RISK ASSESSMENT OF HOSPITAL STRAINS FORMATION AND OCCURRENCE OF HEALTH CARE-ASSOCIATED INFECTIONS AMONG PATIENTS OF A MULTIDISCIPLINARY MEDICAL ORGANIZATION
https://doi.org/10.57256/2949-0715-2023-2-30-36
Abstract
Aim. Risk assessment of the introduction of resistant strains of microorganisms and the formation of their hospital forms in the Clinics of the Irkutsk State Medical University (Clinics of the ISMU)
Materials and methods. To analyze how the level of resistance of microbial strains isolated from patients effect the form of the disease the case histories of patients of the Clinic of the State Medical University for 2022 (n=123) were used.
Bacteriological study of microbial contamination of air and environmental objects in the Clinics of the State Medical University in 2022 using swabs and aspiration method (n = 4523).
Result. When comparing acute and chronic forms of diseases among groups of patients with highly resistant and low resistant strains of microorganisms, a statistically significant difference was found χ2 = 6.2 p<0.012.
In 2022, in the structural subdivisions of the ISMU Clinics, positive results of washings from environmental objects were recorded in only 0.3% (95% CI 0.14 - 0.46) of studies.
In the treatment room of the ENT department of the Clinic of the State Medical University in November 2022, during routine microbiological monitoring, S. aureus, which is resistant to benzylpenicillin, was isolated once. Microbiological study of biomaterial from patients of the ENT department who were hospitalized in the same period showed the presence of S. aureus which has identical resistance to antibiotics in one patient.
The maximum level of resistance was registered in S. epidermidis, isolated from the biomaterial from the patient of the otorhinolaryngological department, and amounted to 88.9%.
Conclusion. Chronic forms of diseases are associated with the presence of highly resistant strains of microorganisms in a patient. Given the constant circulation of resistant pathogens among patients, there is a risk of introduction and formation of hospital clones of microorganisms in medical organizations.
About the Authors
Natalya Yu. Alekseeva
Irkutsk State Medical University
Ivan D. Zarva
Irkutsk State Medical University
References
1. Брико Н.И., Брусина Е.Б., Зуева Л.П. и др. Эпидемиологическая безопасность-важнейшая составляющая обеспечения качества и безопасности медицинской помощи. Вестник Росздравнадзора. 2014;(3):27-32. [Briko N.I., Brusina E.B., Zueva L.P. et al. Epidemiological safety is the most important component of ensuring the quality and safety of medical care. Bulletin of Roszdravnadzor 2014;(3):27-32. (in Russian)]
2. Покровский В.И., Акимкин В.Г., Брико Н.И. и др. Национальная концепция профилактики инфекций, связанных с оказанием медицинской помощи и информационный материал по ее положениям. Нижний Новгород: Ремедиум Приволжье; 2012. [Pokrovsky V.I., Akimkin V.G., Briko N.I. et al. National concept for the prevention of infections associated with the provision of medical care and information material on its provisions. Nizhny Novgorod: Remedium Privolzhye; 2012. (in Russian)]
3. World Health Organization. (2022). Global report on infection prevention and control. World Health Organization. URL: https://apps.who.int/iris/handle/10665/354489 [date of access: 30.03.2023].
4. Алексеева Н.Ю., Зарва И.Д. К вопросу о продолжительности выделения SARS-CoV-2 после перенесенного заболевания новой коронавирусной инфекции (на примере сотрудников клиник ФГБОУ ВО ИГМУ Минздрава России). Система менеджмента качества: опыт и перспективы. 2022;(11):278-281 [Alekseeva N.Y., Zarva I.D. On the issue of the duration of isolation of SARS-CoV-2 after the disease of a new coronavirus infection (on the example of employees of the clinics of the State Medical University of the Russian Ministry of Health). Quality management system: experience and prospects. 2022;(11):278-281 (in Russian)]
5. Suetens C, Latour K, Kärki T, et al. Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017. Euro Surveill. 2018;23(46):1800516. DOI:10.2807/1560-7917.ES.2018.23.46.1800516
6. СанПиН 3.3686-21 «Санитарно-эпидемиологические требования по профилактике инфекционных болезней». 2021 [SanPiN 3.3686-21 «Sanitary and epidemiological requirements for the prevention of infectious diseases». 2021 (in Russian)] URL: https://base.garant.ru/400342149/ [date of access: 30.03.2023].
7. Методические указания МУК 4.2.2942-11 «Методы санитарно-бактериологических исследований объектов окружающей среды, воздуха и контроля стерильности в лечебных организациях». М.: Федеральный центр гигиены и эпидемиологии Роспотребнадзора; 2011. [Guidelines MUK 4.2.2942-11 «Methods of sanitary and bacteriological studies of environmental objects, air and sterility control in medical organizations». Moscow: Federal Center for Hygiene and Epidemiology of Rospotrebnadzor; 2011. (in Russian)]
8. Методические указания МУ 3.5.1.3439-17 «Оценка чувствительности к дезинфицирующим средствам микроорганизмов, циркулирующих в медицинских организациях». М.: Федеральный центр гигиены и эпидемиологии Роспотребнадзора; 2017. [Guidelines MU 3.5.1.3439-17 «Assessment of sensitivity to disinfectants of microorganisms circulating in medical organizations» Moscow: Federal Center for Hygiene and Epidemiology of Rospotrebnadzor; 2017. (in Russian)]
9. Mirghani R, Saba T, Khaliq H, et al. Biofilms: Formation, drug resistance and alternatives to conventional approaches. AIMS Microbiol. 2022;8(3):239-277. DOI:10.3934/microbiol.2022019
10. Козлов Р.С. Селекция резистентных микроорганизмов при использовании антимикробных препаратов: концепция "параллельного ущерба" Клиническая микробиология и антимикробная химиотерапия. 2010;(12):284-294 [Kozlov R.S. Selection of resistant microorganisms using antimicrobials: the concept of "parallel damage" Clinical microbiology and antimicrobial chemotherapy. 2010;(12):284-294 (in Russian)].
11. Профилактика инфекций области хирургического вмешательства. Клинические рекомендации. Н. Новгород: Изд-во «Ремедиум Приволжье»; 2018. [Prevention of infections in the area of surgical intervention. Clinical guidelines. Nizhny Novgorod: Remedium Privolzhye Publishing House; 2018 (in Russian)]. DOI 10.21145/Clinical_Guidelines_NASKI_2018.
Review
For citations:
Alekseeva N.Yu., Zarva I.D. RISK ASSESSMENT OF HOSPITAL STRAINS FORMATION AND OCCURRENCE OF HEALTH CARE-ASSOCIATED INFECTIONS AMONG PATIENTS OF A MULTIDISCIPLINARY MEDICAL ORGANIZATION. Baikal Medical Journal. 2023;2(2):30-36. (In Russ.) https://doi.org/10.57256/2949-0715-2023-2-30-36
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