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Aim. To improve microbiological monitoring of disinfectant-resistance of microorganisms, excreted from clinical material in epidemiological surveillance of HCAI. Materials and methods. Over the period from 2012 to 2016, while conducting resistance monitoring, 3320 investigations of clinical material were performed. The number of studied microorganisms was 1557. The number of excreted disinfectant-resistant microorganism strains was 337. The studies of microorganisms from clinical material for resistance were realized to 48 disinfectants of 15 groups with different reactants. Results. During the present study it was established that microbiological monitoring, oriented for continuous monitoring of microorganisms circulation will permit to increase the number of studies in 2016 by 2.6 times, to reduce the total number of disinfectant-resistant flora in 2016 by 62 %. The greatest weight of excreted cultures was in the units of surgical profile – 48.8 %, resuscitation profile – 30 %, therapeutic one – 21.2 %. Clinical material, from which positive results were obtained, was determined by scourage (from 43.5 % in the surgical unit to 74.8 % in therapeutic), blood sterility (from 2.7 % in therapeutic units to 31.4 % in resuscitation units). Microflora, excreted from clinical material is presented predominantly by P. aeruginosa – 24.0 %, Kl. pneumoniae – 30.0 %, E. coli – from 12.9 to 22.1 %, St. aureus – from 3.0 to 7.6 %. The studies regarding disinfectant-resistance to 48 items from 15 groups of chemical compounds are the evidence of growing resistance to QAC, including QAC + amines – 24.7 %, QAC + aldehyde-containing – 6.8 %, chlorine-containing – 21.9 %. The highest resistance to disinfectants used was in Acinetobacter spp. , Kl. pneumoniae , P. aeruginosa , E. coli . Conclusions. The developed algorithm of microbiological study, based on software, permitted to form the database, to monitor epidemiologically significant microorganisms and correct choice of disinfectants and disinfection tactics.

permskij medicinskij žurnal

Results of studying disinfectant-resistance of bacteria, excreted from patients in microbiological provision of epidemiological surveillance of hcai at multitype medical institution