Application of various methods of laboratory diagnostics in system of epidemiological surveillance on infections associated with medical care

In each health organization is circulating these or other microorganisms that pose a threat to the development of infections associated with health care (HCAI) in patients. The level of colonization of hospital facilities with bacteriological methods of research is from 5 to 36 %. Diagnostic possibilities of molecular genetic methods in epidemiology are not limited by their use to identify the sources of infection and transmission factors of the pathogen during epidemic outbreaks. Objective: to conduct a comparative analysis of bacteriological and molecular genetic methods in epidemiological surveillance of ISMP in the hospital. Materials and methods: a comprehensive laboratory examination of patients of the Hematology Department at admission and discharge, employees of the Hematology Department, as well as objects of the in-hospital environment of surgical, intensive care, Hematology departments of a large multidisciplinary clinic was conducted during 2017. The study Included 13 patients (loci: oropharynx, nose, intestines), 7 employees (loci: oropharynx, nose), as well as 215 samples of washouts from the objects of the in-hospital environment. Results and discussion: microbial contamination of objects in the hospital environment was 54.0 % during bacteriological examination. In 80.0 % of cases, the DNA of microorganisms was found during the molecular genetic study. A strong direct correlation (r = 0.92) was found between the frequency of microorganisms and the DNA of microorganisms in various departments. The coincidence of the results of the two methods of research in most cases was noted at high values of DNA copies (800-10 000). In molecular genetic diagnostic methods in 1.9 times more prevalent gene MRS and 26.0 % of swabs detected MBL genes. All patients for admission at least one locus selected gene mec A. At discharge, the number of loci of patients, of which mec a was allocated, increased by 1.4 times. With the help of molecular genetic methods the epidemiological link of microorganisms circulating in the Hematology Department was established:S. aureus, CNS. Genes of MBL and carbapenemase were revealed both from employees of the Department and from objects of the in-hospital environment.

molecular genetic diagnosis, microorganisms, colonization, infections related to medical care

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