Analysis of the incidence of newborn's healthcare associated infections and intrauterine infections in several maternity hospitals in Moscow

Laboratory Confirmation ◽

Maternity Hospitals ◽

Significant Difference ◽

The Russian Federation ◽

Healthcare Associated ◽

Intrauterine Infections

Purpose of the study. To estimate the incidence of newborn's healthcare associated infections (HAI) and intrauterine infections in the Russian Federation, Moscow and three maternity hospitals in Moscow. Materials and methods. The retrospective epidemiological analysis of neonates HAIs and intrauterine infections during 2008–2017 was performed in the Russian Federation and Moscow and during 2009–2017 in three maternity hospitals (MH) in Moscow. In this study the maternity hospitals would be known as MH № X01, № X02 and № X03. Also, in this study, the calculation and analysis of the proportion of cases of newborn's HAIs and intrauterine infections with laboratory confirmation were performed in Moscow's maternity hospitals. The data was selected from Form № 2 for the Russian Federation and Moscow. Also, the data of the maternity hospitals was drawn from the base of the Hygiene and Epidemiology Center in Moscow. The morbidity rate of HAIs and intrauterine infections of newborns was counted on 1,000 newborns. Microsoft Office Excel 2010 software packages were used for this purpose. The calculation of the increase / decrease rate was made by the method of least squares. Results. The incidence of intrauterine infections and HAIs of newborns in the Russian Federation, Moscow, and maternity hospitals is characterized by the next mutual trends – a significant dominance cases of intrauterine infections' over the cases of HAI, extremely irregular registration and distribution of the nosologies' proportion. Concerning to the dynamics of morbidity during 2009–2017 in maternity hospitals in Moscow, the HAIs newborn's incidence has tendency of decline, and intrauterine infections has considerable increase of the incidence. This consistent pattern is observed in all described maternity hospitals. The structure of the incidence in maternity hospitals is similar to each other. The leading diagnoses among intrauterine infections are intrauterine infection without a lesion and intrauterine pneumonia. The interest of other infections is about 1%. The proportion of cases with laboratory confirmation of the newborn's HAIs and intrauterine infections is extremely small. Besides that, there were identified some indirect signs of poor-quality registration of nosocomial infections. Conclusion. Significant difference in the number of cases of newborn's HAIs and intrauterine infections and their multidirectional incidence trends, once again point to the concealment of a part of nosocomial infections, under such diagnoses, as intrauterine infection without a lesion and intrauterine pneumonia. Laboratory confirmation of cases of HAIs and intrauterine infections in the maternity hospitals is carried out only by a small proportion of patients. Thereby, the incidence rates of HAIs of newborns and intrauterine infections in maternity hospitals in Moscow raise doubts about their reliability.

Incidence of healthcare-associated infections among puerperas and newborns in Russian Federation

Medical alphabet ◽

10.33667/2078-5631-2021-18-7-11 ◽

2021 ◽

pp. 7-11

Author(s):

O. A. Orlova ◽

Yu. A. Abramov ◽

V. G. Akimkin

Keyword(s):

Russian Federation ◽

Systematic Approach ◽

Economic Damage ◽

Puerperal Sepsis ◽

Quality Of Medical Care ◽

The Russian Federation ◽

Healthcare Associated ◽

Intrauterine Infections

One of the leading problems of modern public health is healthcare-associated infections (HAIs), which lead to significant social and economic damage, and affect the quality of medical care. The proportion of HAIs in obstetric institutions among all the Ministry of Defense of the Russian Federation for 9 years decreased by 1.7 times. The number of puerperas of HAIs decreased by 1.4 times, and HAIs of newborns decreased by 1.6 times. The proportion of puerperal sepsis in the structure of purulent-septic infections of puerperas is 1.7 ± 0.5 %, and sepsis of newborns is 4.4 ± 1.5 %. The average incidence of puerperas of IUPS was 2.0 ± 2.1 per 1,000 births. The incidence of HAIs in newborns was 2.0 ± 1.8 per 1,000 newborns. The ratio of HAIs of newborns to intrauterine infections on average was 1: 9, and in some regions 1:2–1:150. The obtained data on the incidence of HAIs in puerperas and newborns indicates the insufficiency of a systematic approach to recording, analyzing and predicting the incidence of HAIs, which requires a detailed development of standard epidemiological definitions of the case HAIs of puerperas and newborns, intrauterine infections of newborns, as well as a detailed analysis of risk factors for the development of HAIs in obstetric facilities.

Comparative Characteristics of the Incidence of Healthcare-Associated Infections in the Chelyabinsk region and in the Russian Federation in Total

Epidemiology and Vaccinal Prevention ◽

10.31631/2073-3046-2015-14-5-56-61 ◽

2015 ◽

Vol 14 (5) ◽

pp. 56-61 ◽

Cited By ~ 2

Author(s):

O. A. Orlova

Keyword(s):

Health Care ◽

Russian Federation ◽

Prevention And Treatment ◽

Hospital Acquired Pneumonia ◽

The Russian Federation ◽

General Demand ◽

Chelyabinsk Region ◽

Healthcare Associated ◽

Hospital Acquired

Currently, the problem of prevention and treatment of healthcare-associated infections (HAI), only in hospitals from 5 to 20% of patients HAI get sick. In Chelyabinsk region, in comparison with the Russian Federation, the quantity of the infections connected with delivery of health care tends to growth. The greatest number of HAI is registered in hospitals of a surgical profile 70.3 ± 5.7% (in the Russian Federation - 31.4 ± 0.2%). In area hospital-acquired pneumonia steadily holds the first - second place in structure of HAI (38.2 ± 10.3%) in the country - the fourth - fifth (10.1 ± 5.1%). Detection of distinctions in structure of HAI in Chelyabinsk region and in the country in general demand further studying for the purpose of identification and introduction of the most effective preventive and antiepidemic actions.

Healthcare-associated infections (HAI) in maternity hospitals of Russian Federation (the state of the problem at the beginning of the XXI century)

Annals of the Russian academy of medical sciences ◽

10.15690/vramn1523 ◽

2021 ◽

Vol 76 (2) ◽

pp. 133-141

Author(s):

Tatiana V. Priputnevich ◽

Lyudmila A. Lyubasovskaya ◽

Marina P. Shuvalova ◽

Elena N. Baibarina ◽

Gennady T. Sukhikh

Keyword(s):

Russian Federation ◽

Maternity Care ◽

Molecular Genetic ◽

Genetic Diagnostics ◽

Organizational Models ◽

National Medical ◽

Maternity Hospitals ◽

Molecular Genetic Diagnostics ◽

Over the past decade, the healthcare system of the Russian Federation has undergone progressive changes in the system of maternity care, which relate to the development of infrastructure and the introduction of new organizational models. In particular, a three-level system of providing medical care to mothers and children has been created, including a network of perinatal centers for patients at high perinatal and obstetric risk. Field events of specialists of National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov of Ministry of Healthcare of Russian Federation to the medical organizations of maternity care in various regions of Russia revealed hot spots that require primary attention: acute shortage of staff for the implementation of diagnostic and therapeutic measures at the modern methodological level, as well as for ensuring epidemiological safety in the medical organizations (medical microbiologists (bacteriologists), clinical pharmacologists and epidemiologists); the lack of registration of healthcare-associated infections, which is associated with the prevailing in the country mainly punitive methods of combating hospital infections. In modern conditions of nursing preterm babies, newborns with various severe somatic and surgical pathologies, it is necessary to know the real indicators of morbidity in order to reasonably and promptly carry out therapeutic and preventive measures; the need to organize modern microbiological laboratories in the perinatal centers with the availability of fast methods (proteomic and molecular-genetic) diagnostics, allowing for microbiological monitoring in specialized departments of newborns and promptly respond to the changes in the epidemiological situation in the hospital, to prevent the development of clinically pronounced cases of healthcare-associated infections.

Epidemiological features of healthcare associated infection of newborns in the Russian Federation during 2007–2017

Journal Infectology ◽

10.22625/2072-6732-2019-11-3-90-101 ◽

2019 ◽

Vol 11 (3) ◽

pp. 90-101 ◽

Cited By ~ 1

Author(s):

M. V. Ivanova ◽

A. Ya. Mindlina

Keyword(s):

Correlation Analysis ◽

Russian Federation ◽

Incidence Rates ◽

Healthcare Associated Infection ◽

Congenital Infections ◽

Strong Positive Relationship ◽

The Russian Federation ◽

Low Incidence ◽

Objective: to offer additional criteria for assessing registration quality of congenital infections and neonates’ pyoseptic infections. Material and methods: a retrospective epidemiological analysis of congenital infections incidence, pyoseptic infections of puerperas and neonates during 2007–2017 was conducted in this study. All subjects of the Russian Federation were divided into some groups according to registered incidence rate and ratio among congenital, pyoseptic infections of puerperas and neonates with using the method of ranging. Comparative correlation analysis was conducted between puerperas’ pyoseptic infections and neonates’ congenital infections in accordance with registered rate. The sample of the date was taken from Statistical Reporting Form No 2 «Report on infectious and parasitic diseases» for the Russian Federation during 2007–2017, Unified interdepartmental information and statistical system. Results: in most regions of the Russian Federation the registration of healthcare associated infections puerperas and neonates is at a low. More than a half of subjects have low incidence rates (less than 1,0) for one or more of the considered infections. Until now, there are several subjects that do not register healthcare associated infections at all. The absence of correlation relation between the morbidity of the puerperas’ pyoseptic infections and neonates’ congenital infections on the whole in the country confirms this fact. At the same time, the correlation analysis of separate regions with the registration close to the real figures has shown a strong positive relationship between puerperas’ pyoseptic infections and congenital infections. Conclusion: thus, it can be concluded that the presence of relation between rates of incidence of puerperas’ healthcare associated infections and neonates’ congenital infections can be used as one of the epidemiological criteria for assessing the completeness of the registration of healthcare associated infections.

1314. From Book to Bedside: Theoretical and Applied Knowledge on the Topic of Healthcare-Associated Infections in Second-Year Nursing Students from a Croatian University

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.1147 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S402-S402

Author(s):

Tomislav Mestrovic ◽

Goran Kozina ◽

Marijana Neuberg ◽

Rosana Ribic

Keyword(s):

Nursing Students ◽

Hand Hygiene ◽

Health Workers ◽

Standard Precautions ◽

Significant Difference ◽

Level Of Knowledge ◽

Second Year ◽

Healthcare Associated ◽

Applied Knowledge

Abstract Background Adequate training of health workers is pivotal in the prevention of healthcare-associated infections (HAI). Our aim was to assess the theoretical and applied knowledge about the risk factors and effective measures of HAI prevention (most notably the use of standard precautions and hand hygiene practices) in second year undergraduate university nursing students that have already completed obligatory courses in microbiology, infectious diseases and epidemiology. Methods This study included a whole generation of second year undergraduate nursing students, comprised of 161 female and 25 male participants (186 in total), from a public university in Croatia (University Centre Varaždin, University North). They were given an anonymous questionnaire (developed on the model used by Tavolacci et al. in 2008) covering three domains: General Knowledge of HAI, Standard Precautions (SP) and Hand Hygiene (HH). The acceptable score overall (max. 30) and for each area (max. 10) was arbitrarily set at ≥ 20 and ≥ 7, respectively (in accordance with prior research). Results The age range of surveyed students was 19–37 (mean: 21.97, median: 21, mod: 20). An accurate definition of nosocomial infections was provided by 98.92% students (with 60.75% of them defining it as the infection occurring 48 hours after hospital admission). The overall score was 21.5, which indicates sufficient level of applied knowledge of healthcare-associated infections. Very high level of knowledge was observed for the SP area (total score of 9.5); however, the level of knowledge in HAI and HH domains was inadequate (5.9 and 6.1, respectively). There was no statistically significant difference in the overall or specific scores between male and female students (P > 0.05). Formal teaching during the curriculum was students’ primary source of information (60.22%), followed by practical learning in the ward during work (23.65%), formal teaching in the ward (9.68%) and self-learning (6.45%). Conclusion Periodical checking of nursing students’ knowledge on HAI and corresponding curriculum modifications in obligatory courses tackling this topic are advised in order to fill the knowledge gaps, improve training, reduce infection rates and increase compliance with prevention measures. Disclosures All authors: No reported disclosures.

Impact of Healthcare-Associated Infections on Length of Stay: A Study in 68 Hospitals in China

BioMed Research International ◽

10.1155/2019/2590563 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Huixue Jia ◽

Liuyi Li ◽

Weiguang Li ◽

Tieying Hou ◽

Hongqiu Ma ◽

...

Keyword(s):

Length Of Stay ◽

Bacterial Infections ◽

Matched Control ◽

Multidrug Resistant ◽

E Coli ◽

Significant Difference ◽

Multidrug Resistant Pathogens ◽

Healthcare Associated ◽

Different Levels

Healthcare-associated infections (HAIs) not only bring additional medical cost to the patients but also prolong the length of stay (LOS). 2119 HAI case-patients and 2119 matched control-patients were identified in 68 hospitals in 14 primary sampling provinces of 7 major regions of China. The HAI caused an increase in stay of 10.4 days. The LOS due to HAI increased from 9.7 to 10.9 days in different levels of hospitals. There was no statistically significant difference in the increased LOS between different hospital levels. The increased LOS due to HAI in different regions was 8.2 to 12.6 days. Comparing between regions, we found that the increased LOS due to HAI in South China is longer than other regions except the Northeast. The gastrointestinal infection (GI) caused the shortest extra LOS of 6.7 days while the BSI caused the longest extra LOS of 12.8 days. The increased LOS for GI was significantly shorter than that of other sites. Among 2119 case-patients, the non-multidrug-resistant pathogens were detected in 365 cases. The average increased LOS due to these bacterial infections was 12.2 days. E. coli infection caused significantly shorter LOS. The studied MDROs, namely, MRSA, VRE, ESBLs-E. coli, ESBLs-KP, CR-E. coli, CR-KP, CR-AB, and CR-PA were detected in 381 cases (18.0%). The average increased LOS due to these MDRO infections was 14 days. Comparing between different MDRO infections, we found that the increased LOS due to HAI caused by CR-PA (26.5 days) is longer than other MDRO infections (shorter than 19.8 days).

CRIMINAL CODE OF THE RUSSIAN FEDERATION TWENTY YEARS: ACHIEVEMENTS AND MISSED OPPORTUNITIES

Proceedings of Southwest State University ◽

10.21869/2223-1560-2017-21-3-130-140 ◽

2017 ◽

Vol 21 (3) ◽

pp. 130-140

Author(s):

G. L. Minakov ◽

L. A. Abashina

Keyword(s):

Russian Federation ◽

Economic Factor ◽

Criminal Code ◽

Forced Labor ◽

Final Decision ◽

Missed Opportunities ◽

Significant Difference ◽

The Russian Federation ◽

Twentieth Anniversary ◽

The Many

This paper analyzes the criminal legislation of the Russian Federation, which is 1 January 2017 marks the twentieth anniversary of the entry into force. Draws attention to a number of problems associated with the many changes made to the text of the Law. There is a significant difference between a modern edition of the Criminal code of the Russian Federation of the sample 2016 from the Criminal code of the Russian Federation at the time of its adoption in 1996. Indicates the number of egregious errors and omissions of the legislator in constructing the norms, not all of which today are corrected. It is stated that hitherto the criminal code of the Russian Federation in full is not entered into force. In particular, not put into effect the provisions of the Criminal code of the Russian Federation on the punishment in the form of arrest, despite the expiry of the deadline of entry (2006). Thus it is proved that stipulated by the legislator in the Criminal-Executive code of the Russian Federation of conditions of serving of arrest for much stricter than the conditions of detention of the convict in jail, which violates the principle of fairness criminal law. The authors emphasize that the economic factor in justifying the imposition of arrest generally not taken into account. In this connection, the conclusion about the need to exclude these norms of the current legislation. It is noted that a similar situation exists with the new punishment in the form of forced labor. The paper argues that the inability of the purpose of forced labor may result in adverse legal consequences for the persons serving compulsory work, corrective labour and restriction of freedom in case of malicious evasion from serving of the latter. The authors note, requires a final decision and issue the death penalty.

Analysis of Long-Term Dynamics of Incidence of Healthcare-Associated Infections in the Irkutsk Region

Acta biomedica scientifica ◽

10.29413/abs.2019-4.3.16 ◽

2019 ◽

Vol 4 (3) ◽

pp. 122-126

Author(s):

O. A. Noskova ◽

N. E. Potalitsyna ◽

E. D. Savilov

Keyword(s):

Russian Federation ◽

Economic Loss ◽

Specific Weight ◽

The State ◽

Irkutsk Region ◽

Rate Of Increase ◽

Tract Infections ◽

Introduction.Healthcare-associated infections incidence is one of the most pressing issues in modern healthcare due to their high abundance as well as economic loss they cause.The aimis to study regional features of the incidence of healthcare-associated infections.Methods.We conducted a retrospective epidemiological analysis of nosocomial morbidity in hospitals of the Irkutsk region within 2006-2017 years. We used data, presented in the following state reports: “On the state of sanitary and epidemiological welfare of the population in the Russian Federation”, “On the state of sanitary and epidemiological welfare of the population in the Irkutsk region”.Results and discussion.According to the results of the conducted analysis, it was shown that the average long-term prevalence of healthcare-associated infections in the Irkutsk region was 41.94 ± 2.040/00000 (Russian Federation – 17.49) with a tendency to stabilization in recent years. The therapeutic and prophylactic organizations of the surgical profile have the highest epidemiological significance (over 51 %). At the same time, the share of postoperative complications during the study period decreased by 1.5 times. We have noted a rising trend line with a positive rate of increase in the incidence of nosocomial pneumonia, which in the last two years has taken a leading position in the structure of healthcare-associated infections. The incidence of infections in newborns in the Irkutsk region ranks the third, with a specific weight of 11.54 %. Moreover, if before 2013 purulent-septic diseases of the newborns were the predominant nosological form, in recent years pneumonia has firmly taken over the leadership. During the study period we revealed an increase in the incidence of postpartum endometritis in puerperas. It has been shown that the registration of sepsis, urinary tract infections in the region is low.

Russian Experience of Transport Extracorporeal Membrane Oxygenation

Russian Sklifosovsky Journal Emergency Medical Care ◽

10.23934/2223-9022-2020-9-4-521-528 ◽

2021 ◽

Vol 9 (4) ◽

pp. 521-528

Author(s):

D. A. Shelukhin ◽

A. V. Karpov ◽

M. V. Ketskalo ◽

K. K. Gubarev

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Clinical Experience ◽

Russian Federation ◽

Age Groups ◽

Clinical Manifestations ◽

Practical Experience ◽

Hospital Survival ◽

Membrane Oxygenation ◽

Significant Difference ◽

The Russian Federation

Relevance. The present time can be called a period of accumulation of experience of national health systems in different countries of the world in the application of transport extracorporeal membrane oxygenation (ECMO) technology at the pre- and inter-hospital stages of evacuation of patients to specialized ECMO-therapy centers. The role of such centers is to provide timely advice and, if necessary, perform inter-hospital evacuation.Material and methods. The study summarized and analyzed with the help of the national register “RosECMO” the own experience of 13 hospitals in the Russian Federation, who performed 68 inter-hospital evacuations under ECMO conditions by different modes of transport in patients of different age groups with symptoms of circulatory and respiratory failure. The following parameters were evaluated: characteristics of transport ECMO, clinical manifestations of potentially negative effects of transport, hospital survival, as well as the effect of experience (less and more than 10 cases of transport ECMO) of the presented clinics on the difference in the results obtained.Results. Connecting patients to the ECMO device reduces the likelihood of death on the SOFA and APACHE IV scales by 1.2 times (p <0.0001) and 1.4 times (p<0.0001), respectively. Despite the absence of deaths during inter-hospital transportation of patients under ECMO conditions, 14.93% of patients died within 3 days from the moment of their execution, without a significant difference in clinics with different practical experience. The overall hospital survival rate of ECMO transport scenarios in all 13 clinics of the Russian Federation was comparable to the data of the international register 48.52% versus 48.81%, at the same time it was significantly lower (1.3 times) in the group of clinics with less clinical experience 40% versus 52.08% (p<0.0001).Conclusion. The results of the first stage of the study we obtained indicate the prospects of using the method of extracorporeal membrane oxygenation at the stage of inter-hospital evacuation, due to the effective stabilization of the patient’s condition and a significant reduction in the risks of the likelihood of death. Clinics with less clinical experience showed significantly worse results of hospital survival of patients who underwent inter-hospital transportation under conditions of extracorporeal membrane oxygenation compared to clinics with more clinical experience, which can be a significant argument in adopting a model for the development of specialized regional centers for extracorporeal membrane oxygenation. The experience accumulated over the past six years and the analysis of new data from the register of transport cases of extracorporeal membrane oxygenation of the national healthcare system will make it possible to formulate the correct trajectory for the development of the method of extracorporeal membrane oxygenation and its application, including at the stage of pre- and inter-hospital evacuations of patients.

Surveillance System and Prevalence of Healthcare-Associated Infections in a Maternity Hospital

ISRN Infectious Diseases ◽

10.5402/2013/849493 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5

Author(s):

Pagona Flevari ◽

Irene Zorou ◽

Athanassios Tsakris ◽

George Saroglou

Keyword(s):

Intensive Care Unit ◽

Surveillance System ◽

Neonatal Intensive Care ◽

Maternity Hospital ◽

Limited Information ◽

Staff Education ◽

Hospitalised Patients ◽

Maternity Hospitals ◽

Obstetrician-gynaecologist (Ob-Gyn) medical and nursing personnel usually have minimal in action training on infection control (IC). Limited information exists also about the epidemiology of healthcare-associated infections (HAIs) in maternity hospitals. The aim of this study was to determine in a 30-day survey prevalence of HAIs among hospitalised patients and neonates in a maternity hospital in Athens, Greece, and to offer to the IC office a practical IC manual. Patients hospitalized for more than 24 h in the clinics and the neonatal intensive care unit (NICU) were enrolled. An IC guide was created and distributed to the medical and nursing staff through educational seminars. Through the survey, among Ob-Gyn patients 16 HAIs were recognized during hospitalization and 14 HAIs after patients’ discharge; the overall prevalence of infected patients was 2.9% and the prevalence of HAIs was 3.2%. Among NICU patients, the prevalence of HAIs was 3.9%. The IC manual was found easily implemented in daily use improving staff’s compliance to IC practices. The results of the survey can be used as a baseline for future comparisons between maternity hospitals (benchmarking). The implementation of steady IC guideline protocols for a maternity hospital may update staff education and promote staff compliance on IC practices.