决定医护人员在大流行性感染传播期间坚持手部防腐的因素(以 COVID-19 为例)

S. Smirnova, Ylia S. Stagilskaya, I. A. Egorov, N. N. Zhuikov
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引用次数: 0

摘要

相关性。在任何流行病爆发期间,医护人员坚持手部防腐都是一个亟待解决的问题。在生物危害较高的情况下,执行正确防腐程序的可能性会降低,同时也会促进医院病原体的传播和医疗相关感染率(HAI)的增长。研究目的研究决定医护人员在大流行感染传播期间(以 COVID-19 为例)坚持手部防腐的因素。材料和方法。研究在整个 COVID-19 大流行期间进行。为了估算医护人员的手部卫生坚持率,我们对传染病医院的工作人员进行了匿名问卷调查(2021-2022 年),并评估了工作人员手部和医院环境物品的病毒和细菌污染率(2021-2023 年)。研究采用了流行病学(描述性评价)、细菌学(常规培养、使用 VITEK2 分析仪测定 AMR)、分子生物学(RT-PCR、Sanger 测序)和统计学(问卷调查、建立机器学习模型)方法。研究结果根据调查结果,确定了影响受过医学和非医学教育的医疗机构工作人员对防腐剂形成态度的主要因素。调查发现,传染病的大范围传播对传染病医院工作人员的手部污染程度产生了负面影响,其中医生占 35.3%,护士占 28.8%,医院清洁工占 25%。分离出的病原体包括病毒(SARS-CoV-2)和机会性微生物(粪肠球菌、粪肠球菌、泛氏聚合菌、鲍曼不动杆菌、肺炎克雷伯菌、金黄色葡萄球菌、大肠埃希菌),其中包括具有广泛抗菌素耐药性的微生物。结论在 COVID-19 流行期间,传染病医院有医学背景的员工坚持手部消毒的比例为 82.3%,无医学背景的员工为 71.2%。结果证实了员工的手在院内传播危险病原体中的重要作用,并表明有必要对医疗机构所有员工的防腐知识水平进行系统监测,无论其专业和教育水平如何。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Factors Determining Adherence to Hand Antisepsis by Healthcare Workers during Pandemic Infection Spread (as exemplified by COVID­-19)
Relevance. The healthcare personnel’s adherence to hand antisepsis is а pressing problem during any epidemic outbreak. In the context of high biological hazards, the possibility of performing proper antiseptic procedures is reduced while nosocomial pathogen transmission and healthcare-associated infection (HAI) rate growth are promoted. Aims. Studying the factors determining the healthcare workers’ adherence to hand antisepsis during a pandemic infection spread (as exemplified by COVID-19). Materials and methods. The study was conducted during the entire COVID-19 pandemic. To estimate the rate of adherence rate by the healthcare personnel to hand hygiene, we conducted an anonymous questionnaire survey of the staff in infectious disease hospitals (2021–2022) as well as assessed the viral and bacterial contamination rates of the personnel’s hands and the hospital environment items (2021–2023). Epidemiological (descriptive-evaluation), bacteriological (conventional culture, AMR determination using a VITEK2 analyzer), molecular biological (RT-PCR, Sanger sequencing) and statistical (a questionnaire survey, building machine learning models) methods were used in the study. Results. Based on the results of the survey, the main factors influencing the formation of attitudes towards antiseptics among the staff of medical organizations with medical and non-medical education were identified. It was found that the pandemic spread of infections negatively affects the level of contamination of the hands of infectious diseases hospital staff, which amounted to 35.3% of doctors, 28.8% of nurses, and 25% of hospital cleaners. The spectrum of isolated pathogens included viruses (SARS-CoV-2) and opportunistic microorganisms (Enterococcus faecalis, Enterococcus faecium, Pantoea agglomerans, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus, Escherichia coli), including those with a wide profile of antimicrobial resistance. Conclusion. During the COVID-19 epidemic, the rate of adherence to hand antisepsis in the infectious disease hospital was 82.3% in the staff with a medical background and 71.2% in the staff without one. The results confirm the significant role of staff hands in the in-hospital transmission of dangerous pathogens and indicate the need for systematic monitoring of the level of knowledge on antiseptics among all employees of a medical organization, regardless of specialization and level of education.
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