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Plasmodium falciparum malaria transmitida en el hospital a través de las cerraduras de heparina
H A Abulrahi1, E A Bohlega, R E Fontaine
1Field Epidemiology Training Program, Ministry of Health, Riyadh, Saudi Arabia.
Lancet (London, England)
|January 4, 1997
Resumen
La transmisión de malaria adquirida en el hospital (HAFM) se produjo debido a las jeringas compartidas utilizadas con bloqueos de heparina. Esto pone de relieve los riesgos de transmisión de patógenos transmitidos por la sangre en entornos de atención médica.
Área de la Ciencia:
- Enfermedades infecciosas Enfermedades infecciosas.
- Epidemiología de los hospitales.
- Salud Pública La salud pública.
Sus antecedentes:
- Un grupo de casos agudos de malaria por Plasmodium falciparum (AFM) en Riad, Arabia Saudita, sugirió la transmisión hospitalaria.
- Las investigaciones comunitarias identificaron el ingreso hospitalario como un factor común entre las personas afectadas.
Objetivo del estudio:
- Para investigar la transmisión en el hospital de la malaria aguda Plasmodium falciparum.
- Para identificar las prácticas específicas que conducen a la malaria adquirida en el hospital (HAFM).
Principales métodos:
- Investigó a todos los pacientes con AFM ingresados en un hospital pediátrico (diciembre de 1991-abril de 1992).
- La malaria se clasifica como adquirida localmente (LAFM) o adquirida en el hospital (HAFM) en función de los antecedentes de viaje y el ingreso hospitalario.
- Comparación de exposiciones y prácticas de enfermería de casos de HAFM con pacientes de control.
- Ha realizado cuestionarios anónimos sobre la administración parenteral de fármacos.
Principales resultados:
- 20 de los 21 casos de LAFM (95%) tuvieron un ingreso hospitalario previo, en comparación con el 25% de los controles (p < 0,001).
- Los pacientes con FMAA eran significativamente más propensos a tener habitaciones compartidas o habitaciones adyacentes con pacientes con FMAA durante las admisiones anteriores (p < 0,001).
- El 90% de los pacientes con FMAH utilizó bloqueos de heparina durante las admisiones anteriores frente al 49% de los pacientes en general (p < 0,001).
- Las enfermeras informaron el uso de jeringas individuales para múltiples bloqueos de heparina (10%) y la preparación de jeringas para dosis múltiples (50%).
Conclusiones:
- La malaria Plasmodium falciparum se transmitió entre pacientes a través de jeringas compartidas utilizadas con bloqueos secuenciales de heparina.
- Esta práctica insegura plantea un riesgo significativo para la transmisión de otros patógenos transmitidos por la sangre en entornos hospitalarios.
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