Challenges in health care attention with regard to bacterial resistance: a review

Abstract

Bacterial resistance is a worldwide health concern to whitch several control initiatives have been proposed to. Therefore, the continuous emergence of resistant microorganisms in health care centers constitutes a challenge attracting attention from different national and international institutions related to epidemiologic control and surveillance. This research aimed to describe bacterial resistance, its occurence mechanisms, control and prevention strategies. It consisted of a critical literature review throughout LILACS, MEDLINE and SciELO databases from 1997 to 2006. From 138 identified articles and according to the inclusion criteria 20 were used to organize this manuscript, in which were pointed the patients inherent risks, transmission and dissemination mechanisms of resistance, besides challenges and strategies to health care service. Amongst other subjects, professionals education, human resources dimensioning, microbiological cultures for surveillance and the implementation of contact isolation strategies for colonized/infected patients by resistant microorganisms and hand hygiene were highlighted along this article. Understanding this reality asserts the necessity of professional participation/ recognition of their responsibility in health care service along with the process of bacterial resistance control, with regard to the individual and collective, institutional and national practices, including the community and society, looking for the public policy reforms.

Key words: Antibacterial drug resistance; Universal precautions and nosocomial infection.