, 14,0% contato com o solo sem luvas, 10,4% consumiam verduras, legumes e frutas cruas sem higiene adequada, 9,6% carne crua e 23,4% carne mal passada, 17,8% consumiam embutidos mal cozidos, 10,6% bebiam leite não pasteurizado e 24,0% água de abastecimento público sem filtrar. Ao comparar os questionários de 145 gestantes pré e pós atividades educativas, o contato com o solo sem uso de luvas teve redução significativa estatisticamente, de 11,0% para 4,8% (p=0,022) e o consumo de água sem filtro reduziu de 26,9% para 20,0% (p=0,000), consumo de carne crua reduziu para 6,9% e de carne mal cozida para 17,9%. Foram mais citados como medidas profiláticas: lavagem dos alimentos (62,1%), lavagem das mãos (62,1%) e consumo de carne cozida (61,4%)...

INTRODUCTION: toxoplasma gondii can cause fetal infection by transplacental route and congenital toxoplasmosis is a serious public health problem. It is fundamental in prenatal early laboratory diagnostics, as well as the transmission of information about the disease. OBJECTIVES: to evaluate the knowledge of toxoplasmosis among pregnant women and health professionals and to contribute to the congenital toxoplasmosis primary prevention implementation in prenatal programs in the city of Niterói, RJ. METHODS: Participated in the study 500 pregnant women and 141 health professionals from 17 modules of the Family Doctor Program and two polyclinics in Niterói-RJ from 2013 to 2016. All signed the consent form and answered a questionnaire. After this stage, health education actions were conducted, usinglectures, educational materials and interactive educational model. After three months,145 pregnant women answered the questionnaires again. RESULTS: Among 500pregnant women, 226 (45.2%) knew toxoplasmosis. 23.5% had information from friends and 19.0% by the doctor. Of the total of pregnant women, 6.8% reported contact with cat feces, 14.0% contact with the ground without gloves, 10.4%consumed vegetables and raw fruits without proper hygiene, 9.6% raw meat and23.4% undercooked meat, 17.8% consumed embedded meat, 10.6% drank raw milk and 24.0% water from public supply system without filtering. By comparing the questionnaires of 145 pregnant women pre and post educational activities, contact with the ground without gloves had statistically significant reduction of 11.0% to 4.8%(p = 0.022) and unfiltered water consumption reduced of 26.9% to 20.0% (p = 0.000),consumption of raw meat reduced to 6.9% and undercooked meat to 17.9%. Theprophylactic measures most frequently cited were: washing food (62.1%), handwashing (62.1%) and consumption of cooked meat (61.4%)...

Programs for controlling congenital toxoplasmosis: study of current status in a brazilian municipality

Measures for congenital toxoplasmosis prevention may be performed at three levels. Primary prevention is characterized by education and public health programs, in which susceptible pregnant women receive guidance on sources of infection and on adopting preventive measures. The secondary level consists of serological screening during prenatal care. Finally, the tertiary level operates in already infected newborns, seeking to prevent clinical damage and late complications. This study aims to describe the situation of control measures for congenital toxoplasmosis in Niterói-RJ according to the National Health Promotion Policy. In Niterói, only secondary prevention is being implemented and there is no guidance on preventive measures to seronegative pregnant women. There is also no notification of congenital and acquired toxoplasmosis cases during pregnancy

Toxoplasmosis-related knowledge among pregnant and postpartum women attended in public health units in Niterói, Rio De Janeiro, Brazil.

The present study conducted a toxoplasmosis-related knowledge level survey with 400 pregnant and puerperal women attended in public health units in the municipality of Niterói, Rio de Janeiro. Only 111 (27.8%) women claimed to know about the disease. Most of them (n = 289; 72.2%) had never heard about toxoplasmosis nor knew how to prevent the infection by Toxoplasma gondii. A significant difference (p = 0.013) regarding the presence of anti-T. gondii IgG was observed between women who claimed to know about the disease and those who had never heard about it. These results highlight the importance of a systematic serological screening process for toxoplasmosis, as well as the importance of primary prevention by accurate information during prenatal care, an important Public Health action to be implemented.

Toxoplasmosis-rllated knowledge among pregnant nd postpartum women attended inn public health units in niterói, rio de janeiro, Braill / Conhecimento sobre toxoplasmose entre gestantes e puérperas atendidas na rede pública de saúde do município de Niterói, Rio de Janeiro, Brasil

The present study conducted a toxoplasmosis-related knowledge level survey with 400 pregnant and puerperal women attended in public health units in the municipality of Niterói, Rio de Janeiro. Only 111 (27.8%) women claimed to know about the disease. Most of them (n = 289; 72.2%) had never heard about toxoplasmosis nor knew how to prevent the infection by Toxoplasma gondii. A significant difference (p = 0.013) regarding the presence of anti-T. gondii IgG was observed between women who claimed to know about the disease and those who had never heard about it. These results highlight the importance of a systematic serological screening process for toxoplasmosis, as well as the importance of primary prevention by accurate information during prenatal care, an important Public Health action to be implemented.

Este estudo teve por objetivo realizar um levantamento do conhecimento de 400 gestantes e puérperas atendidas na rede pública de saúde do município de Niterói, Estado do Rio de Janeiro sobre a toxoplasmose. Apenas 111 (27,8%) participantes relataram conhecer a doença. A maioria 289 (72,2%) nunca ouviu falar sobre a toxoplasmose, principalmente sobre as formas de prevenção da infecção pelo Toxoplasma gondii. Foi encontrada diferença significativa entre as pacientes que disseram conhecer a toxoplasmose e aquelas que relataram desconhecer a doença com relação à presença de anticorpos IgG anti- T.gondii (p = 0,013). Estes resultados permitem ressaltar a importância do rastreamento sorológico sistemático na infecção toxoplásmica, bem como a prevenção primária por meio de informações corretas durante o pré-natal, sendo esta uma importante medida de saúde pública a ser implementada.

Prevalence and risk factors for Toxoplasma gondii infection among pregnant and postpartum women attended at public healthcare facilities in the City of Niterói, State of Rio de Janeiro, Brazil.

INTRODUCTION: To determine the prevalence of immunoglobulin G (IgG) and immunoglobulin M (IgM) anti-Toxoplasma gondii antibodies among pregnant and postpartum women attended within the public healthcare system in Niterói, State of Rio de Janeiro,and to detect possible exposure factors associated with T. gondii infection in this population. METHODS: IgM and IgG anti- T. gondii antibodies were investigated in 276 pregnant and 124 postpartum women by using the indirect immunofluorescence (IFAT) and immunoenzymatic assay (ELISA) techniques. The participants were selected by convenience sampling. All these 400 patients filled out a free and informed consent statement, answered an epidemiological questionnaire and were informed about the disease. RESULTS: Among the 400 samples analyzed, 234 (58.5%) were reactive to IgG anti-T. gondii antibodies, according to the IFAT and/or ELISA assay. One pregnant woman was found to be reactive to IgM anti- T. gondii antibodies, with an intermediate IgG avidity test. Risk factor analysis showed that seropositivity was significantly associated (p<0.05) with age, contact with cats and presence of rodents at home. Through a logistic regression model, these associations were confirmed for age and contact with cats, while education at least of the high school level was found to be a protective factor. CONCLUSIONS: The prevalence rate of IgG anti-T. gondii antibodies in the city of Niterói was high and the risk factors for infection detected after multivariate analysis were: age over 30 years, contact with cats and education levels lower than university graduate level.

Prevalence and risk factors for Toxoplasma gondii infection among pregnant and postpartum women attended at public healthcare facilities in the City of Niterói, State of Rio de Janeiro, Brazil

Introduction To determine the prevalence of immunoglobulin G (IgG) and immunoglobulin M (IgM) anti-Toxoplasma gondii antibodies among pregnant and postpartum women attended within the public healthcare system in Niterói, State of Rio de Janeiro, and to detect possible exposure factors associated with T. gondii infection in this population. Methods IgM and IgG anti-T. gondii antibodies were investigated in 276 pregnant and 124 postpartum women by using the indirect immunofluorescence (IFAT) and immunoenzymatic assay (ELISA) techniques. The participants were selected by convenience sampling. All these 400 patients filled out a free and informed consent statement, answered an epidemiological questionnaire and were informed about the disease. Results Among the 400 samples analyzed, 234 (58.5%) were reactive to IgG anti-T. gondii antibodies, according to the IFAT and/or ELISA assay. One pregnant woman was found to be reactive to IgM anti-T. gondii antibodies, with an intermediate IgG avidity test. Risk factor analysis showed that seropositivity was significantly associated (p<0.05) with age, contact with cats and presence of rodents at home. Through a logistic regression model, these associations were confirmed for age and contact with cats, while education at least of the high school level was found to be a protective factor. Conclusions The prevalence rate of IgG anti-T. gondii antibodies in the City of Niterói was high and the risk factors for infection detected after multivariate analysis were: age over 30 years, contact with cats and education levels lower than university graduate level. .