Objective. To determine the incidence of anti-HBc in groups of health care workers with different risk of occupational parenteral viral hepatitis B (VHB) infection previously vaccinated against hepatitis B.Materials and methods. The total sample of 1643 people was divided into cohorts of people with high risk of occupational infection, 976 people (58.9%), and with low risk of parenteral infection, 676 people (41.1%). The immunofluorescence assay was used for anti-HBs and anti-HBc.Results. The share of anti-HBc positive and anti-HBc negative individuals is almost the same in both groups. Statistical calculations show that the relationship between the presence and absence of anti-HBc and the levels of humoral immunity in both groups is statistically significant (p < 0.001). Anti-HBc in the serum of the vaccinated people is detected 2.7 times less incident compared to the unvaccinated.Conclusion. No significant difference in the detection of anti-HBc in the groups of health workers at high and low risk of parenteral infection was revealed. A statistically significant correlation was found between the level of postvaccinal immunity in vaccinated persons and the presence of anti-HBc. Immunization against VHB prevents not only its acute form, but also sterile, chronic, or latent ones.

Introduction. Among infectious agents associated with provision of medical care, resistant ones to disinfectants from various chemical groups are more often met. In this regard, disinfection measures carried out in a medical facility are not always effective enough. Material and methods. 9 strains of microorganisms were selected for research (Klebsiella pneumoniae -2 pcs., Enterococcus faecalis, Staphylococcus warneri, Serratia rubidaea, Staphylococcus sciuri, Enterobacter cloacae, Acinetobacter baumannii, Enterococcus faecium - per 1 pcs.), isolated from the objects of hospital environment in operating unit, intensive care and trauma units, as well as 5 samples of disinfectants from different chemical groups (on the basis of quaternary ammonium salt, tertiary amine and polyhexamethyleneguanidine; on the basis of sodium percarbonate with activator; on the basis of hydrogen peroxide and didecyldimethylammonium chloride; in the form of tablets on the basis of sodium salt sodium dichloroisocyanurate acid), used in the specified divisions of medical facities. The studies were performed in accordance with the methodology set out in methodology instructions MU 3.5.1.3439-17 “Assessment of sensitivity to disinfectants of microorganisms circulating in medical organizations.” Results. When conducting chemical-analytical studies of samples of disinfectants 4 samples out of 5 were found to have inconsistencies in one or another quality indices. The analysis of instructions on application of disinfectants 4 means from 5 were showed to have unreasonably underestimated modes of application. According to the results of the evaluation of the sensitivity of microorganisms to disinfectants, the majority of isolated microorganisms was found to have resistance to the studied disinfectants Conclusion. Based on the results of the study of sensitivity of microorganisms to disinfectants, a new tactic for improving disinfection measures is proposed for medical facilities: rotation of disinfectants and an enhanced system of microbiological monitoring of the sensitivity of microorganisms to disinfectants

Along with patients, medical personnel are a risk group for the incidence of healthcare-associated infections (HCAI), which determine the effect of the biological production factor on the body of workers. Among the risks of infection, the first place is occupied by the risk of infection with viral hepatitis B (HBV), which belongs to vaccine-preventable infections. The level of аnti-HBs in medical workers, which appears in the serum of the immunized, is an indicator of the degree of their protection from this infection. The objective of the study was to assess the effect of age and timing of the last dose of hepatitis B vaccine during primary vaccination of health care workers on the level of аnti-HBs, which characterizes the degree of postvaccine immunity. Materials and methods. A retrospective epidemiological study of postvaccine immunity of 1,597 medical workers (doctors, nurses, nurses) of three multidisciplinary medical institutions who were initially vaccinated at different time intervals (from 3 months to 23 years) was performed. The study for HBs was carried out using the immunoenzyme test system ‘Vectohep B – HBs-antigen-strip’. Microsoft Office Excel 2010 and Prism9 software (GraphPad, USA) were used in the statistical analysis. Results. It was shown that 41.9% to 49.4% of HBV vaccinated individuals had humoral immunity below protective values (аnti-HBs <10 mIU/mL) regardless of the time frame (1 to 23 years) elapsed from immunization. Protective levels of аnti-HBs were maintained after 5 years of immunization by 58.1% of those vaccinated, and 50.5% of those vaccinated for 6 or more years. The age of health care workers had no noticeable effect on seroconversion. Conclusion. The proportion of individuals with absence of protective levels of аnti-HBs in serum is almost identical in individuals immunized between 3 months and 5 years, 6 to 15 and 16 to 23 years and is approximately 49% of the vaccinated population. Monitoring of the level of postvaccinal immunity to hepatitis B virus allows to identify the group of persons with lack of immunoconversion after immunization and to solve the issue of additional booster dose of the drug. Key words: medical workers, viral hepatitis B, immunity intensity, postvaccinal immunity, аnti-HBs

The article considers the main state and regulatory documents of sanitary and epidemiological legislation related to ISMP. The issues of updating a number of sanitary and epidemiological requirements for medical organizations, which were subsequently included in the updated sanitary and epidemiological rules currently in force, were considered. Keywords: infections associated with the provision of medical care (ISMP), biological threat, epidemiological process of ISMP, prevention of ISMP, regulatory documents on ISMP

There are increasing data concerning changes in hematological (clinical) and biochemical blood tests in patients with COVID-19 infection, which indicate the severity of the manifestations of the infectious process. Coagulopathy often correlates with the severity of COVID-19 disease and the risk of death. In this regard, prediction of developing coagulopathy and its prevention remain quite relevant. The aim of our study was to identify differences in the content of platelets and D-dimer in patients with COVID-19. The study included cohorts of patients vaccinated against SARS-CoV-2, and those not immunized against this infection. A prospective, randomized, observational study of the patients’ response was performed in cohorts of 588/52.2% vaccinated (vaccinated) and 588/52.2% non-immunized (non-vaccinated) patients with diagnosed COVID-19 over the period from 23.06.2021 to 01.05.2022. The levels of blood platelets and D-dimer, as well as clinical outcomes of the disease in patients with COVID-19, were studied in dynamics on days 1-2, 5-6 and 10-12 of hospitalization. Upon admission, the normal value of the blood platelet counts did not differ between the compared groups, being 206.58 × 109 in vaccinated group and 204.85 × 109 in the unvaccinated group, respectively. a moderate increase in the concentration of D-dimer was noted in both groups upon admission, i.e., 2838.60 ng/mL in the group of vaccinated patients and 3242.08 ng/mL among the unvaccinated patients. In the course of the study, we have shown that the dynamics of D-dimer index in vaccinated versus non-immunized persons was similar according to the days of disease, showing an increase from the first day and a trend towards an higher values, starting from 5-6 days. At the same time, the dynamics in the vaccinated patients was somewhat less favorable than that of the non-immunized subjects. In the patients who were not immunized throughout the entire observation period, the platelet count exceeds the levels found in vaccinated subjects, thus suggesting higher risk of thrombosis and cytokine storm. The data obtained show that the dynamics of D-dimer and platelet counts in vaccinated and non-immunized people is similar on appropriate terms of the illness. However, the changes are more pronounced in vaccinated cohort, but it does not indicate a greater risk of adverse outcomes.

Relevance. COVID-19 vaccination reduces mortality and the course of severe diseases. However, there is an insufficiency of studies evaluating factors leading to infection among COVID-19 vaccinated individuals.Aim. Identification of epidemiological features that distinguish cases of the disease in vaccinated and unvaccinated cohorts.Materials and methods. The analysis of the incidence of COVID-19 in 1126 hospitalized patients in the period from 23.06.2021 to 01.05.2022 was carried out taking into account the presence or absence of vaccination against the SARS-CoV-2 virus.Results. It was found that the risk of COVID-19 getting sick in the unimmunized was 1.5 times higher than in the vaccinated (p < 0.05). The incidence of hospitalization, due to the severity of the condition (moderate, severe and extremely severe), in unvaccinated people with no history of comorbidities, is more than 3 times higher than in vaccinated people (p < 0.05) in the same group. The probability of death from COVID-19 among vaccinated people is 1.5 times lower than among unimmunized people (p < 0.05). The age characteristic of mortality in vaccinated people shifts to the «senile» age (76.93 ± 1.32), while among the unimmunized, the age of death is closer to the category of «elderly» (73.74 ± 1.39 years) (p ≤ 0.05). In the structure of mortality among the vaccinated, the main share was made up of patients with a history of 3 to 7 concomitant systemic diseases (66.7%), while among the unvaccinated, the main share (74.5%) were patients either without comorbidities or with a history of 1 to 2 concomitant diseases.Conclusion. The results of the epidemiological features of the COVID-2 epidemic process have shown that vaccination against the SARS-CoV-2 virus is vital for elderly and senile people with comorbid conditions.