1 ФГБУ «Национальный исследовательский центр эпидемиологии и микробиологии имени почетного академика Н.Ф. Гамалеи» Минздрава России, 123098, Москва, Россия; 2 ГБУЗ Московской области «Психиатрическая больница № 2 имени В.И. Яковенко», 142360, пос. Мещерское, Московская обл., Россия; 3 ФГБУ «Национальный медико-хирургический центр имени Н.И. Пирогова» Минздрава России, 105203, Москва, Россия; 4 ФБУЗ «Центр гигиены и эпидемиологии в городе Москве», 129626, Москва, Россия; 5 ГБУЗ Московской области «Московский областной научно-исследовательский клинический институт имени М.Ф. Владимирского», 129110, Москва, РоссияАктуальность. Психиатрические стационары, где находятся пациенты с иммунодефицитными состояниями, часто не соблюдающие элементарных мер профилактики, а также получающие широкий спектр лечебных процедур, в том числе парентеральных, во всем мире являются учреждениями высокого риска распространения в них социально значимых инфекций. Цель -изучить современные эпидемиологические особенности парентеральных гепатитов в крупном психиатрическом стационаре среди различных категорий душевнобольных (с туберкулезом легких и ВИЧ-инфекцией) и медицинского персонала. Материал и методы. Определены серологические маркеры гепатита В (ГВ) и гепатита С (ГС) у 8352 больных и 542 сотрудников крупного психиатрического стационара с применением отечест венных диагностических тест-систем. Результаты. Маркеры ГВ и ГС среди больных выявлены у 7,3% лиц (ГС -3,1%, ГВ -2,8% и ГВ+ГС -1,4%). Проведен анализ половых, возрастных и социальных характеристик пациентов с наличием маркеров вирусов ГВ и ГС. У ВИЧ-инфицированных пациентов значительно чаще были выявлены маркеры ГС (44,4% лиц); основные пути передачи ГВ и ГС -внутривенное употребление наркотиков и половой путь. Среди пациентов с туберкулезом легких обнаружено максимальное количество лиц с маркерами ГВ (44,3%) и ГВ+ГС (38,2%); основная клиническая форма туберкулеза легких представлена инфильтративной формой (60,4%); в 53,7% случаев выявлены бациллярные формы туберкулеза, представляющие серьезную эпидемиологическую опасность распространения туберкулеза в стационаре. Анализ социальной структуры показал, что ГВ+ГС+ВИЧ и туберкулез легких характерны для лиц с отягощенным социальным статусом. Наиболее частыми факторами инфицирования ГВ и ГС является длительная парентеральная нагрузка и внутривенное употребление наркотических веществ. Наибольший коэффициент парентеральной нагрузки отмечается у душевнобольных с ГВ+ГС и сопутствующим туберкулезом. Частота выявления маркеров ГВ и ГС среди медицинского персонала зависит от характера и стажа работы, частоты и степени контакта с кровью в процессе профессиональной деятельности. Заключение. Установлен высокий уровень коморбидности психических расстройств и социально значимых инфекционных заболеваний (ВИЧ-инфекция, туберкулез, ГВ и ГС), что оказывает сущест венное влияние на эпидемический процесс этих инфекций. Профилактические программы, создаваемые в стационарах и на обслуживаемых ими территориях, должны учитывать аспекты их коморбидности. Показана...

Introduction. Preventive maintenance is of great importance for the prophylaxis of healthcare-associated infection (HAI). Material and methods. An assessment of the interventional cleaning program of the epidemiologically significant units of a large medical organization was based on the data of marks erasure control, microbiological studies, a survey of employees of the insourcing department. Results. In 2017, the Center began implementing an intervention program for outsourcing, which began with the creation of the Department of sanitary services (DSS), which took over the functions of cleaning the premises, as well as providing departments with the necessary disinfectants, detergents, and cleaning products. Before the implementation of this intervention program, the staff was trained in the form of theoretical classes (lectures with the display of training videos, presentations). Practical skills were developed directly in the workplace. The interventional insourcing program showed a 1.28-fold decrease in microbial contamination of surfaces in high-epidemiological risk departments. As a result, the consumption of disinfectant was reduced by more than 5 times. The satisfaction of the sanitary service Department operators with the introduction of the new method was more than 90%. Conclusion. The implemented intervention program allowed not only to improve the quality of cleaning, but also to change the attitude of patients, medical personnel, and the administration to the institution of cleaning by the forces of the medical organization itself.

The aim of the study was to determine the role of foreign citizens registered in Moscow region, in the maintenance of the epidemic process of measles, rubella and mumps based on the basis of their susceptibility to these infections and compare with the control group (residents of the Russia Central Federal District - donors of blood). Materials and methods. Examination included 909 samples of blood sera obtained from migrant workers and 939 blood donors (residents of the Central Federal district of Russia) which were tested for the presence of antibodies (IgG) to measles, rubella and mumps with the help of enzyme-linked immunosorbent assay. Results. Average relative density of seronegative persons among the surveyed migrants and donors to rubella virus ranged from 6.6 to 9.8%, the measles virus - 13.5 and 16.5%, respectively, statistically significant distinctions in groups were not established. The proportion of seronegative persons to mumps virus twice and more exceeded the standard documentation level among migrants and donors (32.5 and 47.5% respectively). Conclusion. There was a significant excess of the permissible level of seronegative persons to the measles, rubella and mumps viruses among migrant workers and blood donors, which creates preconditions for maintenance of epidemic process and dictates the necessity of carrying out the corrective vaccination (or revaccination) of non-immune persons

Analysis of dynamics and trends in parenteral viral hepatitides and tuberculosis morbidity rates in Moscow for 1999 - 2013. Analysis of dynamics and trends in parenteral viral hepatitides and tuberculosis morbidity rates in Moscow in 1999 - 2013 based on the statistical data of Moscow regional information collection of federal state-financed healthcare institution Moscow city centre of hygiene and epidemiology. In aggregate, 1389 cards and the data of 24 forms were processed. The tuberculosis morbidity rate of the population of the city of Moscow in 1999 - 2009 exhibited tendency towards increasing and in 2009 - 2013 there was a tendency towards decreasing of the morbidity rate. As distinguished from the aggregate population situation, the tuberculosis morbidity rate among children was increasing steadily between 2003 and 2013. There was a massive children’s morbidity rate peak in 2011 - 2012 which may be caused by both increase of the number of patients and by improvement of diagnostics techniques. While the morbidity rate of virulent forms of hepatitis has decreased, the increase of the morbidity rate of chronic forms of hepatitis B and hepatitis C among the aggregate population of Moscow has been registered. The change in the age distribution of patients getting down with all forms of viral hepatitis B and C towards older patients has been observed. Men get virulent and chronic forms of hepatitis B and C 1.3 - 3.9 times more than women. The analysis of the transmission routes structure of hepatitis B and C has enabled us to establish the main risk factors contributing to transmission of these infectious diseases, namely casual sexual intercourse, drug addiction and insufficient supervision of the safety of procedures involving skin penetration in medical institutions. The main transmission route is sexual (heterosexual) transmission. Conclusion. The special aspects of the present epidemiological situation of hepatitis B and C and tuberculosis in the city of Moscow have been ascertained in the article.

The aim of this study - assessment of knowledge and awareness of drug addicts on the epidemiology, treatment and prevention of hepatitis B and C infections and AIDS in order to improve preventive measures. In total 64 patients were interviewed: 30 women and 34 men. The method of collecting material: questionnaires, interviews with the help of specially designed questionnaires. The method was based on questionnaire of a public survey conducted by specialists General Department of Federal Service for Execution of Punishment (GUFSIN) in St. Petersburg and Leningrad Region, as well as the Biomedical Center of St. Petersburg in cooperation with Yale University, USA. The age distribution of respondents was uneven. The proportion of young people under the age of 25 years was the lowest - 10.9% of patients, cases aged 25-34 years - 46.8%, 35 years and older ones - 42.2. Such a distribution by age, in general, reflects the age structure of addiction incidence rate in Moscow. The results of the survey patients in the Narcological Clinical Hospital № 17 for the assessment of knowledge on the epidemiology, treatment and prevention of hepatitis B and C, HIV infection and AIDS have shown that they are aware of the epidemiology and treatment of these infections, while women were more knowledgeable than men. At the same time, the respondents showed little knowledge of these issues and little interest in treatment that most likely comes from misunderstanding of risk of these diseases. This ultimately leads to higher values of these patients (not interested in their health and the health of others and underestimating the risk of disease) as a potential sources of infection. When checking the knowledge about the transmission of hepatitis B, C and HIV viruses the highest awareness was observed in respect of HIV infection and AIDS, much less patients know about hepatitis C, and even less - about hepatitis B. Consequently, inadequate awareness (in all aspects of the problems) of the threat posed by the HIV epidemic, AIDS and hepatitis B and C, proves to be another of the many factors contributing to the high incidence of hepatitis and HIV infection among drug addicts. Thus, our results also suggest the importance of sanitation-educational work among the addicted patients and the need for the delivery accessible and fascinating instruction booklet highlighting the key issues of epidemiology, treatment and prevention HIV- infection, hepatitis B and C. Each patient should be provided with a such booklet. It is necessary to develop a test control, allowing to catch the interest and focus on critical issues of prevention and treatment of tuberculosis, HIV infection and parenteral hepatitis, if possible, from time to time to lecture.