HOSPITAL INFECTIONS IN NEWBORNS

Аннотация

41newborn children were examined. Bacteriological analysis of culture was carried out in 32 newborns with umbilical wound infection and eye infection of thecontents ofthe conjunctival cavity in 41newborns. The weight of newborns were 3000-4000g-6 (14.6%), 2500-2999g-9 (19.5%), 2499- 2000g-12 (29.2%), less than 2000g-14 (34.1%) ). All newborns underwent bacterial inoculation of the contents of theumbilical cord and conjunctival cavity before receiving antibacterial treatment. The obtained data of bacteriological analysis indicate the leading role of gram-positive bacteria Staph-Epidermis - 71.3% and Staph-aureus - 13.6%, the share of other pathogens was from 3.4%. In 11.7%, theculture was sterile. Key words: nosocomial infection, conjunctivitis, bacterial culture, gram-positive bacteria, premature babies, newborns.. Definition. According to the definition of the CDC (Centers for Disease Control and Prevention – Centers for Disease Control and Prevention), a hospital infection is considered to be a local or systemic condition that occurs as a result of a hostile reaction of the infectious agent(s) or its toxins, which were not present at the time of the patient's admission to the hospital. A clear definition of "hospital-acquired or hospital-acquired infection" is needed at both the hospital and regional or national levels. This ensures the registration of cases of hospital infection according to uniform criteria, helps to accumulate information for analyzing the epidemiological situation and taking measures to prevent cases of hospital infection, makes it possible to compare data from one medical institution with another and create an overall picture (database) ofa region or country. The definition of hospital infection should be based on the clinical signs of infection, the results of laboratory data (general blood analysis, cultures, antigenic determination of microbes or antibodies, microscopy of secretions, etc.), the results of other examination of the patient (X-ray, ultrasound, computed tomography, tissue biopsy, etc.). Nosocomial infections in newborns are infections that develop after the birth of a child in the neonatal unit. These infections are not transmitted in utero, and the baby is not infected by it from the mother during childbirth. These infections can be caused by bacteria, viruses, or fungi. 98,7:ROTCAFTCAPMI.SECNEICSLACIDEM ,5202 ,lirpA,5emuloV gro.srehsilbupcimedaca.www Epidemiology. In the United States, 2 to 25% of cases occur in neonatal intensive care units (Stoll B.J. et al., J Pediatr 1996, 129). Hospital infection, and in particular hospital sepsis, is significantly more common in premature infants (Isaacs D.Arch Dis Child 2003, 88; Lopez Sastre J.B. et al., J Perinat Med 2002, 30). 45% of deaths of newborns after two weeks of age are associated with the late onset of sepsis. In developing countries, 1.6 million newborns die from infection each year, accounting for 40% of all neonatal deaths. The incidence of neonatal sepsis is 6.5–38 per 1,000 live births. If we include gastroenteritis, pneumonia, omphalitis, phlebitis, and urinary tract infection in this number, then the infection rate is 18-130 per 1,000 live births. The incidence of sepsis is 3-20 times higher than in developed countries (1-5 per 1,000 livebirths). Among newborns with very low birth weight, hospital sepsis occurs in 20-41%, and includingother forms ofinfection, itreaches 68%of thesechildren. In Brazil and Indonesia, 51-52% of all newborns admitted to the ICU have a hospital infection. About 70% of infections occur in the first 7 days of life. The main route of transmissionis through thehands of medical personnel. Gram-negative microorganisms (Klebsiella, Pseudomonas, Acinetobacter) account for almost half of all early sepsis. Of all the positive blood cultures, Klebsiella is sown in 16-18%, St.aureus – 8-22%. Klebsiella infection alone kills about 320,000 newborns each year. About 70% of Klebsiella cases are resistant to ampicillin and gentamicin, in morethan 50% ofcases The largest number of hospital infections occurs in neonatal pathology departments, where the child stays for a long time. Purulent–inflammatory diseases of the skin, navel and umbilical vessels, eyes, pneumonia in neonatal age are considered hospital infections. According to D.O.Ivanov (2019), the incidence of such infections in full- term newborns is less than 1%. According to WHO, nosocomial infections (NI) affect 8% of patients in hospitals. The annual damage in the United States from NI is $ 4.6 billion. In Russia, 50-60 thousand are registered annually. cases of nosocomial infection, however, according to estimates, this figure is 40-50 times higher. The incidence oflocal purulent–inflammatory diseases innewborns is approximately8%. According to research data from the Centers for Disease Control and Prevention in the USA, Europe and the Interdepartmental Scientific Council for NI (Russia), the incidenceof hospital infection innewborns