Diversidade e análise de risco da presença de fungos filamentosos isolados em objetos de um hospital localizado no norte do estado do Tocantins

Abstract

One of the major public health problems is Health Care Related Infections (HAI). The entry and permanence of applicants in health institutions exposes them to a multiplicity of pathogenic microorganisms, especially in hospitals, which can aggravate the patient's condition, enabling cross-infection by these microorganisms. The frequency of infections caused by fungi has increased considerably and several factors have contributed to this increase, such as the invasion and proliferation of fungi into biological systems in hospital environments, making it a matter of great importance in public health. One of the ways to keep the hospital environment safe and control environmental contamination is by cleaning the hospital units, following protocols and standards for hygienic sanitary products. Therefore, the objective of this work was to verify the diversity and risk analysis through the identification of public fungi obtaining objects before and after the standard operating procedure (SOP) of cleaning and disinfection of a hospital located in the North of Tocantins. A total of 48 were collected from eight objects from each researched environment: emergency care (ER), infirmary and semi-intensive unit. The collection was carried out in two moments, before and after the sanitation and cleaning procedures of the place, in the period from February to May 2021. The microbiological identifications were carried out by the association of the macroscopic characteristics of the fungi cultivated in Petri dishes and microscopic, by using the slide microculture technique. Fungi were preserved using the Castellani technique. There was growth of filamentous fungi in all analyzed both before and after cleaning the environment, totaling 191 Colony Forming Units (CFU) and the genus of 179 CFU was identified. The objects belonging to the emergency room were the most contaminated, followed by those from the semi-intensive unit and the least contaminated were those from the ward with percentages of 40%, 34.% and 26% of the total of fungi, respectively, but there was no statistical difference significant. Several fungi belonging to genera that have pathogenic representatives were isolated, both before and after cleaning, totaling 13 being: Acremonium, Alternaria, Aspergillus, Cladosporium, Curvularia, Fusarium, Geotrichum, Microsporum, Paecilomyces, Penicillum, Rhizopus, Sporothryx and Trichophyton. There was no statistically significant difference between the treatments assumed before and after cleaning according to the student t test (p=0.3435). According to alpha diversity calculations, diversity and uniformity were higher in the emergency room (1-D = 0.8370 and H´ = 2.0090) and fungal species richness was higher in the ward (DMg = 2.8120). The most frequent genera were Aspergillus (32.0%), Penicillium (22.0%) and Cladosporium (17.0%). The object telephone in the semi-intensive unit was the most contaminated among all those sampled before and after cleaning with 10 CFU each sample. It is concluded that the hospital environment surveyed has a large amount of environmental fungi and it is suggested that control and monitoring measures should be reinforced by the hospital infection control teams to prevent microorganisms from remaining in the hospital environment and causing cross infections to affect mainly immunosuppressed patients in the patients of that hospital.