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 (1824 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.
Highlights
Одной из актуальных проблем современного здравоохранения является профилактика инфекций, связанных с оказанием медицинской помощи (ИСМП) [2]
Modern clinical medicine and surgery problems are associated with infections complications after medical care
made substantial progress related to the new organizational approaches
Summary
Современной проблемой клинической медицины и в большей степени хирургии являются инфекции, связанные с оказанием медицинской помощи. Клинические закономерности развития инфекций, связанных с оказанием медицинской помощи при тяжелых травмах, заключаются в возможности последовательного и параллельного развития как в разные, так и в одинаковые сроки местных, висцеральных и генерализованных инфекционных осложнений с преобладанием сочетанных форм у пациентов хирургического стационара с высоким риском внутрибольничного инфицирования на фоне действия факторов лечебно-диагностического процесса и госпитальной среды, заноса возбудителей. Микробиологический мониторинг в диагностике инфекционных осложнений у пациентов с тяжелыми травмами и эпидемиологическом надзоре за инфекциями, связанными с оказанием медицинской помощи позволяет выявлять возбудителей, способных становиться ведущими патогенами, образовывать. Опыт применения микробиологических методов исследований при инфекционных осложнениях тяжелых травм // Инфекция и иммунитет.
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