fcmedicineФундаментальная и клиническая медицинаFundamental and Clinical Medicine2500-07642542-0941КемГМУ10.23946/2500-0764-2026-11-3-103-113fcmedicine-1256Research ArticleЭПИДЕМИОЛОГИЯEPIDEMIOLOGYПрофилактика инфекций, связанных с оказанием медицинской помощи у пациентов с острым нарушением мозгового кровообращенияPrevention of healthcare-associated infections in patients with acute cerebrovascular accidenthttps://orcid.org/0009-0003-4975-8795ГридинаА. А.GridinaA. A.

Гридина Анна Александровна, заведующая эпидемиологическим отделом, врач-эпидемиолог

бульвар имени академика Л. C. Барбараша, 6, г. Кемерово, 650002

Dr. Anna A. Gridina, MD, Head of the Epidemiological Department

Academician L. S. Barbarash Boulevard, 6, Kemerovo, 650002

grad7908@mail.ruhttps://orcid.org/0000-0003-4649-2947МакаровС. А.MakarovS. A.

Макаров Сергей Анатольевич, доктор медицинских наук, главный врач

бульвар имени академика Л. C. Барбараша, 6, г. Кемерово, 650002

Dr. Sergey А. Makarov, MD, Dr. Sci. (Medicine)

Academician L. S. Barbarash Boulevard, 6, Kemerovo, 650002

https://orcid.org/0000-0002-8616-3227БрусинаЕ. Б.BrusinaE. B.

Брусина Елена Борисовна, член-корреспондент РАН, доктор медицинских наук, профессор, заведующая кафедрой эпидемиологии и инфекционных болезней

ул. Ворошилова 22А, г. Кемерово, 650056

Prof. Elena B. Brusina, MD, Dr. Sci. (Medicine), Corresponding Member of the Russian Academy of Sciences, Professor, Head of the Department of Epidemiology and Infectious Diseases

22a, Voroshilov Street, Kemerovo, 650056

Кузбасский клинический кардиологический диспансер имени академика Л.С. БарбарашаРоссияClinical Cardiology Dispensary named after Academician L. S. BarbarashRussian FederationКемеровский государственный медицинский университетРоссияKemerovo State Medical UniversityRussian Federation202625092026113103113Copyright © Гридина А.А., Макаров С.А., Брусина Е.Б., 20262026Гридина А.А., Макаров С.А., Брусина Е.Б.Gridina A.A., Makarov S.A., Brusina E.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://fcm.kemgmu.ru/jour/article/view/1256

Цель. Совершенствование системы профилактики ИСМП у пациентов с ОНМК. Материалы и методы. Проведено описательное, сплошное, одноцентровое ретроспективное аналитическое эпидемиологическое исследование типа «случай-контроль» на базе специализированного центра оказания медицинской по мощи пациентам (n = 1240) с болезнями системы кровообращения (БСК) в период с 2019 по 2025 гг. Для оценки эффективности внедрения профилактических мер был проведён анализ чек-листов (n = 344), в каждом анализировали 31 параметр. Результаты. В ходе исследования был модифицирован и оптимизирован алгоритм профилактических мероприятий по снижению риска реализации ИСМП у пациентов с ОНМК. Профилактические меры систематизированы в интегрированную модель по трём ключевым направлениям обеспечения безопасности медицинских технологий: профилактика инфекций нижних дыхательных путей (ИНДП), инфекций кожных покровов (по 11 мероприятий в каждой категории) и катетер-ассоциированных инфекций мо чевыводящих путей (КАИМП) – 9 мероприятий; совокупный объём комплекса превентивных мер составил 31 позицию. Результаты аудита и оценки эффективности внедрённой системы продемонстрировали статистически значимое снижение заболе ваемости ИСМП на 41,12 % (ОШ = 5,15; 95 % ДИ [3,63‒7,39], p < 0,0001). Положительная динамика носила универсальный ха рактер и отмечалась во всех нозологических подгруппах ИСМП, при этом кратность снижения показателей варьировала от 1,26 до 7,76 раза. Заключение. Показана высокая эффективность усовершенствованной системы профилактики ИСМП у пациентов с ОНМК, что позволяет рекомендовать ее к внедрению в качестве стандарта профилактических мероприятий в профильных медицинских организациях.

Aim. Improving the system of HAI prevention in patients with ACA. Materials and methods. A descriptive, comprehensive, single-center, retrospective analytical epidemiological case-control study was conducted at a specialized medical care center for patients (n = 1240) with circulatory system diseases (CSD) over the period from 2019 to 2025. To assess the effectiveness of the implemented preventive measures, an analysis of checklists was carried out (n = 344); 31 parameters were analyzed in each checklist. Results. During the study, the algorithm for preventive measures aimed at reducing the risk of HAIs in patients with ACA was modified and optimized. The preventive measures were systematized into an integrated model across three key areas of medical technology safety: prevention of lower respiratory tract infections (LRTIs), prevention of skin and soft tissue infections (11 measures in each category), and prevention of catheter-associated urinary tract infections (CAUTI) – 9 measures. The total volume of the preventive measures package amounted to 31 items. The audit and effectiveness evaluation of the implemented system demonstrated a statistically significant reduction in HAI incidence by 41.12 % (OR = 5.15; 95 % CI [3.63–7.39], p < 0.0001). Positive changes were evident in every HAI category; the magnitude of reduction varied between 1,26- and 7,76-fold. Conclusion. The demonstrated high efficiency of the improved HAI prevention system in ACA patients makes it possible to recommend its implementation as a standard of preventive measures in specialized healthcare settings.

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