Эпидемиология гнойно-септических инфекций, вызванных метициллинрезистентными штаммами золотистого стафилококка

Abstract

The purpose of the work is to reveal the patterns of methicillin-resistant strains of Staphylococcus aureus (MRSA) spread in medical institutions and to develop the approaches to the epidemiological surveillance and control in health care institutions, depending on the level of MRSA spread. Methods. The study of 193.869 samples of biological material has been carried out. We have used standard microbiological techniques, molecular-genetic and statistical methods. Results. Due to the epidemiological monitoring of the circulation of MRSA in Kemerovo region the heterogeneity of distribution of strains in certain territories (from 2.63% to 60.12%; χ2 = 40.97; p = 0.000) has been revealed. The incidence of infections caused by MRSA in patients of health care organizations has been 10.97 per 1000 patients. The differences of circulation intensity of MRSA in patients of hospitals of different profiles (from 219.4 to 131.8 per 1000 patients; c2 = 755, p = 0.0003) has been revealed. The belonging of the cultures to the clonal complex CC8/239 has been determined. The dependence of MRSA circulation on the frequency of disinfection processing of medical personnel hands has been established, the sensitivity of the cultures to disinfectant preparations and the preparations for local treatment of wounds has been investigated. Conclusions. 1. The circulation of MRSA in Kemerovo region in a population of people without pathological processes, in hospital patients and in closed institutions has been unequal. 2. The sources of MRSA in outpatient medical institutions are mostly patients with purulent infections of skin and soft tissues, infections of respiratory tract, ENT-organs and eyes. 3. The strains of MRSA, identified in surgical hospitals, have a significant pathogenic potential due to the genes embodying the synthesis of pathogenicity factors, that provide the immunosuppressive properties. 4. The dynamics of infections caused by MRSA remains stable; however, it is necessary to differentially develop the approaches to the surveillance of the given group of infections and correction of anti-epidemic measures depending on the prevalence of MRSA.