The official way of transmission of infection is the parenteral transmission of the pathogen through the medical apparatus in the treatment and diagnostic manipulations

Now in medicine there are such technologies that can only be called fantastic. It would seem that, on the general background of the triumph of medical genius, the death of a patient due to non-observance of sanitary norms in a medical institution should have long been forgotten. Why is the official way of infection in our safe time gaining momentum? Why are staphylococcus, hepatitis, HIV still "walking" in hospitals and maternity hospitals? The dry statistics say that the frequency of only purulent-septic infections in hospitals has increased by 20% in recent years, with their share in intensive care units 22%, in surgery up to 22%, in urology over 32%, in gynecology 12%, in maternity hospitals ( 33%).

To be more precise, the official way of transmission of infection is, the so-called artificial infection of a person in medical institutions, mainly with invasive procedures. How does it turn out that people who enter the hospital for the treatment of one disease, in addition, get sick there by others?

Natural infection

With all the variety of opportunities to pick up the infection, there are only two mechanisms for transferring microbes from a healthy patient:

1. Natural, depending on the compliance of the person with the rules and rules of hygiene.

2. Artificial or medically formal way of transmission of infection. It is a mechanism, almost entirely dependent on the fulfillment of its duties by medical personnel.

With a natural pathway, the introduction of pathogenic microorganisms can occur when a person contacts a pathogenic environment. Ways of infection:

- air-drop, that is, when sneezing, coughing, talking (flu, tuberculosis);

-fakalno-oral, that is, through dirty hands, water and products (infectious diseases of the digestive tract);

-contact-household (a very wide range of infections, including venereal, skin, helminthiasis, typhoid, diphtheria and dozens of others).

It's incredible, but that's how you can pick up any illness by going to the hospital for treatment.

Artificial infection

In medical institutions, there are two main ways of infecting patients, characterized as an official way of transmission of infection. It:

1.Parenteral, that is, associated with a violation of the skin of the patient.

2. Enteral, possible for some types of examination of patients, and also for certain therapeutic procedures.

In addition, the same natural mechanism of transmission of infection, which repeatedly exacerbates the condition of patients, is flourishing in hospitals. It turns out, you can catch an infection with medical manipulations of doctors and nurses, as well as simply staying in the hospital.

Causes of infection of patients in medical institutions

Where do hospitals get the conditions for infection of patients naturally, and how does it affect the official mechanism of infection transmission. The reasons are:

1.In hospitals there are many infected people. In addition, about 38% of the population, including health workers, is a carrier of various pathogens, but people do not suspect that they are carriers.

2. Increase in the number of patients (old people, children), who significantly lowered the threshold of resistance of their body.

3. The combination of highly specialized hospitals into large complexes, where a specific ecological environment is created, voluntarily or involuntarily.

In some cases, there is an official infection of the patient with dressings, if the nurse, who is the carrier, does not perform their work in a face mask and gloves. Conversely, the patient can infect the health worker if he performs medical manipulations (blood sampling, dental treatment, and others) without a protective mask, gloves, special glasses.

Work of junior medical staff

In many ways, the infection of patients depends on the work of junior staff. All the same statistics say that only in Russia, intrahospital infection with shingles increased to 26%, opportunistic parasites to 18%, and salmonellosis to 40%!

What in this case causes an official way of transmission of the infection? This is primarily a complete or insufficient compliance with health standards. Sample checks have shown that in many hospitals, nurses clean the wards, manipulative, and even operating poorly. Namely, all surfaces are treated with a single rag, disinfecting solutions for cleaning the premises are prepared with a lower concentration than prescribed by standards, in the wards and cabinets, quartz lamps are not treated, even if they are present and in good order.

The situation is especially sad in maternity homes. An official infection of the fetus or parturient woman, for example, purulent-septic infections can occur due to violation of the rules of antiseptic treatment of the umbilical cord, with obstetric care and further care. The reason may be an elementary lack of a mask on the face of a nurse or a nurse who are carriers of pathogenic microbes, not to mention poorly sterilized instruments, diapers and so on.

Antibiotics

As noted above, people with an unclear diagnosis often enter the hospital. The patient is assigned laboratory tests, as well as modern diagnostic methods, in which the enteral route of administration (through the mouth) is applied to the body cavity of the appropriate equipment. While the results of the analyzes are being prepared, the practice has been established to prescribe antibiotics with a wide spectrum of action. This in a small part causes positive dynamics, and in large part leads to the fact that strains of pathogens are created inside the hospital that do not react to the effects directed against them (disinfection, quartz, medical therapy). Due to the natural ways of spreading these strains settle in the hospital. Unjustified prescription of antibiotics was noted in 72% of patients. In 42% of cases this was in vain. In general, the country's infection rate in hospitals reached 13% due to unreasonable antibiotic treatment.

Diagnosis and treatment

It would seem that new methods of diagnosis should help to quickly and correctly identify all the ailments. All this, but that there is no artificial infection of patients, the diagnostic equipment must be properly processed. For example, a bronchoscope after each patient should be disinfected by ¾ hours. Inspections have shown that this is not very much respected, because doctors should not examine 5-8 patients at the norm, but 10-15 on the list. Clearly, they do not have enough time to process the equipment. The same applies to gastroscopy, colonoscopy, catheter installation, puncture, instrumental examination, and inhalation.

But reduces the level of infection enteral route of administration of drugs. Here, only the duodenal method poses a threat, when the drug is injected directly into the duodenum using a probe. But oral (taking potions and tablets through the mouth, washing down or not washing them with water), sublingual (under the tongue) and buccal (attaching special pharmaceutical films to the mucous gums and cheeks) are practically safe.

Parenteral route of transmission of infection

This transmission mechanism is the leader in the spread of AIDS and hepatitis. Means the perarantal route - infection through the blood and in violation of the integrity of mucous membranes, skin. In a hospital environment, this is possible in such cases:

Blood / plasma transfusion;

Infection through a syringe when injected;

-surgical intervention;

-production of medical procedures.

Often, artificial infection occurs in dental clinics and when visiting a gynecologist because doctors use improperly treated tools to examine mucous membranes of their patients, and also because of the work of doctors in non-sterile gloves.

Injections

This type of therapy has been used for a long time. When syringes were reusable, they were subjected to mandatory sterilization before use. In practice, unfortunately, they led to the infection of patients with dangerous diseases, including AIDS, due to the glaring negligence of physicians. Now for treatment (intravenous and intramuscular injections), and for blood sampling only single-use syringes are used for analysis, so the risk of official infection is minimized. Health workers are required before the procedure to check the tightness of the syringe packaging and under no circumstances use it or the needle again for further manipulation. A different situation with the instrumentation for endoscopes (needles, biopsy syringes and others), which in practice are not processed at all. At best, they are simply immersed in disinfectants.

Operations

A high percentage of infection occurs during surgery. It is curious that in 1941-1945, 8% of the wounded were registered, and in our time the postoperative rates of purulent-septic infections increased to 15%. This happens for the following reasons:

- use during the operation or after it of poorly sterilized dressings;

- Inadequate sterilization of cutting or non-cutting tools;

- wide application of various implants (in orthopedics, in stomatology, in cardiology). Many microorganisms are able to exist inside these structures, in addition, they cover themselves with a special protective film, making them inaccessible to antibiotics.

Disinfection should be carried out in special bixes, autoclaves or chambers, which depends on the method of sterilization. Now in the operating room try to use disposable sterile sheets, clothes of surgeons and patients, which should reduce the level of official infection. To exclude infection through implants, patients undergo intensive antibiotic therapy after surgery.

Blood transfusion

It is believed that with blood transfusions, only syphilis, AIDS and two hepatitis viruses, B and C, can be caught. It is these pathogens that are screened for donor blood at fence points. But the practice shows that even using only disposable syringes, hemotransfusion can transmit hepatitis viruses D, G, TTV, toxoplasmosis, cytomegalovirus, listeriosis and other contagion. All donors must check for infection before giving blood. In fact, often there is not enough time to conduct tests, or negligence is simply allowed. Therefore, it is necessary to carefully check the blood taken from the donor. But this is not always the case, so even in Moscow clinics there are cases of infection of patients with blood transfusion. The second problem is that there are a lot of mutated strains that even the newest test systems do not recognize. The same situation is with the infection and during the transplantation of donor organs.