Circulation fungi of the genus Candida in the internal environment of multidisciplinary hospital

В останні роки кількість інвазивних грибкових інфекцій, що виникають у відділеннях ВРІТ, помітно зросла. У змивах, отриманих з об’єктів лікарняного середовища ВРІТ частота висіювання грибів роду Candida склала 10,7%, при високій питомій частці епідемічно значимих об’єктів: руки медичного персоналу та апарат штучної вентиляції легень. Рівень висіювання цих грибів із повітря становить 16,7%. Видове різноманіття виявлених у повітрі грибів роду Candida представлене C. albicans, C. parapsilosis, у змивах ідентифіковано чотири види – C. albicans, C. parapsilosis, C. glabrata, C. kruzei. Оскільки контамінація грибами роду Candida може сприяти інфікуванню імуноскомпрометованих хворих, то отримані нами результати із відсоткового вмісту та видової структури збудників в межах лікарняного простору свідчать про те, що моніторинг на грибкову контамінацію необхідно включати в плановий графік обстеження внутрішньолікарняного середовища на наявність збудників ВЛІ; В последние годы количество инвазивных грибковых инфекций, которые возникают в отделениях ОРИТ, заметно выросло. В смывах, полученных с объектов внутренней среды ОРИТ, частота высевания грибов рода Candida составила 10,7%, при высокой доле эпидемически значимых объектов: руки медицинского персонала и аппарат искусственной вентиляции легких. Уровень контаминации этими грибами из воздуха составил 16,7%. Видовое разнообразие грибов рода Candida в воздухе представлено C. albicans, C. parapsilosis, в смывах идентифицировано четыре вида – C. albicans, C. parapsilosis, C. glabrata, C. kruzei. Поскольку контаминация грибами рода Candida может вызывать инфицирование иммуноскомпроментированных больных, полученные нами результаты процентного содержания и видовой структуры возбудителей кандидозной этиологии показывают, что мониторинг на грибковую контаминацию необходимо включать в плановый график контроля внутрибольничной среды на наличие возбудителей ВБИ; In recent years, the number of invasive fungal infections occurring in intensive care units (ICU) has increased markedly, and the incidence of fungal infections in General. Candida fungi are the causative agent of approximately 15% of all snooty infections. Given the current trends in the frequencies and ratios of selected pathogens in biopsies of patients with multidisciplinary hospital, in particular the fact that the structure of causative agents of nosocomial infection tigemonam fungi of the genus Candida belongs to the important role the monitoring of internal environment of the hospital and a systematic analysis of specific identification of Candida contaminants etiology is essential in developing strategies to prevent nosocomial infection. The purpose of the study. Set the probability with which a source of nosocomial infection in the form of the causative agents of Candida infections there may be, medical instruments, equipment, surfaces, hands of medical staff and hospital air. Object and methods. In the course of 2015 in this work, we studied 150 washings from objects of environment and analyzed 30 samples of air and level of contamination with fungi of the genus Candida air, swabs, medical instruments and equipment in the surgical Department of reanimation and intensive therapy. Data were processed by standard methods of variation statistics with the definition of arithmetic mean value (M) and their standard error (m). The results of the study and discussion. Investigating the contamination of yeast fungi of the genus Candida obtained from a hospital environment the ICU, we found that the level of contamination was 11.7%. It is shown that the proportion of Candida in the washings obtained from objects of hospital environment in the ICU was 10.7%. The high proportion accounted for epidemically significant objects: hands of medical staff — 13.3% and the artificial lung ventilation device – 5,0% (p<0.05). Analyzing air samples found that 16.7% of the contamination by fungi of the genus Candida (p<0,05). Analyzing the species composition of yeast-like fungi of the genus Candida isolated from the swabs and air in hospital environment the NICU we found that the leading role in the contamination of these isolates belong to Candida albicans – 65%, C. parapsiolis – 25% of all cases, the share C. Kruzei, C. glabrata accounted for 5%. Special concern species diversity of the strains that we identified on the artificial lung ventilation device. Although the level of contamination was only 11.6 percent, but the presence in this equipment C. kruzei, all strains which is high activity and, therefore, high pathogenic, is an indicator for the application of effective measures for the prevention of intra-hospital infection. On the mask, tube and the suctioner ALV identified as C. albicans, C. parapsilosis. Conclusion. So, in the washings obtained from objects of hospital environment the DRIT frequency of seeding of Candida was 10.7% with a high share of epidemically significant objects: hands of medical staff and the artificial lung ventilation device. The level of seeding of fungi from the air is 16.7% with a maximum frequency of detection in isolation wards in the Department of reanimation and intensive therapy. The species diversity detected in the air of fungi of the genus Candida represented by C. albicans, C. parapsilosis, washings identified four species – C. albicans, C. parapsilosis, C. glabrata, C. kruzei. As contamination of objects by these fungi may contribute to infection monobromomethane patients, our results of the percentage and species composition of pathogens within hospital spaces indicate that the monitoring for fungal contamination should be included in a planned schedule of examinations-hospital environment for the presence of pathogens of nosocomial infection