Assuring epidemiological safety for healthcare of patients with diabetes mellitus

Abstract

Healthcare associated infections (HAI) — infections that patients develop during the course of receiving healthcare in hospitals, outpatient department and at home, out of healthcare facilities, and infection resulting from occupational exposure. Patients with diabetes are vulnerable to HAI. Infections increase metabolism problems in patients with diabetes; and vice versa, high blood glucose level increases risk of infections. For assuring epidemiological safety for patients with diabetes infection control must be provided for the following medical practices: insulin injections; blood glucose test; care of diabetes foot; intravascular catheterization and surgery. Any invasive procedures increase the HAI risk. HAI are most commonly transferred through direct and indirect contact with the infection. Some of the main HIA preventive practices: staff cleaning hands with alcohol based sanitizer, single use of medical gloves, single use of insulin needles and syringes. In health facilities only multiple users and multiple blood glucose monitoring devices must be used by health providers. The protocol of glucose blood testing should include detailed disinfection procedures and additional measures to decrease the risk of potentially transmitting disease between patients and between patients and providers. Health providers should have special skills to care of patients with diabetes foot to perform non-traumatic procedures and infections control practices. Proper hand hygiene and gloves use combined with effective aseptic technique before catheter insertion and maintenance protect against severe HAI. Risk of infections significantly decreases when single-dose antibiotic was used before surgery as antimicrobial prophylaxis. To disease risk of infections patients should be recommended to strictly control diabetes during the weeks before elective surgical procedures.

Approaches to vaccine prophilaxis of respiratory infections in patients with diabetes mellitus in the modern epidemiological situation

“…В настоящее время вакцины относятся к иммунобиологическим лекарственным препаратам, которые, в соответствии с международными рекомендациями, должны входить в комплекс лечебных и профилактических мероприятий у пациентов с СД [16,34]. Эпидемиологическая безопасность при оказании помощи пациентам с СД также не подразумевает профилактику респираторных инфекций ни в условиях стационара, ни амбулаторно, ни вакцинации медицинских работников, но при этом делается акцент на особую уязвимость в отношении инфекций [54]. Следовательно, требуется изменение существующих рекомендаций по организации специализированной стационарной и амбулаторной медицинской помощи пациентам с СД1 и СД2 различных возрастов.…”