Microbiological monitoring in the facility obstetric care: results and significance
Authors:   Institute of Disinfectology of the Federal Scientific Center of Hygiene named after F.F. Erisman, Serov  Alexey A. , Eremeeva Natalya I. ,   Institute of Disinfectology of the Federal Scientific Center of Hygiene named after F.F. Erisman, Demina Yulia V. ,   Institute of Disinfectology of the Federal Scientific Center of Hygiene named after F.F. Erisman, Mukabenov Fedor А. ,   Institute of Disinfectology of the Federal Scientific Center of Hygiene named after F.F. Erisman, Gonchar Anzhelica S. ,   Institute of Disinfectology of the Federal Scientific Center of Hygiene named after F.F. Erisman, Novikov Vyacheslav A. ,   Institute of Disinfectology of the Federal Scientific Center of Hygiene named after F.F. Erisman, Ilyakova Anastasia V. ,   Institute of Disinfectology of the Federal Scientific Center of Hygiene named after F.F. Erisman
Published: December 2024

Introduction. One of the main preventive measures aimed at preventing the spread of pathogens of HAI in medical organizations, including obstetric, is the organization of disinfection measures, the effectiveness of which is determined in the course of microbiological monitoring and determining the sensitivity of hospital microflora to the disinfectants used. Purpose of the study: determination of sensitivity to disinfectants and antibiotics of isolates of microorganisms isolated from the objects of the nosocomial environment of a medical organization within the framework of microbiological monitoring. Materials and Methods. Quarterly sampling from the objects of nosocomial environment was carried out in the units of obstetrics and maternity hospitals according to MR 3.1.0346-24. Susceptibility of isolates to antibiotics was assessed in accordance with the IACMAС clinical recommendations «Determination of susceptibility of microorganisms to antimicrobial agents (2021)». Sensitivity to disinfectants was assessed in accordance with the methodology presented in MU 3.5.1.3439-17. Results. A total of 352 samples of flushes from the objects of the hospital environment of obstetric hospitals of the Central Federal District were taken, 36.65?% (n?=?129; 129/352) were positive, in which 196 isolates of microorganisms were found in the cultures. 78,06?% (n?=?153; 153/196) of isolates are represented by species: S. epidermidis, P.?aeruginosa, K.?pneumoniae, S. haemoliticus, E.?coli, E.?faecalis, S.?aureus, K. aerogenes, which have different spectrum of resistance to antibacterial drugs. Evaluation of the sensitivity of isolated isolates of microorganisms to DCs showed that 67.86?% (n?=?133; 133/196) of isolates were resistant to disinfectant № 1, 19.9?% (n?=?39; 39/196) of isolates were resistant to disinfectant № 2, and 12.76?% (n?=?25; 25/196) of isolates were resistant to disinfectant № 3. At the same time, it was determined that the concentration of active substances in working solutions of disinfectant №?1 is low and cannot provide bactericidal efficiency even in relation to test strains. 7 isolates with simultaneous resistance to disinfectants and antibacterial drugs were identified. Conclusion. The results of this study emphasize the importance of microbiological monitoring in health care organizations, especially in obstetrics facilities, where patients are most vulnerable and susceptible to contracting healthcare-associated infections. Microbiological monitoring made it possible to timely identify ineffective disinfectants and exclude their use in obstetric medical organizations. Detection of isolates simultaneously resistant to disinfectants and antibiotics is the basis for searching for approaches and / or adjusting methods for assessing the effectiveness of disinfectants and technologies of their use.
Keywords: medical organizations; healthcare-associated infections; disinfectants; resistance to antibiotic; resistance to disinfectants.