Abstract

The article discusses the current problems of preventing of health care-associated infections (HAIs) that arise at the present stage, in particular the spread of antibiotic resistance. It is noted that at present, in terms of reducing the risk of development of resistance of pathogenic microorganisms, it is necessary to take into account the phenomenon of bacterial antibiotic tolerance, which is associated with a decrease in the level of metabolism, cessation of cell growth and shutdown of targets for antibiotics. Similar persistent forms (persisters) of microorganisms ensure the survival of the bacterial population, but not reproduction in the presence of lethal doses of antimicrobial agents. This kind of phenotypic resistance is not inherited, associated with such specific forms as growth in biofilms, and its carriers (persisters) are a reservoir of the spread of resistance genes. The article presents modern possibilities of avoiding the accumulation of persistent forms of HAIs pathogens, including the creation of antibiotic compositions and substances that block the adaptive reactions of the microorganism. A separate chapter is devoted to bacteriophages and the possibilities of their use for the therapy and prevention of HAIs. Modern methods of indicating the pathogens of HAIs, existing on the objects of the hospital environment in the form of biofilms, as well as new methodological approaches to the destruction of such biofilms are proposed.

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