Features and directions for the prevention of health care-associated infections at the stage of specialized medical care

Abstract

Microbial contamination of the wound at the stages of medical evacuation is inevitable even if all the rules of asepsis and antiseptics are observed. The development of infectious complications in the wounded and affected surgical profile increases the risk of adverse treatment outcomes. Infectious complications of wounds and injuries prevail at the stage of specialized medical care and are one of the causes of deaths in the late period of complications of injuries. Of the total number of deaths from combined and multiple injuries, 20% die from severe injuries complicated by the development of infection. At hospitalization in a multidisciplinary hospital in patients with surgical profile is a change of wound microflora. Prevention and treatment of infectious complications in combat surgical trauma are the most important tasks of military medicine. The solution of these problems requires the development of modern approaches to the prevention of infections associated with the provision of medical care in the system of stage treatment of the wounded and injured. 2292 samples of clinical material obtained from 640 patients with surgical pathology who were treated in a multidisciplinary hospital were investigated. In the course of the study it was found that in 2016–2017. K. pneumoniae, P. aeruginosa, Enterococcus spp prevailed in the General spectrum of the isolated microorganisms. A. baumanii and S. aureus), whose significance in the development of infections associated with medical care varied in dynamics. The data obtained indicate the variability of the etiological structure of infectious complications in surgical patients of a multidisciplinary hospital. Isolation of microorganisms from individual biotopes and types of clinical material under study makes it possible to predict the formation of microbial resistance to antibacterial drugs.

Keywords

health care-associated infections / specialized medical care / infectious complications / pathogens infections / stages of medical evacuation / epidemiology / microbiological monitoring / patients

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