vestommВестник охраны материнства и младенчестваBulletin of maternal and child care3034-395XФГБУ «НИИ ОММ» Минздрава России10.69964/BMCC-2024-1-3-53-59vestomm-51Research ArticleОБЗОРЫREVIEWSОснова бактериологической безопасности в отделении реанимации и интенсивной терапии новорожденных (обзор литературы)The basis of bacteriological safety in the neonatal intensive care unit (literature review)https://orcid.org/0000-0001-8183-0089ШакироваК. П.ShakirovaKsenia P.

Шакирова Ксения Павловна — врач анестезиолог-реаниматолог, заведующая отделением реанимации и интенсивной терапии, к.м.н

ул. Репина, д. 1, г. Екатеринбург, 620028

Ksenia P. Shakirova — anesthesiologist-resuscitator, head of the resuscitation and intensive care department, CoMS

st. Repina, 1, Ekaterinburg, 620028

ksushamova@gmail.comИвановМ. М.IvanovMikhail M.

Иванов Михаил Михайлович — врач-ординатор по специальности «неонатология

ул. Репина, д. 1, г. Екатеринбург, 620028

Mikhail M. Ivanov — resident physician specializing in neonatology

st. Repina, 1, Ekaterinburg, 620028

ivanovmihail098@mail.ruГаеваА. И.GaevaAlexandra I.

Гаева Александра Игоревна — врач анестезиолог-реаниматолог, заместитель директора по педиатрической работе

ул. Репина, д. 1, г. Екатеринбург, 620028

Gaeva Alexandra Igorevna — anesthesiologist-resuscitator, deputy director for pediatric work

st. Repina, 1, Ekaterinburg, 620028

gaeva_al@mail.ruФедеральное государственное бюджетное учреждение «Уральский научно-исследовательский институт охраны материнства и младенчества» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Institution “Ural Research Institute of Maternity and Child Care” of the Ministry of Health of the Russian FederationRussian Federation202414012025135359Copyright © Шакирова К.П., Иванов М.М., Гаева А.И., 20252025Шакирова К.П., Иванов М.М., Гаева А.И.Shakirova K.P., Ivanov M.M., Gaeva A.I.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnikomm.ru/jour/article/view/51Введение

Введение. По данным мировой статистики у 7% пациентов из 100, в странах с высоким уровнем дохода, и 15% пациентов из 100 в странах с низким и средним уровнем дохода, развиваются инфекции, связанные с оказанием медицинской помощи. Как следует из доклада Всемирной организации здравоохранения, каждый четвертый случай госпитального сепсиса, возникшего в отделении интенсивной терапии, вызван госпитальными штаммами. В среднем у каждого десятого из этих пациентов внутрибольничная инфекция приводит к летальному исходу. К группе повышенного риска относятся пациенты реанимационных отделений, в том числе новорожденные. Стратегии профилактики и контроля инфекций направленные как на пациентов, так и на их окружение, имеют первостепенное значение в отделениях интенсивной терапии для новорождённых.

Цель исследования

Цель исследования. Обобщить современные актуальные данные по профилактике госпитальных инфекций в отделениях реанимации новорожденных.

Материалы и методы

Материалы и методы. Проведён обзор литературы с использованием базы данных MEDLINE (PubMed) по состоянию на декабрь 2024 года с использованием ключевых слов и фильтра: рандомизированное контролируемое исследование, метаанализ, систематический обзор.

Результаты

Результаты. В данном обзоре суммированы основные данные по профилактике госпитальных инфекций в отделениях реанимации и интенсивной терапии новорожденных. По данным литературы, обеспечение бактериологической безопасности в отношении развития госпитальных инфекций зависит от множества факторов: гигиены рук медицинского персонала, организации контроля за венозным доступом, дезинфекции медицинского оборудования и помещений, соблюдения правил асептики и антисептики при выполнении инвазивных манипуляций, внедрения современных подходов в выхаживании недоношенных детей.

Заключение

Заключение. В отделении интенсивной терапии существует множество уникальных задач, требующих инновационных стратегий для обеспечения безопасного ухода за недоношенными новорожденными. Совместные усилия по стандартизации обработки специализированного оборудования, поддержанию чистоты окружающей среды, соблюдению протоколов ухода за сосудистыми доступами, адекватная гигиена рук, активное внедрение родителей в уход за новорожденными являются неотъемлемой частью программы направленной на профилактику внутрибольничных инфекций. Активное сотрудничество отделения интенсивной терапии новорожденных и эпидемиологической службой учреждения позволит разработать рациональную политику по управлению рисками и мониторингу госпитальных инфекций.

Background

Background. According to world statistics, 7% of patients out of 100 in high-income countries and 15% of patients out of 100 in low- and middle-income countries develop infections related to medical care. As follows from the report of the World Health Organization, one in four cases of hospital sepsis that occurred in the intensive care unit is caused by hospital strains. On average, one in ten of these patients has a hospital-acquired infection that is fatal. The high-risk group includes patients in intensive care units, including newborns. In 2023, 28973 cases of neonatal infections (including intrauterine infection) were registered in medical organizations of the Russian Federation. The highest rates of neonatal morbidity were recorded in the Sverdlovsk Region (42.2%), the Trans-Baikal Territory (33.0%), the Novosibirsk Region (26.0%), the Chelyabinsk Region (22.4%), the Krasnoyarsk Territory (21.8%) and the Irkutsk Region (21.3%). Thus, infection prevention and control strategies aimed at both patients and their environment are of paramount importance in neonatal intensive care units.

Objective

Objective. To summarize current relevant data on the prevention of hospital infections in neonatal intensive care units.

Materials and methods

Materials and methods. A literature review was conducted using the MEDLINE database (PubMed) as of December 2024 using keywords and a filter: randomized controlled trial, meta-analysis, systematic review.

Results

Results. This review summarizes the main data on the prevention of hospital infections in neonatal intensive care units. According to the literature, ensuring bacteriological safety in relation to the development of hospital infections depends on many factors: hand hygiene of medical personnel, organization of venous access control, disinfection of medical equipment and premises, compliance with the rules of asepsis and antiseptics when performing invasive manipulations, the introduction of modern approaches in the care of premature infants.

Conclusion

Conclusion. There are many tasks in the intensive care unit that require innovative strategies to ensure the safe care of premature newborns. Joint efforts to standardize the processing of specialized equipment, maintain the cleanliness of the environment, comply with vascular access care protocols, adequate hand hygiene, and the active introduction of parents into newborn care are an integral part of the program aimed at preventing nosocomial infections. Active cooperation between the neonatal intensive care unit and the epidemiological service of the institution will allow us to develop a rational policy for risk management and monitoring of hospital infections.

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The authors declare that there are no conflicts of interest present.