OCCURRENCE OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS IN PRIMARY HEALTH CARE UNITS AND INFECTION PREVENTION CONFORMITY INDEX

Background and Objective: To identify the association between the presence of methicillin-resistant Staphylococcus aureus (MRSA) in wounds and the conformity of the structure, work processes, and exposure related to wound care in Primary Healthcare Units (PHU). Methods: This is a prospective, cross-sectional study.  Patients cared at 15 BHUs in the interior of Sao Paulo were screened to identify the presence of MRSA in chronic wounds and nasal cavities. Concurrently, an evaluation of conformity of the structure and work process for infection prevention related to the wound care procedure was conducted. The frequency of patients’ exposure to healthcare procedures was recorded as well. Results: The study included 65 patients, with a prevalence of Staphylococcus aureus and MRSA (wound and/or nasal cavity) of 64.6% (n=42) and 10.7% (n=7), respectively. No association was identified to the either healthcare exposure or conformity of structure and process and the presence of MRSA. However, the mean value of the conformity index of the dressing process was low (59.7%). As for process evaluated, hand hygiene displayed a lower index, being performed only 41% of the times before and 72% after the completion of the dressing. Conclusions: This study demonstrated the occurrence of MRSA and the vulnerability to pathogen transmission of patients receiving wound care at PHU due to the low conformity index of structure and process for infection prevention.