Infectious Diseases Hospital Research Articles

КЛИНИКО-ЭПИДЕМИОЛОГИЧЕСКИЕ ОСОБЕННОСТИ БОЛЕЗНИ ЛАЙМА В НОВГОРОДСКОЙ ОБЛАСТИ

Lyme disease is the most common vector-borne disease of the forest zone of the Northern hemisphere of the planet, which is characterized by polymorphism of clinical forms of the infectious process. The polysystemic nature of lesions, the complexity of specific diagnosis and the lack of information to the public and primary care physicians make it difficult to verify the diagnosis and often lead to late diagnosis and the development of irreversible functional disorders. The aim of the study is to study the clinical and epidemiological features of Lyme disease in the Novgorod region. Materials and methods. A retrospective analysis of the epidemic situation in the morbidity of the population of the Novgorod region and a retrospective analysis of the medical histories of hospitalized patients diagnosed with Lyme disease in the Novgorod Regional Infectious Diseases Hospital for the period 2013-2023 were carried out. The results obtained. The high incidence of Lyme disease in the Novgorod region determines a special wariness towards this disease. The number of ticks in nature increases annually (the average number of ticks in nature in 2023 was 1,9 ex/km, and in 2013 – 1,2 ex/km), which is directly related to an increase in the average climatic temperature. Lyme disease is a seasonal disease, and people of retirement age are most often infected. In 90% of cases, patients do not know about the danger of this disease, the possibility of its transition to a chronic form and do not go to medical institutions for specific emergency prevention. The most vulnerable places of tick suction are the abdomen and the inner surface of the shoulder. According to the clinical picture, the erythemic form of the disease prevailed (70,7%), the febrile form (20,3%) and the meningeal form (8,98%) were less common. The majority of patients are admitted to the hospital with early manifestations of the disease by the type of localized erythema. In 94,5% of cases, the diagnosis was confirmed by ELISA, in 8,98% by PCR. In 100% of cases, patients received antibacterial therapy. No complications were detected.

The impact of the COVID-19 pandemic on burnout levels among healthcare workers: A comparative analysis of the pandemic period and post-pandemic period

Emotional burnout among physicians is a serious problem that can affect their health and the quality of medical care. This condition occurs when physicians experience excessive stress and pressure at work, often due to high demands and expectations imposed on them by patients. This study aims to assess the experience and factors associated with emotional burnout among health workers who deal with COVID-19-positive patients. The study population includes employees at the infectious diseases hospital and the inpatient clinical hospital examined using the Maslach Burnout Inventory. The prevalence of high emotional exhaustion among infectious diseases specialists and inpatient physicians was 51.2 ± 3.4 % and 43.3 ± 8.1 %, respectively. The prevalence of high depersonalization was 39.4 ± 7.9 % and 40.5 ± 8.1 %, respectively. Finally, the prevalence of reduced professional efficacy was 26.3 ± 7.1 % and 41.3 ± 8.3 %, respectively. The main burnout contributors were a heavy workload, a high risk of infection, the lack of protective equipment, insufficient social support, constant interaction with suffering patients, and work-life imbalance. To prevent burnout among health workers who deal with COVID-19-positive patients, it is best to create a working environment that is conducive to good physical and mental health, implement stress management courses, and provide employees with enough time for rest and recovery. These preventive measures will help to improve the quality of health care. The findings of the study can be utilized for the development of support programs for healthcare professionals, improvement of working conditions, and reduction of the risk of emotional burnout.

Pulmonary Tuberculosis Diagnosis Using an Intelligent Microscopy Scanner and Image Recognition Model for Improved Acid-Fast Bacilli Detection in Smears.

Microscopic examination of acid-fast mycobacterial bacilli (AFB) in sputum smears remains the most economical and readily available method for laboratory diagnosis of pulmonary tuberculosis (TB). However, this conventional approach is low in sensitivity and labor-intensive. An automated microscopy system incorporating artificial intelligence and machine learning for AFB identification was evaluated. The study was conducted at an infectious disease hospital in Jiangsu Province, China, utilizing an intelligent microscope system. A total of 1000 sputum smears were included in the study, with the system capturing digital microscopic images and employing an image recognition model to automatically identify and classify AFBs. Referee technicians served as the gold standard for discrepant results. The automated system demonstrated an overall accuracy of 96.70% (967/1000), sensitivity of 91.94% (194/211), specificity of 97.97% (773/789), and negative predictive value (NPV) of 97.85% (773/790) at a prevalence of 21.1% (211/1000). Incorporating AI and machine learning into an automated microscopy system demonstrated the potential to enhance the sensitivity and efficiency of AFB detection in sputum smears compared to conventional manual microscopy. This approach holds promise for widespread application in TB diagnostics and potentially other fields requiring labor-intensive microscopic examination.

Clinical application of whole-genome sequencing in the management of extensively drug-resistant tuberculosis: a case report

BackgroundWhole-genome sequencing (WGS)-based prediction of drug resistance in Mycobacterium tuberculosis has the potential to guide clinical decisions in the design of optimal treatment regimens.MethodsWe utilized WGS to investigate drug resistance mutations in a 32-year-old Tanzanian male admitted to Kibong’oto Infectious Diseases Hospital with a history of interrupted multidrug-resistant tuberculosis treatment for more than three years. Before admission, he received various all-oral bedaquiline-based multidrug-resistant tuberculosis treatment regimens with unfavourable outcomes.ResultsDrug susceptibility testing of serial M. tuberculosis isolates using Mycobacterium Growth Incubator Tubes culture and WGS revealed resistance to first-line anti-TB drugs, bedaquiline, and fluoroquinolones but susceptibility to linezolid, clofazimine, and delamanid. WGS of serial cultured isolates revealed that the Beijing (Lineage 2.2.2) strain was resistant to bedaquiline, with mutations in the mmpR5 gene (Rv0678. This study also revealed the emergence of two distinct subpopulations of bedaquiline-resistant tuberculosis strains with Asp47f and Glu49fs frameshift mutations in the mmpR5 gene, which might be the underlying cause of prolonged resistance. An individualized regimen comprising bedaquiline, delamanid, pyrazinamide, ethionamide, and para-aminosalicylic acid was designed. The patient was discharged home at month 8 and is currently in the ninth month of treatment. He reported no cough, chest pain, fever, or chest tightness but still experienced numbness in his lower limbs.ConclusionWe propose the incorporation of WGS in the diagnostic framework for the optimal management of patients with drug-resistant and extensively drug-resistant tuberculosis.

The Impact of Long COVID on the Quality of Life.

Background and Objectives: The term long COVID refers to patients with a history of confirmed COVID-19 infection, who present symptoms that last for at least 2 months and cannot be explained by another diagnosis. Objectives: The present study aims to determine the most common symptoms of the long COVID syndrome and their impact on the quality of life. Materials and Methods: A prospective observational study was conducted on patients diagnosed with mild and moderate COVID-19 (based on a positive SARS-CoV-2 molecular diagnostic or rapid antigen test and severity form definition) at the Clinical Hospital of Infectious Diseases, Cluj-Napoca, Romania. Clinical examinations with detailed questions about symptoms were performed at the time of the diagnosis of COVID-19 and the six-month follow-up. Two years after COVID-19 infection, patients were invited to complete an online quality-of-life questionnaire regarding long COVID symptoms. Results: A total of 103 patients (35.92% males) with a mean age of 41.56 ± 11.77 were included in this study. Of the total number of patients, 65.04% presented mild forms of COVID-19. Data regarding the vaccination status showed that 83.5% were vaccinated against SARS-CoV-2. The most common symptoms at diagnosis were cough (80.6%), fatigue (80.4%), odynophagia (76.7%), and headaches (67.6%), with female patients being statistically more likely to experience it (p = 0.014). Patients with moderate forms of the disease had higher levels of both systolic (p = 0.008) and diastolic (p = 0.037) blood pressure at diagnosis, but no statistical difference was observed in the 6-month follow-up. The most common symptoms at 2 years (in 29 respondent subjects) were represented by asthenia (51.7%), headache (34.5%), memory disorders (27.6%), abdominal meteorism (27.6%), and arthralgia (27.6%). In terms of cardiovascular symptoms, fluctuating blood pressure values (20.7%), palpitations (17.2%), and increased heart rate values (17.2%) were recorded. Conclusions: If at the time of diagnosis, the most frequent manifestations of the disease were respiratory, together with headache and fatigue, at re-evaluation, asthenia, decreased effort tolerance, and neuropsychiatric symptoms prevailed. Regarding the cardiovascular changes as part of the long COVID clinical picture, some patients developed prehypertension, palpitations, and tachycardia.

Role and benefits of infectious diseases specialists in the COVID-19 pandemic: Multilevel analysis of care provision in German hospitals using data from the Lean European Open Survey on SARS-CoV-2 infected patients (LEOSS) cohort.

This study investigates the care provision and the role of infectious disease (ID) specialists during the coronavirus disease-2019 (COVID-19) pandemic. A survey was conducted at German study sites participating in the Lean European Open Survey on SARS-CoV-2 infected patients (LEOSS). Hospitals certified by the German Society of Infectious diseases (DGI) were identified as ID centers. We compared care provision and the involvement of ID specialists between ID and non-ID hospitals. Then we applied a multivariable regression model to analyse how clinical ID care influenced the mortality of COVID-19 patients in the LEOSS cohort. Of the 40 participating hospitals in the study, 35% (14/40) were identified as ID centers. Among those, clinical ID care structures were more commonly established, and ID specialists were always involved in pandemic management and the care of COVID-19 patients. Overall, 68% (27/40) of the hospitals involved ID specialists in the crisis management team, 78% (31/40) in normal inpatient care, and 80% (28/35) in intensive care. Multivariable analysis revealed that COVID-19 patients in ID centers had a lower mortality risk compared to those in non-ID centers (odds ratio: 0.61 (95% CI 0.40-0.93), p = 0.021). ID specialists played a crucial role in pandemic management and inpatient care.

Construction and validation of a predictive model of mortality of tuberculosis-destroyed lung patients requiring mechanical ventilation: A single-center retrospective cohort study.

The mortality rate for intensive care unit tuberculosis-destroyed lung (TDL) patients requiring mechanical ventilation (MV) remains high. We conducted a retrospective analysis of adult TDL patients requiring MV who were admitted to the intensive care unit of a tertiary infectious disease hospital in Chengdu, Sichuan Province, China from January 2019 to March 2023. Univariate and multivariate COX regression analyses were conducted to determine independent patient prognostic risk factors that were used to construct a predictive model of patient mortality. A total of 331 patients were included, the median age was 63.0 (50.0-71.0) years, 262 (79.2%) were males and the mortality rate was 48.64% (161/331). Training and validation data sets were obtained from 245 and 86 patients, respectively. Analysis of the training data set revealed that body mass index <18.5 kg/m2, blood urea nitrogen ≥7.14 mmol/L and septic shock were independent risk factors for increased mortality of TDL patients requiring MV. These variables were then used to construct a risk-based model for predicting patient mortality. Area under curve, sensitivity, and specificity values obtained using the model for the training data set were 0.808, 79.17%, and 68.80%, respectively, and corresponding values obtained using the validation data set were 0.876, 95.12%, and 62.22%, respectively. Concurrent correction curve and decision curve analyses confirmed the high predictive ability of the model, indicating its potential to facilitate early identification and classification-based clinical management of high-risk TDL patients requiring MV.

Assessing molecular genetic and immunological predictors of COVID-19 course in healthcare worker risk group

Relevance. Studying features of innate and adaptive mechanisms of immune response in medical workers (MW), the most vulnerable social group with a high risk of infection, is an urgent research task. The aim of the study: Comprehensive study of innate and adaptive immune mechanisms and analyzing relationships between clinically significant polymorphisms (SNPs) in TLR2, TLR4 genes, TLR2 expression level on peripheral blood monocytes, peripheral blood cytokine profile (IL-1β, IL-10, IL-6, IFNγ, platelet activation marker) and SARS-CoV-2-specific humoral immune response in medical workers (MW) at a temporary infectious disease hospital in early and late COVID-19 convalescence. Materials and methods. immunologic, cytofluorimetric and molecular-genetic research methods were applied. Adaptive immune response in medical workers — COVID-19 convalescent subjects. Results. Early post-COVID-19 convalescence period in MW was linked to higher TLR2 monocyte expression; the mean fluorescence intensity was significantly elevated by 1.5-fold compared to control group. Late convalescence period (7 months post-COVID-19) was characterized by lowered serum IFNγ level. A decline in IFNγ production was significant: decreased by 82-fold in MR that was markedly stronger compared to control group (59 times). The imbalance of cytokines controlling antiviral innate and adaptive immune response was revealed in MW with identified combination of polymorphisms rs5743708 and rs4986790 in TLR2, TLR4 genes with the rate not exceeding 6.7%. It was found that 7 months after COVID-19 there was a markedly decreased IFNγ, IL-1β and IL-10 levels. The studies indicate both altered innate and adaptive immune mechanisms and a need to optimize therapeutic and prophylactic measures aimed at increasing patient-intrinsic resistance, protection of respiratory tract mucosal barriers and identification of genetic predictors of defects in innate and adaptive immune response in medical workers — COVID-19 convalescent subjects.

Prognostic Utility of dNLR, ALRI, APRI, and SII in COVID-19 Patients with Diabetes: A Cross-Sectional Study.

The coronavirus disease 2019 (COVID-19) pandemic has necessitated the identification of biomarkers that can predict disease severity, particularly in vulnerable populations such as individuals with diabetes. This study aims to evaluate the predictive value of inflammatory and liver function markers, specifically derived Neutrophil to Lymphocyte Ratio (dNLR), aspartate aminotransferase (AST)-to-lymphocyte ratio (ALRI), AST to Platelet Ratio Index (APRI), and Systemic Inflammation Index (SII), in COVID-19 patients with and without diabetes. This cross-sectional study included 336 participants, comprising 168 patients with diabetes matched with 168 without, based on gender, body mass index (BMI), and COVID-19 severity at hospitalization. The study was conducted at Victor Babes Hospital for Infectious Diseases and Pulmonology from January 2021 to December 2023. All participants had a confirmed SARS-CoV-2 infection and met the inclusion criteria of being 18 years or older with type 1 or type 2 diabetes as per American Diabetes Association guidelines. At 3 days post symptom onset, significant differences in inflammatory and liver function markers were observed between the two groups. The dNLR, ALRI, APRI, and SII were notably higher in diabetic patients. At a dNLR cutoff of 2.685, the sensitivity and specificity were 70.312% and 65.978%, respectively, with an AUC of 0.624 (p < 0.001). The ALRI showed a cutoff of 0.812, with a sensitivity of 76.429% and specificity of 69.541% (AUC 0.752, p < 0.001). These markers demonstrated statistically significant hazard ratios at both 3 and 7 days, indicating their predictive relevance for severe COVID-19 outcomes. For instance, at 7 days, SII demonstrated a hazard ratio of 2.62 (CI: 1.29-5.04, p < 0.001), highlighting its strong prognostic capability. The study successfully identified significant differences in inflammatory and liver function markers between COVID-19 patients with and without diabetes, with these markers showing good predictive value for disease severity. The results underscore the potential of these biomarkers, particularly ALRI and SII, as valuable tools in managing COVID-19, aiding in the timely identification of patients at increased risk of severe outcomes.

Potential healthcare resource use and associated costs of every 2 month injectable cabotegravir plus rilpivirine long-acting regimen implementation in the Spanish National Healthcare System compared to daily oral HIV treatments

IntroductionHIV treatment currently consists of daily oral antiretroviral therapy (ART). Cabotegravir + rilpivirine long-acting (CAB + RPV LA) is the first ART available in Spain administered every 2 months through intramuscular injection by a healthcare professional (HCP). The objective of this analysis was to assess potential healthcare resource use (HRU) and cost impact of implementing CAB + RPV LA vs. daily oral ART at National Health System (NHS) hospitals.MethodsOnline quantitative interviews and cost analysis were performed. Infectious disease specialists (IDS), hospital pharmacists (HP) and nurses were asked about their perception of potential differences in HRU between CAB + RPV LA vs. daily oral ART, among other concepts of interest. Spanish official tariffs were applied as unit costs to the HRU estimates (€2022).Results120 responders (n = 40 IDS, n = 40 HP, n = 40 nurses) estimated an average number of annual visits per patient by speciality (IDS, HP, and nurse, respectively) of 3.3 vs. 3.7; 4.4 vs. 6.2; 6.1 vs. 3.9, for CAB + RPV LA vs. daily oral ART, and 3.0 vs. 3.2; 4.8 vs. 5.8; 6.9 vs. 4.9, respectively when adjusting by corresponding specialist responses. Estimation by the total sample led to an annual total cost per patient of €2,076 vs. €2,473, being €2,032 vs. €2,237 after adjusting by corresponding HCP, for CAB + RPV LA vs. daily oral ART.ConclusionsThese results suggest that the implementation of CAB + RPV LA in NHS hospitals would not incur in increased HRU-related costs compared to current daily oral ARTs, being potentially neutral or even cost-saving.

Cardiovascular Risk Assessment in Young HIV Patients from Constanţa County, Romania, Using Cardiovascular Risk Scores

Abstract HIV/AIDS remains one of the greatest global health challenges, affecting millions of people worldwide. Realizing the seriousness of the situation, various strategies were designed and implemented, aiming to mitigate the impact of the disease and, finally, to eradicate it. Although these strategies have produced remarkable progress over time, a new category is emerging, the aging population with HIV. Cardiovascular pathology is increasingly common in young population with HIV infection, aged due to the presence of this virus and the antiretroviral therapy instituted for decades. Cardiovascular risk scores are useful for the general population, but for HIV patients, they need to be adapted. The aim of this study was to evaluate cardiovascular risk scores used in HIV patients from Dobrogea regional center, in the records of the Clinical Hospital of Infectious Diseases in Constanța.

The immun function of dendritic cells in SFTS patients

ObjectivesSevere fever with thrombocytopenia syndrome (SFTS) is a newly emerging infectious disease caused by a novel bunyavirus in which host immune system suppression is thought to be crucial in disease development. Dendritic cells (DCs) are professional antigen-presenting cells (APCs) critical for initiation and orchestration of the immune response. And it have been suggested that functionally impaired DCs may mediate the suppression of host-specific T-cell immune responses and thus facilitate viral persistence and disease progression.This study was designed to improve the in vitro culture method for DCs and investigate the different immunologic functions of DCs between SFTS patients and healthy people. MethodsAll confirmed SFTS patients (N = 10) were recruited from the Jinan Infectious Diseases Hospital in 2019; routine laboratory parameters were collected. The frequencies, phenotypes were analyzed by flow cytometry. And the levels of 8 cytokines in the cell culture supernatant were detected by flow cytometry. ResultsOn day 8 of the incubation period, cells were harvested and analyzed by flow cytometry. There were significant differences in the rates of CD1a-, CD83-positive cells between SFTS patients and healthy people (all P < 0.05). The detection of 8 cytokines in the culture supernatant showed that the expressions of IFN-α and IFN-γ in the culture supernatant of DC cells in SFTS patients were lower than those in normal people (P < 0.05, P < 0.01). ConclusionsThe present results indicate that DCs may be functionally impaired in SFTS. A decreased level of circulating mDCs was closely correlated with SFTS progression.

Risk factors associated with influenza A (H1N1)pdm09: a nested case control study of TB patients with ILI in Lahore District, Pakistan

BackgroundCo-morbidity with respiratory viruses including influenza A, cause varying degree of morbidity especially in TB patients compared to general population. This study estimates the risk factors associated with influenza A (H1N1)pdm09 in TB patients with ILI.MethodsA cohort of tuberculosis (TB) patients who were admitted to and enrolled in a TB Directly Observed Therapy Program (DOTs) in tertiary care hospitals of Lahore (Mayo Hospital and Infectious Disease Hospital) were followed for 12 weeks. At the start of study period, to record influenza-like illness (ILI), a symptom card was provided to all the participants. Every participant was contacted once a week, in person. When the symptoms were reported by the participant, a throat swab was taken for the detection of influenza A (H1N1)pdm09. A nested case control study was conducted and TB patients with ILI diagnosed with influenza A (H1N1)pdm09 by conventional RT-PCR were selected as cases, while those who tested negative by conventional RT-PCR were enrolled as controls. All cases and controls in the study were interviewed face-to-face in the local language. Epidemiological data about potential risk factors were collected on a predesigned questionnaire. Logistic analysis was conducted to identify associated risk factors in TB patients with ILI.ResultsFrom the main cohort of TB patients (n = 152) who were followed during the study period, 59 (39%) developed ILI symptoms; of them, 39 tested positive for influenza A (H1N1)pdm09, while 20 were detected negative for influenza A (H1N1)pdm09. In univariable analysis, four factors were identified as risk factors (p < 0.05). The final multivariable model identified one risk factor (sharing of towels, P = 0.008)) and one protective factor (wearing a face mask, p = < 0.001)) for influenza A (H1N1)pdm09 infection.ConclusionThe current study identified the risk factors of influenza A (H1N1)pdm09 infection among TB patients with ILI.

The Retrospective Implementation of Standardized In Utero HIV Exposure Definitions Using Routinely Collected Public Sector Data Across the Western Cape Province, South Africa.

Using the Data Evaluation and Preparation for HIV-Exposed Uninfected Child Cohorts project's standardized child HIV exposure definitions, 64%, 64% and 90% of children exposed to HIV in utero could be classified as HIV-uninfected with moderate or high certainty at the ages of 1 and 3 years and at the time of first infectious disease hospitalization, respectively. These definitions can be applied retrospectively to routine datasets with linked mother-child data.

Detection and type identification of non-polio enteroviruses in children against the background of acute intestinal infections of various etiologies: 2018–2023

Introduction. Enteroviruses (EV) are characterized by: species and type diversity, polymorphism of clinical manifestations, a tendency to epidemic spread, and are often the cause of disease outbreaks, which determines the relevance of monitoring EV strains in various clinical forms of infection, including in conditions of anti-epidemic measures. The aim of the study: to characterize the prevalence and diversity of non-polio enteroviruses (NPEV) types in children with acute intestinal infection (AII) in the period 2018–2023, including the COVID-19 pandemic. Materials and methods. The RT-PCR method was used to study 7302 samples of feces from children hospitalized with a diagnosis of AII in the infectious diseases hospital of Nizhny Novgorod. Genotyping of EV strains was carried out using fragment Sanger sequencing of the genome region encoding capsid protein 1 (VP1) and the online resource BLAST. Results. EVs were found in 5.0 ± 0.3% (1.7–7.8%), both in mono- and mixed infections with other enteric viruses. The long-term dynamics of the frequency of EV detection and the incidence of EV infection in children in the Nizhny Novgorod region was characterized by a sharp decrease in indicators in 2020 against the backdrop of the introduction of anti-epidemic measures. When genotyping 299 strains, 41 types of NPEV of 4 species were identified. The spectrum included the main pathogens of exanthema and neuroinfections and rare types found in “minor” or intestinal forms of infection. During the study period, a redistribution of NPEV species was established. Before the pandemic, the ratio of Enterovirus A : Enterovirus B : Enterovirus C species was as follows — 41.0 : 46.7 : 12.3%; during the 2020 pandemic season the ratio was 0.0 : 37.5 : 62.5%; after the lifting of restrictive measures — 47 : 29 : 23%, which may be due to the different effectiveness of the restrictive measures on the mechanisms of transmission of EVs of different types. Conclusion. The genetic diversity of NPEVs detected in children with AII complements information on the typical composition of the territorial enterovirus population. In children with AII, when the airborne transmission of SARS-CoV-2 was blocked, there was a decrease in the frequency of detection of viruses of the Enterovirus B type, the absence of detection of Enterovirus A and the constant presence of Enterovirus C.

Analysis of Drinking Water Quality among Employees of Sulianti Saroso Infectious Disease Hospital

Drinking water is water through or without processing that meets health requirements and can be drunk directly. The aim of the study is to check the quality of drinking water for employees of Sulianti Saroso Infectious Disease Hospital (SSIDH) so that it is suitable or not for consumption in accordance with established quality standards. Drinking water sampling is carried out twice a year with a sampling point of 8 (eight) samples at every 6 (six) months. Based on the results of physical tests, namely smell, turbidity, taste, temperature, total dissolved solids, and color, it shows that the employee's drinking water has met the quality standards according to applicable regulations. Chemical drinking water quality requirements show pH concentrations ranging from 7.22 – 8 and other parameters including organic substances have met the quality standard requirements. Biological test results show the bacteriological quality of drinking water Total Coliform and Escherichia Coli is 0 according the required quality standard of 0 per 100 ml. The quality of drinking water for employees of RSPI Prof. Dr. Sulianti Saroso based on the results of laboratory examinations shows 100% of samples meet the requirements in accordance with the drinking water quality standard.

Assessment of the level of herd immunity to measles virus, chickenpox and hepatitis B among medical workers in an infectious diseases hospital

Herd immunity is formed through vaccination in a certain group of people, the purpose of which is to prevent infection and spread of infectious diseases. Thanks to vaccination, the incidence of some infections has decreased several times, especially among risk groups. We consider medical personnel who are in constant contact with patients of various diseases to be one of the risk groups. The study analyzed data from 250 employees of an anti-tuberculosis dispensary, among whom the proportion of women was 86.0 %. The mean age was 51 ± 7.8 years. Among those surveyed, the share of doctors was 16.4 %, paramedical personnel — 37.2 %, junior medical personnel — 24.0 %, general non-medical personnel — 22.4 %. A selection was made from medical documentation on vaccination of dispensary employees (sanitary records, extracts from outpatient cards, vaccination certificates). The data was entered into the database, analysis was carried out using licensed software version Statistica 13. The purpose of our study was to study collective immunity against measles, chickenpox and viral hepatitis B among employees of an anti-tuberculosis hospital. All employees were found to have high titers of post-vaccination immunity to measles (3.1±4.1 IU/ml) and chickenpox (9.1±0.8 mIU/ml). Post-vaccination immunity to hepatitis B differed among those examined. 18.1 % of employees did not have postvaccination protective antibodies. In 16.4 %, the level of anti-HBsAg was low, which made it possible to immediately formulate and carry out revaccination against viral hepatitis B among these employees. In the majority of medical personnel, the titer of anti-HBs was sufficient. Preventive measures and high-quality work of epidemiologists are an extremely important link in the work of all medical institutions. Where the infection spreads spontaneously, where human will does not interfere, the level and collective susceptibility of the population are the main limiting factors of the epidemic process.

Comparison of the Psychological Impact of COVID-19 on Healthcare Workers between 2022 and 2023 in a Romanian COVID-19 Hub Hospital

We assessed depression, anxiety, and stress in healthcare workers (HCWs) in 2023 and the evolution of depression in 2023 compared with 2022. In September–November 2023, 181 HCWs from the Infectious Diseases Hospital, Cluj-Napoca, Romania, completed the Depression, Anxiety, and Stress 21 Scale (DASS-21 R), the Patient Health Questionnaire 9 (PHQ-9), and the Hamilton Anxiety Rating Scale (HAM-A). The prevalence of moderate-to-severe levels was 13.8% for DASS-Depression, 18.8% for DASS-Anxiety, 16.1% for DASS-Stress, 19.9% for PHQ-9, and 18.2% for HAM-A. Moderate-to-severe PHQ-9 depression was significantly lower in the 2023 study group (19.9%, N = 181) compared with 2022 (30.6%, N = 114) (p = 0.04), also within the 2022–2023 follow-up participants (N = 88) (p = 0.03). We did not find significant statistical differences between those infected vs. non-infected, vaccinated vs. non-vaccinated, or working with vs. not working with SARS-CoV-2 infected patients. Males were significantly more stressed (p = 0.02) and anxious (p = 0.03), and physicians in training had the highest prevalence of moderate-to-severe depression (31.6%), followed by physicians (25.6%). In 2023, depression, anxiety, and stress symptoms decreased but remained within a concerning range. By addressing these psychological issues, we may reduce the possibility of medical errors and prevent professional crises in the healthcare system.

Factors Determining Adherence to Hand Antisepsis by Healthcare Workers during Pandemic Infection Spread (as exemplified by COVID­-19)

Relevance. The healthcare personnel’s adherence to hand antisepsis is а pressing problem during any epidemic outbreak. In the context of high biological hazards, the possibility of performing proper antiseptic procedures is reduced while nosocomial pathogen transmission and healthcare-associated infection (HAI) rate growth are promoted. Aims. Studying the factors determining the healthcare workers’ adherence to hand antisepsis during a pandemic infection spread (as exemplified by COVID-19). Materials and methods. The study was conducted during the entire COVID-19 pandemic. To estimate the rate of adherence rate by the healthcare personnel to hand hygiene, we conducted an anonymous questionnaire survey of the staff in infectious disease hospitals (2021–2022) as well as assessed the viral and bacterial contamination rates of the personnel’s hands and the hospital environment items (2021–2023). Epidemiological (descriptive-evaluation), bacteriological (conventional culture, AMR determination using a VITEK2 analyzer), molecular biological (RT-PCR, Sanger sequencing) and statistical (a questionnaire survey, building machine learning models) methods were used in the study. Results. Based on the results of the survey, the main factors influencing the formation of attitudes towards antiseptics among the staff of medical organizations with medical and non-medical education were identified. It was found that the pandemic spread of infections negatively affects the level of contamination of the hands of infectious diseases hospital staff, which amounted to 35.3% of doctors, 28.8% of nurses, and 25% of hospital cleaners. The spectrum of isolated pathogens included viruses (SARS-CoV-2) and opportunistic microorganisms (Enterococcus faecalis, Enterococcus faecium, Pantoea agglomerans, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus, Escherichia coli), including those with a wide profile of antimicrobial resistance. Conclusion. During the COVID-19 epidemic, the rate of adherence to hand antisepsis in the infectious disease hospital was 82.3% in the staff with a medical background and 71.2% in the staff without one. The results confirm the significant role of staff hands in the in-hospital transmission of dangerous pathogens and indicate the need for systematic monitoring of the level of knowledge on antiseptics among all employees of a medical organization, regardless of specialization and level of education.

New technologies for organizing the work of middle and junior medical personnel

The article presents new technologies for organizing the work of nursing and junior medical personnel in an infectious diseases hospital. Methods for freeing nurses from functions unusual for them are described, and changes in the content of the activities of a nurse interacting with other departments of a multidisciplinary hospital are given.