Relevance. During the pandemic of the new coronavirus infection (COVID-19), one of the most vulnerable and actively involved in the epidemic process categories of the population were medical workers. The study of the incidence of COVID-19 among medical workers, risk factors for infection and safety measures is an important area of research in modern conditions. The aim of the study is to assess the prevalence of COVID-19 among employees of medical organizations and occupational risk factors for infection in order to develop proposals for corrective measures. Materials and methods. To study the incidence of COVID-19 among employees of medical organizations, an anonymous online questionnaire developed by the authors was used, which was posted on the Google platform and distributed during the first wave of the pandemic among employees of medical organizations in several regions of the Russian Federation through corporate e-mail or specialized online resources adapted for health workers. The survey involved 1,872 medical workers of different genders, ages, positions and work experience. Results and discussion. Among the survey participants, 161 employees have already had a new coronavirus infection. In the majority (64.0%) of them, the disease occurred in the form of acute respiratory infection, in 28.6% - interstitial pneumonia, in 7.4% only the fact of isolation of the SARSCoV-2 antigen without clinical manifestations of infection was documented. The most affected contingents were secondary and junior medical personnel, mainly hospital staff. The likelihood of infection in the workplace was increased by factors such as providing care to patients with confirmed COVID-19, participating in procedures related to aerosol generation, working with biomaterials of patients with COVID-19, contact with surfaces in the environment of a COVID-19 patient, ignorance of infectious safety issues due to lack of instruction before admission to work. When assessing the efficiency of personal protective equipment (PPE) when they are used in the process, it was found that the highest value for the prevention of infection COVID-19 had a PPE for face protection, respiratory and eye, and hand hygiene. At the same time, many employees are faced with the problem of an insufficient number of protective equipment in the workplace. When assessing the availability of SARS-CoV-2 testing to employees, it was found that only 77.4% of survey participants had the opportunity to be tested for coronavirus infection in a timely manner. Conclusion. Thus, for more effective protection of employees of medical organizations, it is necessary to have a sufficient number of personal protective equipment, especially for the face, respiratory organs and vision, the availability of hygienic hand treatment during work, regular instruction on infectious safety, using interactive forms of training, and the organization of screening examinations of previously unvaccinated and unvaccinated employees.

К вопросу оценки эффективности вакцинации сотрудников медицинских организаций против COVID-19

Despite the improvement of the obstetric care system, purulent-septic infections (PSI) of puerperas and the associated maternal mortality do not lose relevance at the present time. This study analyzed publications on the following information resources: eLibrary, Google Scholar, PubMed, NCBI on the clinical and pathogenetic characteristics of postpartum GSI (sepsis, peritonitis, endometritis, mastitis, and surgical site infections (SSI)) and their leading pathogens. It should be said that the clinical picture of PSI in the postpartum period does not always correspond to the degree of activity of the infectious process, which leads to late diagnosis of the local focus of infection and, in the future, to its generalization. A modern feature of the PSI of puerperas is their polyetiology, with a predominance of opportunistic microorganisms, the role of individual representatives of which is far from unambiguous and requires discussion. In recent years, the etiological and epidemiological significance of gram-negative microorganisms of the Enterobacteriaceae family, including those with multidrug resistance, has been increasing. Thus, despite a sufficient amount of information on the etiology and clinical and pathogenetic features of PSI in the postpartum period, an interdisciplinary approach is needed to study this problem with the participation of different specialists: obstetricians-gynecologists, microbiologists, clinical pharmacologists and epidemiologists.

Эпидемический процесс COVID-19 в Российской Федерации: детерминанты и проявления

Внутриутробные инфекции новорожденных как маркер эпидемического неблагополучия в учреждениях родовспоможения

Introduction: One of the key elements of the infectious disease surveillance system is microbiological monitoring of contamination of environmental objects and health care personnel hands. In the context of the COVID-19 pandemic, virology testing of swabs from hospital objects and personal protective equipment of workers of infectious disease hospitals for patients with COVID-19 has acquired special importance. According to the current regulatory documents, however, greater priority in microbiological monitoring is given to determination and identification of bacterial pathogens, thus necessitating the development and implementation of an advanced technique of a simultaneous assessment of viral and bacterial contamination. Objective: To compare different environmental surface sampling techniques used to assess viral and bacterial contamination. Materials and methods: Samples for environmental swab testing were collected in accordance with the “Scheme for sampling environmental swabs for simultaneous assessment of viral and bacterial contamination” patented by the authors (Industrial Design Patent No. 132971 of September 5, 2022). We applied bacteriological, molecular genetic, and statistical methods in the study. Results: Overall, 343 wipe samples were tested, of which 68 were atypical (two 38-swab portions, 11.1 % each, contained SARS-CoV-2 RNA and opportunistic microorganisms). Among the opportunistic microorganisms, 42 bacterial strains were identified, including 16 strains of Enterococcus faecalis (38.1 %), 9 strains of Klebsiella pneumoniae (21.4 %), 7 strains of Escherichia coli (16.7 %), 3 strains of Enterococcus faecium (7.1 %), 3 strains of Staphylococcus aureus (7.1 %), 2 strains of Pseudomonas aeruginosa (4.9 %), and 2 strains of Pantoea agglomerans (4.9 %). Eleven variants of viral and bacterial associations were identified. The comparison of environmental swabbing performed by the technique under study with that performed by the standard method, based on test results, indicated a significant 11.1 and 12.3-fold difference in the proportion of non-standard findings for SARS-CoV-2 and opportunistic microorganisms, respectively. Conclusions: The study results prove that our technique of environmental swabbing meets all modern requirements and facilitates an objective assessment of the level of viral and bacterial contamination of the study objects. This approach can be used for laboratory testing within state and industrial control at institutions of various specialties (healthcare, food industry, childcare facilities, etc.).