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The concept of "nosocomial infection"

Nosocomial infection (hospital, hospital, nosocomial) - any infectious disease that affects a patient undergoing treatment or who has applied to medical facilities, or employees of this institution, is called an nosocomial infection.

The main causative agents of nosocomial infections are: • bacteria (Staphylococcus aureus, Streptococcus, Escherichia coli, Proteus, Pseudomonas aeruginosa, sporiferous non-clostridial and clostridial anaerobes, etc.); • viruses (viral hepatitis, influenza, herpes, HIV, etc.); • mushrooms (causative agents of candidiasis, aspergillosis, etc.); • mycoplasma; • protozoa (pneumocysts); • parasites (pinworms, scabies).

The entrance gate of an infection is any violation of the integrity of the skin and mucous membranes. Even minor damage to the skin (for example, a needle prick) or mucous membrane must be treated with an antiseptic.

Healthy skin and mucous membranes reliably protect the body from microbial infection. Weakened by the disease or surgery, the patient is more susceptible to infection.

There are two sources of surgical infection - exogenous (external) and endogenous (internal).

Endogenous infection is less common and comes from chronic sluggish foci of infection in the human body. The source of this infection can be carious teeth, chronic inflammation in the gums, tonsils (tonsillitis), pustular skin lesions, and other chronic inflammatory processes in the body. Endogenous infection can spread through the bloodstream (hematogenous pathway) and lymphatic vessels (lymphogenous pathway) and upon contact (contact pathway) from organs or tissues affected by the infection. You must always remember about the endogenous infection in the preoperative period and carefully prepare the patient - to identify and eliminate foci of chronic infection in his body before the operation. There are four types of exogenous infection: • Contact infection is of the greatest practical importance, since in most cases contamination of wounds occurs through contact.
Currently, the prevention of contact infection is the main task of operating nurses and surgeons. Even NI Pirogov, not knowing about the existence of microbes, expressed the idea that infection of wounds is caused by “miasms” and is transmitted through the hands of surgeons, instruments, linen, bedding. • Implant infection is introduced into the tissue with injections or with foreign bodies, prostheses, suture material. For prevention, it is necessary to thoroughly sterilize the suture material, prostheses, objects implanted in the tissues of the body. An implant infection can manifest itself after a long period after surgery or injury, proceeding in the manner of a “dormant” infection. • Airborne infection is infection of a wound by germs from the air of an operating room. Such an infection is prevented by strict adherence to the operating unit. • Drip infection is the contamination of a wound by an infection from droplets of saliva falling into the wound, flying through the air during a conversation. Prevention consists in wearing a mask, restricting conversations in the operating room and dressing room.

More than 100 occupational infectious diseases of medical personnel are known in the world, including more than 30 forms of infections with the parenteral mechanism of infection. The most common forms of occupational disease are viral hepatitis B and C.

Modern principles of the fight against pathogens of infectious diseases allow us to build effective barriers to protect the patient in the operating room, dressing room and hospital ward. However, at present they should be reevaluated through the prism of the possibility of protecting the attending physician, the surgeon. At the same time, various viral infections are of primary importance due to the high level of morbidity and mortality, as well as significant socio-economic damage caused by them. In our work, we consider the prevention of such viral diseases as hepatitis and HIV infection.
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