Foram selecionados, aleatoriamente, 12 equipos em 7 clínicas da FOB/USP, dois foram preenchidos com água destilada (Ortodontia e Urgência), um com água de torneira (UBAs), em um o reservatório ficou seco por 30 dias (Odontopediatria) em outro por 60 dias (Pós-graduação), um equipo com a tecnologia B-Safe® (Multidisciplinar) e, em três, a limpeza com o detergente enzimático foi avaliado (Dentística). Amostras de 10 mL de água dos reservatórios e tubulações das canetas de alta rotação foram obtidas e diluições feitas até 10-4, semeadas nos meios de cultura R2A, Peptona Diluída - PD, Plate Count Agar - PCA e Sabouraund Dextrose Agar SDA. Alíquotas de 100 L das amostras foram semeadas nos meios de cultura R2A, PD, PCA e SDA pela técnica de esgotamento, alíquotas de 25 L foram semeadas (R2A, PD, PCA e SDA) pela técnica da gota e alíquotas de 100 L das amostras foram semeadas no meio PCA pela técnica de pour plate. As placas de R2A, PD, PCA foram incubadas por 72 horas a 24°C e as placas de SDA por 4 a 7 dias a 24°C. Foi feita a identificação bacteriana através do kit Bactray I, II ou III e a fúngica através do microcultivo. A média bacteriana obtida foi de 128.151 UFC/mL na Odontopediatria, 1.834.807 UFC/mL na Ortodontia, 60.422 UFC/mL na Pós-Graduação, 615,68 UFC/mL na UBAs, 899,64 UFC/mL na Urgência, 97.632 UFC/mL na Multidisciplinar e 417.619 UFC/mL na Dentística sem limpeza e 135.924 UFC/mL após a limpeza. A média dos fungos foram 205 UFC/mL na Odontopediatria, 702,50 UFC/mL na Ortodontia, 12,50 UFC/mL na Pós-Graduação, 41.475 UFC/mL UBAs, 117.500 UFC/mL Urgência, 4.469 UFC/mL na Multidisciplinar e 64.642 UFC/mL e de 23.627 UFC/mL, antes e após a limpeza na Dentística. A presença de micro-organismos foi detectada nos reservatórios e tubulações de água em todas as 7 clínicas; para quantificar as bactérias, o meio R2A seguido do PD foram melhores que o PCA e, para detectar diferentes espécies o meio PCA foi superior ao R2A e PD; a técnica da gota foi melhor do que a de esgotamento e pour plate para as bactérias, enquanto a de esgotamento foi superior para os fungos. O detergente enzimático foi eficaz em desestruturar o biofilme, atuando mais sobre os fungos do que para as bactérias, que não foram eliminadas após as limpezas. Foram identificadas 22 espécies de bactérias: Acinetobacter baumanni/calcoaceticus, Aeromonas hydrophila, Alcaligenes xylosoxidans denitrificans, Brevundimonas vesicularis, Burkholderia cepacia, Burkholderia pseudomallei, Chromobacterium violaceum, Hafnia alvei, Hafnia alvei (Biogrupo 1), Ochrobactrum anthropi, Pseudomonas aeruginosa, Pseudomonas alcaligenes, Pseudomonas fluorescens, Pseudomonas luteola, Pseudomonas oryzihabitans, Pseudomonas pseudoalcaligenes, Pseudomonas putida, Pseudomonas stutzeri, Serratia liquefaciens, Serratia plymuthica, Sphingobacterium multivorum, Tatumella ptyseos. Foram identificados 12 gêneros de fungos: Acremonium sp, Alternaria sp, Aspergillus sp, Cladosporium sp, Curvularia sp, Exophiala sp, Fonsecaea sp, Fusarium sp, Paecylomices sp, Penicillium sp, Rhinocladiella sp, Verticillium sp. / Twelve dental units of 7 clinics of FOB/USP were randomly selected, two were filled with distilled water (Orthodontics and Urgency), one with tap water (UBAs), one reservoir was dry for 30 days (Odontopediatry) and another for 60 days (Postgraduate Clinic), one dental unit was filled with the B - Safe ® technology (Multidisciplinary Clinic). Three dental clinics were evaluated concerning the cleaning procedure with enzymatic detergent. Samples of 10 mL of water reservoirs and high-speed handpieces were collected and made up to 10-4 dilutions, plated on R2A media, Peptone Diluted culture - PD, Plate Count Agar - PCA and Sabouraund Dextrose Agar - SDA. Aliquots of 100 L of the samples were plated on R2A media, PD, PCA and SDA culture technique for spreading. Aliquots of 25 L were seeded (R2A, PD, PCA and SDA) in drops and aliquots of 100 L samples were seeded in PCA by the pour plate technique. R2A plates, PD, PCA were incubated for 72 hours at 24°C and SDA plates for 4 to 7 days at 24°C. Bacterial identification was performed using Bactray I, II or III kit and fungal identification by microculture. Bacterial average was 128.151 CFU/mL in Odontopediatry, 1.834.807 CFU/mL in Orthodontics, 60.422 CFU/mL in Postgraduate Clinic, 615.68 CFU/mL in UBAs, 899.64 CFU/mL in Urgency, 97.632 CFU/mL in Multidisciplinary Clinic and 417.619 CFU/mL in Dentistry without the cleaning procedure and 135.924 CFU/mL after it. The average of fungi was 205 CFU/mL in Odontopediatry, 702.50 CFU/mL in Orthodontics, 12.50 CFU/mL in Postgraduate Clinic, 41.475 CFU/mL in UBAs, 117.500 CFU/mL in Urgency, 4.469 CFU/mL in Multidisciplinary and 64.642 CFU/mL and 23.627 CFU/mL before and after cleaning procedure in Dentistry. The presence of micro - organisms occurred in reservoirs and waterlines in all of the 7 clinics evaluated. To quantify bacteria, R2A and PD medium provided more accurate results than PCA. To detect different species, PCA medium was better than R2A and PD. The drop technique was better than the spreading technique and pour plate for bacteria; however, the spreading technique provided better results for the yeasts. The enzymatic detergent was effective on disrupting the biofilm eliminating more yeasts than residual bacteria. Twenty-two species of bacteria were identified: Acinetobacter baumanni/calcoaceticus, Aeromonas hydrophila, Alcaligenes xylosoxidans denitrificans, Brevundimonas vesicularis, Burkholderia cepacia, Burkholderia pseudomallei, Chromobacterium violaceum, Hafnia alvei, Hafnia alvei (Biogroup 1), Ochrobactrum anthropi, Pseudomonas aeruginosa, Pseudomonas alcaligenes, Pseudomonas fluorescens, Pseudomonas luteola, Pseudomonas oryzihabitans, Pseudomonas pseudoalcaligenes, Pseudomonas putida, Pseudomonas stutzeri, Serratia liquefaciens, Serratia plymuthica, Sphingobacterium multivorum, Tatumella ptyseos. Twelve genus of fungi were identified: Acremonium sp, Alternaria sp, Aspergillus sp, Cladosporium sp, Curvularia sp, Exophiala sp, Fonsecaea sp, Fusarium sp, Paecylomices sp, Penicillium sp, Rhinocladiella sp, Verticillium sp.

Foram selecionados, aleatoriamente, 12 equipos em 7 clínicas da FOB/USP, dois foram preenchidos com água destilada (Ortodontia e Urgência), um com água de torneira (UBAs), em um o reservatório ficou seco por 30 dias (Odontopediatria) em outro por 60 dias (Pós-graduação), um equipo com a tecnologia B-Safe® (Multidisciplinar) e, em três, a limpeza com o detergente enzimático foi avaliado (Dentística). Amostras de 10 mL de água dos reservatórios e tubulações das canetas de alta rotação foram obtidas e diluições feitas até 10-4, semeadas nos meios de cultura R2A, Peptona Diluída - PD, Plate Count Agar - PCA e Sabouraund Dextrose Agar SDA. Alíquotas de 100 L das amostras foram semeadas nos meios de cultura R2A, PD, PCA e SDA pela técnica de esgotamento, alíquotas de 25 L foram semeadas (R2A, PD, PCA e SDA) pela técnica da gota e alíquotas de 100 L das amostras foram semeadas no meio PCA pela técnica de pour plate. As placas de R2A, PD, PCA foram incubadas por 72 horas a 24°C e as placas de SDA por 4 a 7 dias a 24°C. Foi feita a identificação bacteriana através do kit Bactray I, II ou III e a fúngica através do microcultivo. A média bacteriana obtida foi de 128.151 UFC/mL na Odontopediatria, 1.834.807 UFC/mL na Ortodontia, 60.422 UFC/mL na Pós-Graduação, 615,68 UFC/mL na UBAs, 899,64 UFC/mL na Urgência, 97.632 UFC/mL na Multidisciplinar e 417.619 UFC/mL na Dentística sem limpeza e 135.924 UFC/mL após a limpeza. A média dos fungos foram 205 UFC/mL na Odontopediatria, 702,50 UFC/mL na Ortodontia, 12,50 UFC/mL na Pós-Graduação, 41.475 UFC/mL UBAs, 117.500 UFC/mL Urgência, 4.469 UFC/mL na Multidisciplinar e 64.642 UFC/mL e de 23.627 UFC/mL, antes e após a limpeza na Dentística. A presença de micro-organismos foi detectada nos reservatórios e tubulações de água em todas as 7 clínicas; para quantificar as bactérias, o meio R2A seguido do PD foram melhores que o PCA e, para detectar diferentes espécies o meio PCA foi superior ao R2A e PD; a técnica da gota foi melhor do que a de esgotamento e pour plate para as bactérias, enquanto a de esgotamento foi superior para os fungos. O detergente enzimático foi eficaz em desestruturar o biofilme, atuando mais sobre os fungos do que para as bactérias, que não foram eliminadas após as limpezas. Foram identificadas 22 espécies de bactérias: Acinetobacter baumanni/calcoaceticus, Aeromonas hydrophila, Alcaligenes xylosoxidans denitrificans, Brevundimonas vesicularis, Burkholderia cepacia, Burkholderia pseudomallei, Chromobacterium violaceum, Hafnia alvei, Hafnia alvei (Biogrupo 1), Ochrobactrum anthropi, Pseudomonas aeruginosa, Pseudomonas alcaligenes, Pseudomonas fluorescens, Pseudomonas luteola, Pseudomonas oryzihabitans, Pseudomonas pseudoalcaligenes, Pseudomonas putida, Pseudomonas stutzeri, Serratia liquefaciens, Serratia plymuthica, Sphingobacterium multivorum, Tatumella ptyseos. Foram identificados 12 gêneros de fungos: Acremonium sp, Alternaria sp, Aspergillus sp, Cladosporium sp, Curvularia sp, Exophiala sp, Fonsecaea sp, Fusarium sp, Paecylomices sp, Penicillium sp, Rhinocladiella sp, Verticillium sp. / Twelve dental units of 7 clinics of FOB/USP were randomly selected, two were filled with distilled water (Orthodontics and Urgency), one with tap water (UBAs), one reservoir was dry for 30 days (Odontopediatry) and another for 60 days (Postgraduate Clinic), one dental unit was filled with the B - Safe ® technology (Multidisciplinary Clinic). Three dental clinics were evaluated concerning the cleaning procedure with enzymatic detergent. Samples of 10 mL of water reservoirs and high-speed handpieces were collected and made up to 10-4 dilutions, plated on R2A media, Peptone Diluted culture - PD, Plate Count Agar - PCA and Sabouraund Dextrose Agar - SDA. Aliquots of 100 L of the samples were plated on R2A media, PD, PCA and SDA culture technique for spreading. Aliquots of 25 L were seeded (R2A, PD, PCA and SDA) in drops and aliquots of 100 L samples were seeded in PCA by the pour plate technique. R2A plates, PD, PCA were incubated for 72 hours at 24°C and SDA plates for 4 to 7 days at 24°C. Bacterial identification was performed using Bactray I, II or III kit and fungal identification by microculture. Bacterial average was 128.151 CFU/mL in Odontopediatry, 1.834.807 CFU/mL in Orthodontics, 60.422 CFU/mL in Postgraduate Clinic, 615.68 CFU/mL in UBAs, 899.64 CFU/mL in Urgency, 97.632 CFU/mL in Multidisciplinary Clinic and 417.619 CFU/mL in Dentistry without the cleaning procedure and 135.924 CFU/mL after it. The average of fungi was 205 CFU/mL in Odontopediatry, 702.50 CFU/mL in Orthodontics, 12.50 CFU/mL in Postgraduate Clinic, 41.475 CFU/mL in UBAs, 117.500 CFU/mL in Urgency, 4.469 CFU/mL in Multidisciplinary and 64.642 CFU/mL and 23.627 CFU/mL before and after cleaning procedure in Dentistry. The presence of micro - organisms occurred in reservoirs and waterlines in all of the 7 clinics evaluated. To quantify bacteria, R2A and PD medium provided more accurate results than PCA. To detect different species, PCA medium was better than R2A and PD. The drop technique was better than the spreading technique and pour plate for bacteria; however, the spreading technique provided better results for the yeasts. The enzymatic detergent was effective on disrupting the biofilm eliminating more yeasts than residual bacteria. Twenty-two species of bacteria were identified: Acinetobacter baumanni/calcoaceticus, Aeromonas hydrophila, Alcaligenes xylosoxidans denitrificans, Brevundimonas vesicularis, Burkholderia cepacia, Burkholderia pseudomallei, Chromobacterium violaceum, Hafnia alvei, Hafnia alvei (Biogroup 1), Ochrobactrum anthropi, Pseudomonas aeruginosa, Pseudomonas alcaligenes, Pseudomonas fluorescens, Pseudomonas luteola, Pseudomonas oryzihabitans, Pseudomonas pseudoalcaligenes, Pseudomonas putida, Pseudomonas stutzeri, Serratia liquefaciens, Serratia plymuthica, Sphingobacterium multivorum, Tatumella ptyseos. Twelve genus of fungi were identified: Acremonium sp, Alternaria sp, Aspergillus sp, Cladosporium sp, Curvularia sp, Exophiala sp, Fonsecaea sp, Fusarium sp, Paecylomices sp, Penicillium sp, Rhinocladiella sp, Verticillium sp.

Orientador: Regina Célia Popim / Resumo: Introdução: Os riscos biológicos podem trazer prejuízos para saúde dos acadêmicos de enfermagem, pois na prática acadêmica estão expostos como os profissionais da área da saúde. Objetivo: identificar o conhecimento pelos acadêmicos da 4ª série em enfermagem, provenientes de Instituição de Ensino Superior pública e privada acerca dos riscos biológicos, medidas preventivas, tipos de exposições e conduta pós acidente envolvendo material biológico. Método: o estudo foi realizado em duas etapas: 1) pesquisa documental como estratégia para analisar os Planos de Ensino, analisados 78 PE, sendo 41 da IES pública e 37 da privada, entre outubro de 2016 a fevereiro de 2017; 2) estudo transversal, descritivo de abordagem quantitativa, participaram 42 acadêmicos da IES privada e 19 da pública, cursando a 4ª série, os quais responderam questionário, contendo questões relacionadas aos aspectos demográficos, experiência profissional prévia, e o conhecimento dos acadêmicos acerca dos riscos biológicos, medidas de prevenção, tipos de exposição e conduta pós acidente com material biológico, a coleta ocorreu nos meses de março e abril de 2017. Resultados: dos 78 PE analisados, a grande maioria não expressava o conteúdo sobre os riscos biológicos, medidas preventivas, tipos de exposição e conduta pós-exposição a material biológicos nas suas ementas, objetivo e conteúdo. Detectamos que os acadêmicos da IES pública sem formação previa de auxiliar ou técnico de enfermagem tem maior conhecimento sobr... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: Biological risks can cause health risks for nursing students, since in academic practice they are exposed as health professionals. Objective: to identify the knowledge about the biological risks, preventive measures, types of exposures and post-accident behavior involving biological material by the 4th grade students in nursing, from Public and Private Higher Education Institutions. Method: the study was carried out in two stages: 1) documentary research as a strategy to analyze the Education Plans, analyzed 78 PE, 41 of the public HEI and 37 of the private one, between October 2016 and February 2017; 2) a cross-sectional, descriptive study with a quantitative approach, 42 students from the private HEI and 19 from the public attended the 4th grade, who answered a questionnaire, containing questions related to the demographic aspects, previous professional experience, and academic knowledge about the risks biological measurements, prevention measures, types of exposure and conduct after accidents with biological material, collection occurred in March and April 2017. Results: We analyzed 78 PE and the majority of which did not express the content of the biological risks, preventive measures, types of exposure and post-exposure behavior to biological material in their menus, purpose and content. We have detected that the academics of public HEI without previous training of auxiliary or nursing technician have greater knowledge about the practices of risk. The study... (Complete abstract click electronic access below) / Doutor

Une préoccupation grandissante face aux risques biologiques reliés aux maladies infectieuses est palpable tant au niveau international que national ou provincial. Des maladies émergentes telles que le SRAS ou la grippe A/H1N1 ont amené une prise en charge des risques pandémiques et à l’élaboration de mesures d’urgence pour maîtriser ces risques : développer une culture de sécurité est devenu une priorité de recherche de l’OMS. Malgré tout, peu d’écrits existent face à cette volonté de sécuriser la santé et le bien-être par toute une série de dispositifs au sein desquels les discours occupent une place importante en matière de culture de sécurité face aux risques biologiques. Une réflexion sociopolitique était nécessaire pour les infirmières qui sont aux premières loges en dispensant des soins à la population dans une perspective de prévention et de contrôle des infections (PCI) dans laquelle elles se spécialisent. Dès lors, ce projet avait pour buts d’explorer la perception du risque et de la sécurité face aux maladies infectieuses auprès des infirmières cliniciennes et gestionnaires québécoises; d’explorer plus spécifiquement l'existence ou l'absence de culture de sécurité dans un centre de santé et de services sociaux québécois (CSSS); et d’explorer les discours en présence dans le CSSS en matière de sécurité et de risques biologiques face aux maladies infectieuses et comment ces discours de sécurité face aux risques biologiques se traduisent dans le quotidien des infirmières. Les risques biologiques sont perçus comme identifiables, mesurables et évitables dans la mesure où les infirmières appliquent les mesures de préventions et contrôle des infections, ce qui s’inscrit dans une perspective positiviste du risque (Lupton, 1999). La gestion de ces risques se décline au travers de rituels de purification et de protection afin de se protéger de toute maladie infectieuse. Face à ces risques, une culture de sécurité unique est en émergence dans le CSSS dans une perspective de prévention de la maladie. Toutefois, cette culture de sécurité désirée est confrontée à une mosaïque de cultures qui couvrent différentes façons d’appliquer ou non les mesures de PCI selon les participants. La contribution de cette recherche est pertinente dans ce nouveau domaine de spécialité que constituent la prévention et le contrôle des infections pour les infirmières québécoises. Une analyse critique des relations de pouvoir tel qu’entendu par Foucault a permis de soulever les questions de surveillance infirmière, de politique de l’aveu valorisée, de punition de tout écart à l’application rigoureuse des normes de PCI, de contrôle de la part des cadres infirmiers et d’assujettissement des corps relevant des mécanismes disciplinaires. Elle a permis également de documenter la présence de dispositifs de sécurité en lien avec la tenue de statistiques sur les patients qui sont répertoriés en tant que cas infectieux, mais également en termes de circulation des personnes au sein de l’établissement. La présence d’un pouvoir pastoral est perceptible dans la traduction du rôle d’infirmière gestionnaire qui doit s’assurer que ses équipes agissent de la bonne façon et appliquent les normes de PCI privilégiées au sein du CSSS afin de réguler les taux d’infections nosocomiales présents dans l’établissement. En cas de non-respect des mesures de PCI touchant à l’hygiène des mains ou à la vaccination, l’infirmière s’expose à des mesures disciplinaires passant de l’avertissement, la relocalisation, l’exclusion ou la suspension de l’emploi. Une culture du blâme a été décrite par la recherche d’un coupable au sein de l’institution, particulièrement en temps de pandémie. Au CSSS, l’Autre est perçu comme étant à l’origine de la contamination, tandis que le Soi est perçu comme à l’abri de tout risque à partir du moment où l’infirmière respecte les normes d’hygiène de vie en termes de saines habitudes alimentaires et d’activité physique. Par ailleurs, les infirmières se doivent de respecter des normes de PCI qu’elles connaissent peu, puisque les participantes à la recherche ont souligné le manque de formation académique et continue quant aux maladies infectieuses, aux risques biologiques et à la culture de sécurité qu’elles considèrent pourtant comme des sujets priorisés par leur établissement de santé. Le pouvoir produit des effets sur les corps en les modifiant. Cette étude ethnographique critique a permis de soulever les enjeux sociopolitiques reliés aux discours en présence et de mettre en lumière ce que Foucault a appelé le gouvernement des corps et ses effets qui se capillarisent dans le quotidien des infirmières. Des recherches ultérieures sont nécessaires afin d’approfondir ce champ de spécialité de notre discipline infirmière et de mieux arrimer la formation académique et continue aux réalités infectieuses cliniques. / At an international, national or provincial level, there is a growing concern related to biological risks and infectious disease. Emerging diseases such as SARS or influenza A/H1N1 brought a pandemic risk management and the development of emergency measures to control these risks: developing a safety culture has become a research priority for the WHO. However, few writings exist about the desire to secure health and well-being through a variety of devices in which the discourses takes a predominant place as regards of security against biological risks. From the perspective of prevention and infection control (PCI), in which the nurses specialize, a socio-political reflexion was necessary since they are at the forefront in providing care to the population. Therefore, the purpose of this project was to explore the discourses surrounding the safety culture against biological risks in the context of a Quebec healthcare facility “Centre de santé et de services sociaux” (CSSS). Biological hazards are perceived as identifiable, measurable and avoidable if the nurses apply the preventive and infection control measures, which is part of a positivist perspective of risk (Lupton, 1999). Managing these risks is declined through a purification and protection rituals in order to protect themselves from any infectious disease. Faced with these risks, a unique safety culture is emerging in the CSSS following a disease prevention perspective. However, the desired safety culture is faced with a mosaic of cultures that cover different ways to apply or not the prevention and infection control (PIC) measures according to participants. The contribution of this research is important within the prevention and control of infection field for Quebecois nurses. Critical analysis of power relations has raised questions about nursing surveillance, valorized confession policy, punishment for any deviation from the normative application of the PCI standards, monitoring by the nursing managers and subjugation of bodies within disciplinary mechanisms. It made it possible to document the presence of safety devices in conjunction with maintaining statistics on patients who are listed as infectious cases, but also in terms of flux of person’s movements within the institution. The presence of a pastoral power is perceptible in the translation of the administrative role of nurse who must ensure that its teams act in the right way and apply the preferred CSSS PIC standards to regulate the rate of nosocomial infections present within the establishment. In case of non-compliance with PIC related measures to hand hygiene or vaccination, the nurse may be subject to disciplinary action from the warning, the relocation, the exclusion or suspension of the employment. A culture of blame has been described by the search for a culprit in the institution. Within the CSSS, the Other is perceived as being the source of contamination, while the Self is seen as free from any risk from the moment the nurse respects the standards of hygiene of life in terms of healthy dietary habits and physical activity. In addition, nurses must respect the PIC standards they know little, since the research participants noted the lack of academic and continuous training concerning infectious diseases, biological hazards and safety culture that they consider prioritized by their health institution. Power produces effects on the bodies by modifying them. This ethnographic study criticizes, made it possible to raise the sociopolitic stakes connected to the involved speeches and to clarify what Foucault called the government of the bodies and his effects which are capillaries in the nurse’s daily normalities. Further researches are necessary to explore this nursing speciality and to link academic and continuous training to clinical infectious realities.

Une préoccupation grandissante face aux risques biologiques reliés aux maladies infectieuses est palpable tant au niveau international que national ou provincial. Des maladies émergentes telles que le SRAS ou la grippe A/H1N1 ont amené une prise en charge des risques pandémiques et à l’élaboration de mesures d’urgence pour maîtriser ces risques : développer une culture de sécurité est devenu une priorité de recherche de l’OMS. Malgré tout, peu d’écrits existent face à cette volonté de sécuriser la santé et le bien-être par toute une série de dispositifs au sein desquels les discours occupent une place importante en matière de culture de sécurité face aux risques biologiques. Une réflexion sociopolitique était nécessaire pour les infirmières qui sont aux premières loges en dispensant des soins à la population dans une perspective de prévention et de contrôle des infections (PCI) dans laquelle elles se spécialisent. Dès lors, ce projet avait pour buts d’explorer la perception du risque et de la sécurité face aux maladies infectieuses auprès des infirmières cliniciennes et gestionnaires québécoises; d’explorer plus spécifiquement l'existence ou l'absence de culture de sécurité dans un centre de santé et de services sociaux québécois (CSSS); et d’explorer les discours en présence dans le CSSS en matière de sécurité et de risques biologiques face aux maladies infectieuses et comment ces discours de sécurité face aux risques biologiques se traduisent dans le quotidien des infirmières. Les risques biologiques sont perçus comme identifiables, mesurables et évitables dans la mesure où les infirmières appliquent les mesures de préventions et contrôle des infections, ce qui s’inscrit dans une perspective positiviste du risque (Lupton, 1999). La gestion de ces risques se décline au travers de rituels de purification et de protection afin de se protéger de toute maladie infectieuse. Face à ces risques, une culture de sécurité unique est en émergence dans le CSSS dans une perspective de prévention de la maladie. Toutefois, cette culture de sécurité désirée est confrontée à une mosaïque de cultures qui couvrent différentes façons d’appliquer ou non les mesures de PCI selon les participants. La contribution de cette recherche est pertinente dans ce nouveau domaine de spécialité que constituent la prévention et le contrôle des infections pour les infirmières québécoises. Une analyse critique des relations de pouvoir tel qu’entendu par Foucault a permis de soulever les questions de surveillance infirmière, de politique de l’aveu valorisée, de punition de tout écart à l’application rigoureuse des normes de PCI, de contrôle de la part des cadres infirmiers et d’assujettissement des corps relevant des mécanismes disciplinaires. Elle a permis également de documenter la présence de dispositifs de sécurité en lien avec la tenue de statistiques sur les patients qui sont répertoriés en tant que cas infectieux, mais également en termes de circulation des personnes au sein de l’établissement. La présence d’un pouvoir pastoral est perceptible dans la traduction du rôle d’infirmière gestionnaire qui doit s’assurer que ses équipes agissent de la bonne façon et appliquent les normes de PCI privilégiées au sein du CSSS afin de réguler les taux d’infections nosocomiales présents dans l’établissement. En cas de non-respect des mesures de PCI touchant à l’hygiène des mains ou à la vaccination, l’infirmière s’expose à des mesures disciplinaires passant de l’avertissement, la relocalisation, l’exclusion ou la suspension de l’emploi. Une culture du blâme a été décrite par la recherche d’un coupable au sein de l’institution, particulièrement en temps de pandémie. Au CSSS, l’Autre est perçu comme étant à l’origine de la contamination, tandis que le Soi est perçu comme à l’abri de tout risque à partir du moment où l’infirmière respecte les normes d’hygiène de vie en termes de saines habitudes alimentaires et d’activité physique. Par ailleurs, les infirmières se doivent de respecter des normes de PCI qu’elles connaissent peu, puisque les participantes à la recherche ont souligné le manque de formation académique et continue quant aux maladies infectieuses, aux risques biologiques et à la culture de sécurité qu’elles considèrent pourtant comme des sujets priorisés par leur établissement de santé. Le pouvoir produit des effets sur les corps en les modifiant. Cette étude ethnographique critique a permis de soulever les enjeux sociopolitiques reliés aux discours en présence et de mettre en lumière ce que Foucault a appelé le gouvernement des corps et ses effets qui se capillarisent dans le quotidien des infirmières. Des recherches ultérieures sont nécessaires afin d’approfondir ce champ de spécialité de notre discipline infirmière et de mieux arrimer la formation académique et continue aux réalités infectieuses cliniques. / At an international, national or provincial level, there is a growing concern related to biological risks and infectious disease. Emerging diseases such as SARS or influenza A/H1N1 brought a pandemic risk management and the development of emergency measures to control these risks: developing a safety culture has become a research priority for the WHO. However, few writings exist about the desire to secure health and well-being through a variety of devices in which the discourses takes a predominant place as regards of security against biological risks. From the perspective of prevention and infection control (PCI), in which the nurses specialize, a socio-political reflexion was necessary since they are at the forefront in providing care to the population. Therefore, the purpose of this project was to explore the discourses surrounding the safety culture against biological risks in the context of a Quebec healthcare facility “Centre de santé et de services sociaux” (CSSS). Biological hazards are perceived as identifiable, measurable and avoidable if the nurses apply the preventive and infection control measures, which is part of a positivist perspective of risk (Lupton, 1999). Managing these risks is declined through a purification and protection rituals in order to protect themselves from any infectious disease. Faced with these risks, a unique safety culture is emerging in the CSSS following a disease prevention perspective. However, the desired safety culture is faced with a mosaic of cultures that cover different ways to apply or not the prevention and infection control (PIC) measures according to participants. The contribution of this research is important within the prevention and control of infection field for Quebecois nurses. Critical analysis of power relations has raised questions about nursing surveillance, valorized confession policy, punishment for any deviation from the normative application of the PCI standards, monitoring by the nursing managers and subjugation of bodies within disciplinary mechanisms. It made it possible to document the presence of safety devices in conjunction with maintaining statistics on patients who are listed as infectious cases, but also in terms of flux of person’s movements within the institution. The presence of a pastoral power is perceptible in the translation of the administrative role of nurse who must ensure that its teams act in the right way and apply the preferred CSSS PIC standards to regulate the rate of nosocomial infections present within the establishment. In case of non-compliance with PIC related measures to hand hygiene or vaccination, the nurse may be subject to disciplinary action from the warning, the relocation, the exclusion or suspension of the employment. A culture of blame has been described by the search for a culprit in the institution. Within the CSSS, the Other is perceived as being the source of contamination, while the Self is seen as free from any risk from the moment the nurse respects the standards of hygiene of life in terms of healthy dietary habits and physical activity. In addition, nurses must respect the PIC standards they know little, since the research participants noted the lack of academic and continuous training concerning infectious diseases, biological hazards and safety culture that they consider prioritized by their health institution. Power produces effects on the bodies by modifying them. This ethnographic study criticizes, made it possible to raise the sociopolitic stakes connected to the involved speeches and to clarify what Foucault called the government of the bodies and his effects which are capillaries in the nurse’s daily normalities. Further researches are necessary to explore this nursing speciality and to link academic and continuous training to clinical infectious realities.