Microbial resistance increases morbidity, mortality, and healthcare costs, requiring active epidemiological surveillance (ES) and strategies tailored to the reality of services. Multidrug-resistant (MDR) microorganisms, such as Acinetobacter baumannii, Pseudomonas aeruginosa, and carbapenem-resistant enterobacteria, require effective local measures. In rehabilitation institutions, where there is overlap of flows between surgical patients and those in rehabilitation, additional challenges arise for infection control. In these situations, contact precautions, although essential, may interfere with group therapies, impacting continuity of programs. This study aimed to describe the microbiological profile of patients under contact precautions resulting from ES and analyze the impacts of these measures on rehabilitation therapies. Descriptive, retrospective study conducted between May/2024 and May/2025, based on data from patients who underwent surveillance swabs according to the institutional protocol. Isolated microorganisms, implementation of contact precautions, and records of therapeutic impact in the electronic medical record were evaluated. A total of 212 patients in ES under contact precautions were included, of whom 52% were linked to the spinal cord injury (SCI) rehabilitation program, with 62% admitted for rehabilitation. SCI patients have a higher risk of colonization by MDR due to frequent invasive procedures and recurrent use of antimicrobials. In total, 631 swabs were collected, with a positivity rate of 44%. The main pathogens were carbapenem-resistant enterobacteria (35%) and carbapenem-resistant Pseudomonas aeruginosa (18%). Most colonized patients were in rehabilitation and had their therapeutic plans modified, replacing group activities with individual care. The high prevalence of MDR among rehabilitation patients imposes obstacles to the comprehensive conduct of therapeutic programs. Continuous microbiological surveillance, coupled with review of contact precautions, is essential to ensure care safety without compromising functional objectives of rehabilitation. Additional studies are needed to propose innovative and sustainable solutions to balance infection control and therapeutic effectiveness in environments integrating surgical and rehabilitation care.
Tabari et al. (2026) studied this question.