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The concept of "nosocomial infection"

Hospital-acquired infection (hospital, hospital, nosocomial) - any infectious disease that affects a patient who is on treatment in a health facility or who has turned to him for medical treatment, or the staff of that institution, is called a nosocomial infection.

The main pathogens of nosocomial infections are: • bacteria (staphylococcus, streptococcus, Escherichia coli, Proteus, Pseudomonas aeruginosa, spore-bearing nonclostridial and clostridial anaerobes, etc.); • viruses (viral hepatitis, influenza, herpes, HIV, etc.); • fungi (pathogens of candidiasis, aspergillosis, etc.); • mycoplasma; • protozoa (pneumocysts); • parasites (pinworms, scabies mites).

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

Healthy skin and mucous membranes reliably protect the body from microbial infection. Weakened as a result of illness 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 on contact (contact path) from organs or tissues affected by the infection. It is necessary to always remember the endogenous infection in the preoperative period and carefully prepare the patient - to identify and eliminate the 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, because in most cases, contamination of wounds occurs by contact.
Currently, the prevention of contact infection is the main task of operating sisters and surgeons. Still NI Pirogov, not knowing about the existence of microbes, expressed the idea that infection of wounds is caused by "miasma" and transmitted through the hands of surgeons, tools, through linens, bedding. • Implantation infection is introduced into the tissues at injection or with foreign bodies, prostheses, suture material. For prevention, you must carefully sterilize the suture material, prostheses, objects implanted in the tissues of the body. Implantation infection can manifest after a long time after surgery or injury, leaking by the type of "dormant" infection. • Air infection is the infection of the wound with germs from the air of the operating room. Such infection is prevented by strict adherence to the regime of the operating unit. • A drop infection is the contamination of a wound by an infection from getting into it droplets of saliva that fly through the air during a conversation. Prevention consists in wearing a mask, limiting conversations in the operating room and dressing.

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 frequent forms of occupational disease are viral hepatitis B and C.

Modern principles of the fight against the causative agents of infectious diseases make it possible to build effective barriers to the protection of the patient in the operating room, dressing room and hospital ward. However, at present they must be reassessed through the prism of the possibility of protecting the attending physician, surgeon. In this case, the main importance is acquired by various viral infections due to the high incidence and mortality rate, 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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