Optimization of Monitoring of Nosocomial Infections in Hospitals of the Republic of North Ossetia–Alania

Abstract

Introduction: Optimization of epidemiological and microbiological monitoring of nosocomial infections at the regional level will contribute to limiting circulation and spread of pathogens and improving preventive measures on the territory of the Russian Federation. Objective: To determine directions of optimization of epidemiological and microbiological monitoring of healthcare-associated infections in surgery departments and intensive care units of hospitals of the Republic of North Ossetia – Alania. Materials and methods: We carried out a retrospective epidemiological analysis of the incidence of nosocomial infections and results of microbiological monitoring conducted in surgery departments and intensive care units of ten multidisciplinary hospitals of the Republic of North Ossetia – Alania in 2015–2019. We also examined data on evaluation of preventive measures, infection control, and compliance with criteria of internal quality control and safety in health care. Results: According to the results of routine surveillance and specially organized epidemiological and microbiological monitoring, the incidence rates of healthcare-associated infections were 0.85 and 26.4 per 1,000 inpatients in surgery departments and intensive care units of hospitals of the Republic of North Ossetia – Alania, respectively. The incidence rates of certain types of nosocomial infections were statistically different (p ≤ 0.05) depending on the type of monitoring (routine/optimized): surgical site infections – 15.9/132.8 per 1,000 surgeries, catheter-associated urinary tract infections – 8.5/69.4 per 1,000 catheter days, central line-associated bloodstream infections – 7.74/89.12 per 1,000 catheter days, and ventilator-associated pneumonia – 8.12/39.74 per 1,000 ventilator days. K. pneumoniae strains isolated from surgery and intensive care patients and exhibiting extreme resistance to antimicrobial drugs belong to sequence type 1082, possess a high pandemic potential, and are widespread in many countries. According to the results of assessing compliance with the criteria of internal quality control and safety of health care, only three of ten hospitals in the Republic of North Ossetia – Alania had the compliance rate ≥ 70 %. As for the readiness for infection prevention and control in surgery departments and intensive care units, 60 % of the hospitals demonstrated a basic level and 40 % – an intermediate level of measures taken. Conclusions: Optimization of approaches to tracing healthcare-associated infections in the hospitals of the Republic of North Ossetia – Alania helped establish that actual incidence rates of nosocomial infections were on the average 26.4 times higher than those officially registered based on the results of routine surveillance.