MICROBIOLOGICAL METHODS APPLICATION EXPERIENCE IN THE SEVERE INJURIES INFECTIOUS COMPLICATIONS

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Abstract

Modern clinical medicine and surgery problems are associated with infections complications after medical care. In recent years, surgery has made substantial progress related to the new organizational approaches and medical technology specialized medical care to the wounded and injured. However, these gains are offset by a high rate of infectious complications that require finding effective measures emerging infectious complications timely diagnosis and their prevention. Clinical manifestations are often nosocomial in patients with severe injuries and are largely determined by the influence of clinical and pathogenetic risk factors. Such infectious complications require a comprehensive assessment, including microbiological testing. The main causative agents of infectious complications in surgical hospitals are S. aureus, K. pneumoniae, P. aeruginosa, Acinetobacter spp., which can cause bloodstream infections, soft tissue, respiratory and urinary tract infections, especially in debilitated and immunocompromised patients and patients in intensive care units. These micro organisms are dangerous to patients and medical staff, as they can survive for a long time in the hospital environment, as well as to spread from patient to patient in violation of isolation restrictive measures and requirements for hygiene of medical workers hands. Clinical patterns of infection associated with medical care for severe injuries are to the possibility of serial and parallel development, both in different and in the same time frame of local, visceral and generalized infection with prevalence of combined forms of patients surgical hospital with a high risk of nosocomial infection against the background of factors, diagnostic and treatment process and hospital environment, introduction of the agent. Early etiological diagnosis allows timely assign empirical causal treatment and arrange for infection control to prevent the spread of microorganisms in the hospital. The use of chromogenic (fluorogenic) environments in the study samples of clinical material at the stage of primary seeding makes it possible to obtain rapid response (18–24 h). Microbiological monitoring in the diagnosis of infectious complications in patients with severe injuries and epidemiological surveillance for infections associated with medical care can detect agents capable of becoming the leading pathogens, form stable intra and inter group associations and change the nature of the infection on persistence type superinfection and reinfection, as well as the features of the multi year and intra change frequency allocation pathogens.

About the authors

S. A. Svistunov

Military Medical Academy named after S.M. Kirov, St. Petersburg, Russian Federation

Email: svistunoww@rambler.ru
PhD (Medicine), Senior Lecturer, Department of Epidemiology Россия

A. A. Kuzin

Military Medical Academy named after S.M. Kirov, St. Petersburg, Russian Federation

Email: svistunoww@rambler.ru
PhD, MD (Medicine), Associate Professor, Department of Epidemiology Россия

T. N. Suborova

Military Medical Academy named after S.M. Kirov, St. Petersburg, Russian Federation

Email: svistunoww@rambler.ru
PhD, MD (Biology), Senior Researcher, Lecturer, Department of Microbiology Россия

D. A. Zharkov

Military Medical Academy named after S.M. Kirov, St. Petersburg, Russian Federation

Author for correspondence.
Email: svistunoww@rambler.ru

Lecturer, Department of Epidemiology

Россия

References

  1. Акимкин В.Г., Азаров И.И., Волынков И.О., Бобылев В.А. Основные направления деятельности специалистов медико-профилактического профиля в военных госпиталях // Военно-медицинский журнал. 2015. Т. 336, № 9. С. 11–16. [Akimkin V.G., Azarov I.I., Volynkov I.O., Bobylev V.A. The main directions of activity of specialists of medical and preventive profile in military hospitals. Voenno-meditsinskii zhurnal = Military Medical Journal, 2015, vol. 336, no. 9, pp. 11–16. (In Russ.)]
  2. Брико Н.И. Госпитальная эпидемиология: реальность и перспективы // Поликлиника. 2014. № 3. С. 11–17. [Briko N.I. Hospital epidemiology: reality and perspectives. Poliklinika = Polyclinic, 2014, no. 6, pp. 11–17. (In Russ.)]
  3. Брико Н.И., Брусина Е.Б., Зуева Л.П., Ефимов Г.Е., Ковалишена О.В., Стасенко В.Л., Фельдблюм И.В., Шкарин В.В. Эпидемиологическая безопасность важнейшая составляющая обеспечения качества и безопасности медицинской помощи // Вестник Росздравнадзора. 2014. № 3. С. 27–32. [Briko N.I., Brusina E.B., Zueva L.P., Efimov G.E., Kovalishena O.V., Stasenko V.L., Feldblum I.V., Shkarin V.V. Epidemiological safety is the key component for ensuring quality and safety of medical care. Vestnik Roszdravnadzora = Herald of Roszdravnadzor, 2014, no. 3, pp. 37–32. (In Russ.)]
  4. Габриэлян Н.И., Савостьянова О.А., Горская Е.М., Батыршина Л.Р., Ромашкина Л.Ю., Попцов В.Н., Акимкин В.Г. Эпидемиологическая и микробиологическая характеристика послеоперационного периода у пациентов старшего возраста в кардиохирургии // Эпидемиология и вакцинопрофилактика. 2015. Т. 14, № 5 (84). С. 51–56. Gabrielyan N.I., Savostyanova O.A., Gorskaya E.M., Batirchina L.R., Romashkina L.Yu., Poptsov V.N., Akimkin V.G. The epidemiological and microbiological characteristics of the postoperative period in older patients in cardiac surgery. Epidemiologiya i vaktsinoprofilaktika = Epidemiology and Vaccinal Prevention, 2015, vol. 14, no. 5 (84), pp. 51–56. (In Russ.)]
  5. Гусаров В.Г., Нестерова Е.В., Лашенкова Н.Н., Петрова Н.В., Силаева Н.А., Тертицкая А.Б., Теплых Б.А., Гороховатский Ю.И., Замятин М.Н. Изменение антибиотикорезистентности нозокомиальной микрофлоры: результаты внедрения стратегии контроля антимикробной терапии в многопрофильном стационаре // Эпидемиология и инфекционные болезни. 2015. Т. 20, № 5. С. 11–18. [Gusarov V.G., Nesterova E.E., Lashenkova N.N., Petrova N.V., Silaeva N.A., Tertitskaya A.B., Teplykh B.A., Gorokhovatsky Yu.I., Zamyatin M.N. Change of antibiotic-resistant nosocomial microflora: results of implementation of the strategy for control of antimicrobial treatment in multi speciality in-patient hospital. Epidemiologiya i infektsionnye bolezni = Epidemiology and Infectious Diseases, 2015, vol. 20, no. 5, pp. 11–18. (In Russ.)]
  6. Дубров В.Э., Колтович А.П., Ханин М.Ю., Палтышев И.А., Ивченко Д.Р., Цвигун О.В., Кобрицов Г.П., Герейханов Ф.Г. Особенности хирургического лечения раненых с комбинированными термомеханическими повреждениями конечностей в условиях контртеррористической операции // Военно-медицинский журнал. 2015. Т. 336, № 11. С. 27–37. [Dubrov V.E., Koltovich A.P., Khanin M.Yu., Paltyshev I.A., Ivchenko D.R., Tsvigun O.V., Kobritsov G.P., Gerejkhanov F.G. Especially the surgical treatment of the wounded limb with combined thermomechanical damages in a counter-terrorist operation. Voenno-meditsinskii zhurnal = Military Medical Journal, 2015, vol. 336, no. 11, pp. 27–37. (In Russ.)]
  7. Крыжановская О.А., Лазарева А.В., Чеботарь И.В., Бочарова Ю.А., Маянский Н.А. Спектр антибиотикорезистентности и распространенности ОХА-карбапенемаз среди штаммов Acinetоbacter baumanii, выделенных у пациентов хирургических и реанимационных отделений в Москве // Журнал микробиологии, эпидемиологии и иммунобиологии. 2016. № 1. С. 40–45. [Kryzhanovskaya O.A., Lazareva A.V., Chebotar I.V., Bocharova Yu.A., Mayansky N.A. Spectrum of antibiotic resistance and prevalence of oxa-carbapenemases among acinetobacter baumannii strains, isolated from patients of surgical and reanimation departments in Moscow. Zhurnal mikrobiologii, epidemiologii i immunobiologii = Journal of Microbiology, Epidemiology and Immunobiology, 2016, no. 1, pp. 40–45. (In Russ.)]
  8. Кувшинов К.Э., Рыжман Н.Н., Реутский И.А., Буценко С.А. Внутренний контроль качества медицинской помощи в военно-медицинских организациях // Военно-медицинский журнал. 2015. Т. 336, № 2. С. 4–10. [Kuvshinov K.E., Ryzhman N.N., Reutskij I.A., Butsenko S.A. Internal control of the quality of care in military medical institutions. Voennomeditsinskii zhurnal = Military Medical Journal, 2015, vol. 336, no. 2, pp. 4–10. (In Russ.)]
  9. Мартынова А.М., Ющенко Г.В. Особенности распространения заболеваний, вызванных Acinetobacter spp., в детском многопрофильном стационаре // Эпидемиология и инфекционные болезни. Актуальные вопросы. 2015. № 3. С. 11–15. [Martynova A.M., Yushchenko G.V. Specific Features of the spread of diseases caused by Acinetobacter spp. at a children’s multidisciplinary hospital. Epidemiologiya i infektsionnye bolezni. Aktual’nye voprosy = Epidemiology and Infectious Diseases. Current Items, 2015, no. 3, pp. 11–15. (In Russ.)]
  10. Чефранова Ж.Ю., Казакова Е.Е., Землянский О.А., Башкирев А.А., Аверина Е.А. Эпидемиологический и микробиологический мониторинг за возбудителями инфекций, связанных с оказанием медицинской помощи в условиях многопрофильного стационара // Эпидемиология и инфекционные болезни. Актуальные вопросы. 2015. № 3. С. 16–20. [Chefranova Zh.Yu., Kazakova E.E., Zemlyansky O.A., Bashkirev A.A., Averina E.A. Epidemiological and Microbiological monitoring of the causative agents of healthcare-associated infections at multidisciplinary hospital. Epidemiologiya i infektsionnye bolezni. Aktual’nye voprosy = Epidemiology and Infectious Diseases. Current Items, 2015, no. 3, pp. 16–20. (In Russ.)]
  11. CDC. Core Elements of Hospital Antibiotic Stewardship Programs. Atlanta, GA: US Department of Health and Human Services, 2014.
  12. Fagan R.P., Edwards J.R., Park B.J., Fridkin S.K., Magill S.S. Incidence trends in pathogen specific central line-associated bloodstream infections in US intensive care units, 1990–2010. Infect. Control. Hosp. Epidemiol., 2013, vol. 34, no. 9, pp. 893–899. doi: 10.1086/671724
  13. King C., Garcia Alvarez L., Holmes A., Moore L., Galletly T., Aylin P. Risk factors for healthcare-associated urinary tract infection and their applications in surveillance using hospital administrative data: a systematic review. J. Hosp. Infect., 2012, vol. 82, pp. 219–226. doi: 10.1016/j.jhin.2015.05.004

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Copyright (c) 2017 Svistunov S.A., Kuzin A.A., Suborova T.N., Zharkov D.A.

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