Healthcare-associated infections: features of the epidemic process in maternity patients

Objective. The purpose of our study is to reveal the epidemic process features of healthcare-associated infections (HAI) among maternity patients in maternity hospitals of the city with population exceeding one million.

Materials and methods. A retrospective epidemiological analysis of the morbidity of HAI in four maternity hospitals in Yekaterinburg was carried out in 2012–2021. The data on 191875 maternity patients was analyzed. Statistical processing of the material was performed with Microsoft Office Word and Excel 2007 programs.

Results. Healthcare-associated infections varied from 306–505 cases in maternity hospitals of Yekaterinburg from 2012 to 2021. The percent of localized forms was 99.7 % in average. In 2013 and 2020 years generalized forms of infection were not registered. Among the localized forms of postpartum endometritis prevailed in average 20.5 cases per 1000 births. The etiology of individual HAI in maternity hospitals (n=1607) was determined, E. coli (n=576) amounted 35.8 %, Enterococcus spp. – 25.3 % (n=406), S. aureus – 15.1 % (n=242), other microorganisms amounted 23.8 % (n=383). In terms of etiology of postpartum endometritis E. coli amounted 37.7 %, Enterococcus spp. – 26.8 % and they were dominants. Among infections after surgical intervention S.аureus amounted 38.4 %; in postpartum mastitis S.аureus was 89.8 %. The etiological agent of generalized forms of HAI in maternity hospitals E. coli was presented in 62.5 % mainly. The proportion of staphylococci isolated from hospital environment objects (air, flushes) was 51.8 % but enterobacteria, non-fermenting gram-negative bacteria, anaerobes were found rarely.

Conclusions. Endometritis prevailed among the localized forms. The cause of postpartum endometritis was E. coli and Enterococcus spp., which were dominants. As for postpartum mastitis and infections after surgical interventions caused by S.аureus were prevailed. Staphylococci were found while air and dust sampling from environmental objects in hospitals had been studied.

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