RESUMEN
Objetivos:
evaluar la carga microbiana y adherencia de Escherichia coli en diferentes áreas de la superficie de instrumento quirúrgico expuesto a la contaminación experimental a lo largo del tiempo.
Métodos:
estudio experimental en que fragmentos de tenacillas quirúrgicas (sierra, asta y cremallera), contaminados por inmersión en Tryptic Soy Broth, conteniendo 106 UFC/mL de E. coli, por 1, 2, 4, 6, 8, 12 y 24 horas. La carga microbiana y la adherencia bacteriana evaluadas con uso de cultivo y microscopia electrónica de barredura, respectivamente
Resultados: verificó aumento de la carga microbiana en el instrumento quirúrgico, proporcional al intervalo de contaminación, variando de 102 tras 1 hora a 105 UFC/cm2 en 24 horas. La presencia de polisacárido detectada tras 2 horas de contaminación.
Conclusiones:
carga microbiana y adherencia de E. coli aumentaron a lo largo del tiempo, atingiendo 105 UFC/cm2 tras 24 horas de contaminación, iniciándose formación de biopelícula tras 2 horas.
Descriptores:
Biopelícula; Escherichia coli; Instrumentos Quirúrgicos; Seguridad del Paciente; Contaminación de Equipamientos
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Note: cm - centimeters; h - hours.
Note: HV - acceleration voltage; spot - beam diameter; mag - magnification; WD - working distance; det - detector type; HFW - image width; MC - microscopy center; (A) Jaw (5,000×), (B) Shank (10,000×) and (C) Ratchet (10,000×) after 1 hour, with presence of isolated rods on the surface; (D) Jaw (20,000×) after two hours, with typical E. coli rods grouped in area of slit of the surface of the surgical instrument, with presence of pili and production of amorphous material suggestive of EPS; (E) shank (5,000×) after 2 hours, with isolated rods on the surface of the surgical instrument; (F) ratchet (10,000×) after 2 hours, with rods in the process of cell division agglomerated in slit; (G) jaw (5,000×) after 4 hours - it is observed increase in the concentration of bacteria in relation to the previous time; (H) shank (5,000×) after 4 hours, with clustering of rods in the groove area of the surgical instrument; (I) ratchet (15,000×) after 4 hours, with clustering of rods with evidence of the expression of ribs on the surface of the microbial cell; (J) jaw (5,000×) after 6 hours, with clustering of microorganisms in the central area of the image and presence of isolated cells in the adjacencies; (K) shank (2,000×) after 6 hours - islands with clustering of microorganisms on the surface of the surgical instrument; (L) ratchet (5,000×) after 6 hours, with presence of clustering of rods in the groove area of the surgical instrument; (M) jaw (5,000×) after 8 hours, showing microorganisms dispersed on the surface with EPS production; (N) shank (5,000×) and (O) ratchet (5,000×) after 8 hours, with grouping of microorganisms covered with amorphous material suggestive of EPS; (P) jaw (8,000×), (Q) shank (5,000×) and (R) ratchet (10,000×) after 12 hours – there is a high concentration of E. coli in relation to previous times; (S) jaw (10,000×), (T) shank (5,000×) and (U) ratchet (1,500×) after 24 hours - enlargement of the area filled with microorganisms that agglomerate covering a large part of the surface of the surgical instrument.