The paper analyzes the parameters of epidemiological surveillance of nosocomial pyoseptic infections (NPSI) at surgical hospitals. It considers its basic concepts and presents the authors own findings. Particular emphasis is laid on guidelines for detecting NPSI cases and on epidemiological surveillance. A method of a follow-up is proposed to solve problems in the informational and analytical support of surveillance.
The results of the epidemiological analysis of morbidity in purulent septic infection in a cardiosurgical hospital during the period of 1990-1963 is presented. As revealed by this analysis, until 1993 the dominating causative agent of this infection was Pseudomonas aeruginosa O16, and since 1994 Staphylococcus epidermidis prevailed. The morbidity dynamics for several years and during individual years is shown. The main risk factors were established. The reanimation department was found to be the main areas where the contamination of patients occurred.
Coagulase-negative staphylococci (CoNS) are considered as a reservoir of mobile genetic elements and first of all of the staphylococcal cassette chromosome mec (SCCmec), defining staphylococci resistance to beta-lactams. Types II, IV, IVa, V, VII and VIII SCCmec were detected among 95 staphylococcal strains isolated in different regions of the Russian Federation. Subtypes C1a, C1b, C1c and C1 SCCmec were also identified (class B mec complex and two complexes of ccr1 and ccr2 genes recombinases). Some other cassette types carrying A, C1 and C2 classes of the mec complexes in combination with various recombinase genes were detected. The S.epidermidis isolates mainly formed cassettes carrying mec complex B, while the S. haemolyticus isolates had cassettes carrying classes C1 and C2 mec complex. Out of 9 isolates of S. hominis 5 isolates carried a new type cassette: class A mec complex in combination with the complex of the recombinase ccr1 genes. SCCmec was not identified in S. capitis and S. pasteuri. Their representatives carried either mec complex (1 isolate of S. pasteuri) or the recombinase complexes (2 isolates of S. capitis). The detected SCCmec variants in CoNS could be a source of emergence of new genetic lines of MRSA.