Distribution of more than 90% of infections can be stopped with a skin antiseptic
This and many other things were discussed at theInternational Congress "Modern means and technologies of disinfection and sterilization in the prevention of infections associated with the provision of medical care", which was held in Moscow from 6 to 7 November 2014. The Congress was organized under the auspices of Rospotrebnadzor in conjunction with the Research Institute of Disinfectology of Rospotrebnadzor.
The Congress discussed various aspects of theepidemiology and infection control, in particular, the modern international methods of preventing and combating infections related to the provision of medical care turned out to be the focus. In the light of the recent mass outbreaks of infectious diseases caused by the Ebola virus, coronaviruses, etc., this event became especially relevant this year.
The reports were made by recognized international andRussian experts in the field of disinfection and epidemiology, representatives of Rospotrebnadzor, as well as key specialists from leading specialized research institutes of the Russian Federation. Professors from Germany, Austria, Great Britain, Belgium and Italy took part in the event as guests. In particular, Dr. Axel Kramer, Doctor of Medical Sciences, Director of the Institute of Hygiene and Environmental Medicine of the Medical University of Greifswald (Germany) , Head of the Department of Hygiene and Clinical Microbiology, Medical University of Vienna, Consultant on Infectious Diseases and Tropical Medicine of the Central Hospital in Vienna (Austria) I), President of the Austrian Society for Infection Control Professor Ojan Assadian. In his report, Professor Kramer noted the important role of hand disinfection in infection control. According to Professor Kramer, the most effective method of hygienic hand treatment is the use of an alcoholic cutaneous antiseptic. "About 90% of nosocomial infections can be stopped by using "He notes. - Compared to normal hand washing or hand washing with antibacterial soap, alcohol antiseptic agents have higher efficacy against a wide range of microorganisms, and their use significantly reduces the time of hand treatment, thus increasing the level of adherence to this procedure. In addition, skin antiseptics have a significantly less irritating effect on the skin compared to soap. "
In the course of the report, Professor Kramer presented hisa study of methods of improving the compliance (adherence to the procedure) of hand hygiene, conducted at the Medical University of Greifswald. According to the results of the study it was found that to increase the compliance it is necessary to provide a sufficient number of dispensers for hygienic treatment of hands. For example, should be placed near the patient's bed, beforeentrance and exit from the ward, on trolleys, in the toilet rooms. In the event that it is not possible to install the dispenser in all necessary places, it is recommended to use a pocket vial with an antiseptic. It was interesting that the type and color of the dispensers also affect the adherence of the staff and patients to hand processing. Thus, the consumption of antiseptic is significantly increased in the case of using a sensory dispenser (1.8 liters per week in comparison with 0.15 liters when using a pressure metering device). The sensor dosimeter of yellow color increases the weekly consumption of antiseptic up to 2.65 liters.
In his speech, the professor presented one morea study in which the main factors affecting the perforation of medical gloves were identified. The study showed that the time of wearing gloves, material, kind of manipulation and repeated disinfection can be the main reasons for breaking gloves. It has been established that the use of nitrile gloves is preferable when working with infected patients, gloves should be replaced after 15 minutes of operation, and gloves can be disinfected 3 times within the recommended 15 minutes.
"The indisputable fact was that hand hygieneis a fundamental measure to prevent nosocomial infections - said Professor Kramer in concluding his speech - the ability to apply the knowledge accumulated in this area should spread with the speed of a forest fire. "
In the framework of his report Professor Ojan Assadiannoted that at the moment, insufficient attention is paid to the disinfection of surfaces in the LPO. In support of his words, he demonstrated a study in which the level of contamination of the handrails of patient beds before and after disinfection was determined. "After disinfection, the number of microorganisms decreased from more than 1000 KOE / 100 cm2 to 100 KOE / 100 cm2 for 35 minutes," he noted. According to Dr. Assadian, in conditions of insufficient disinfection of surfaces and objects surrounding the patient, gloves can become a reliable way of protecting medical staff, but not patients. "Moreover, hands in gloves carry more microorganisms than hands without gloves," - said the professor.
"With proper use of glovesthe medical officer should disinfect hands, wear gloves, carry out the necessary manipulations with the patient, remove gloves and disinfect hands again. And so for each patient. But in practice, in conditions of a large flow of patients, the fulfillment of such a sequence is difficult to achieve. The solution to the problem may be the disinfection of gloves, but it is necessary to understand and take into account the properties of gloves and disinfectants, "said Professor Assadian, citing the study of Axel Cramer.
According to the professor, elastic gloves are lessPermeable for bacteria after disinfection, rather than more dense and rigid gloves. This conclusion is confirmed by a study conducted by scientists from the Medical University of Vienna under the guidance of Professor Assadian.
