The main sources of exogenous infection. Relationships between endogenous and exogenous oncornaviruses Exogenous route

Various infections for pregnant women are of great danger, since they can infect the fetus in utero.

Water should not be taken directly from lakes or rivers when there is a high risk of contamination. If necessary, boil the water for one minute to remove cryptosporidium and other microorganisms from the water. Using a submicron water filter for personal use may reduce the risk of infection. Be aware that swimming can accidentally ingest water and increase the chance of acquiring Cryptosporidium, even in public pools. Avoid situations where you can breathe in environmental spores, especially damp and dark areas. Hot tubs with hot water, saunas and other shared bathrooms are generally not recommended. Bacteria and other microorganisms thrive in warm water. However, if the immunosuppressed person is confident that the bath is disinfected regularly as recommended, there are no contraindications that prevent its use. Caving should not be practiced due to the contamination risks associated with guano exposure. Travel abroad: For people at very high risk of infection, this risk increases when traveling to developing countries.

• source of infection, such as a sick person;
• pathogen transmission mechanism - horizontal, vertical, artificial or artificial;
• susceptible organism.

• bacillus carriers are patients or medical workers, less often animals;
• patients with purulent-inflammatory diseases;
• iatrogenic infections, when infection occurs from medical staff within the walls of the hospital.

Ways of infection with exogenous infection

Horizontal

• Airborne. The most common way of infection. From air environment macroscopic "creatures" get inside a healthy person. It is enough to be near the source of infection - a sick person or inhale contaminated air. In this way, measles and a number of other diseases are spread.
• Air-dust. This type is typical for pathogenic agents that retain their pathogenic properties for several days. When sneezing and coughing, they enter the air, then settle on dust particles and enter the body. These are pathogenic microorganisms of diseases such as diphtheria, scarlet fever, tuberculosis.
• Fecal-oral. The causative agents of diseases of "dirty hands" - intestinal infection, helminthiasis and salmonellosis. There are two methods here. The first is the alimentary method of infection, when pathogens settle on food, getting on them from the soil, animal waste. Second - water way distribution. Drinking raw water, you can get cholera or typhoid fever.
• Contact household. Allocate direct and indirect routes of infection. With direct transmission, a person becomes infected by direct contact with the patient through saliva, kiss, sex. These are gonorrhea, syphilis, as well as erysipelas, herpes, scabies. With the indirect method, pathogens settle on various household items, that is, the carrier of the virus, for example, dried himself with a towel or took a glass and left some of his "pathogenic friends" on them. A healthy person used the same items and after some time fell ill with dysentery or typhoid.
• Transmissive. Infection occurs as a result of human interaction with disease carriers. In a non-specific way, the carriers are insects - flies and cockroaches, which carry pathogenic microorganisms on their paws that get on food or drinks. Flies can introduce typhoid fever bacillus, hepatitis A virus, or intestinal pathogens into food. Insects that carry only one type of disease are “responsible” for a specific route of infection. Mosquitoes carry malaria, ticks carry encephalitis, fleas carry plague, and lice carry typhus.

vertical

• hepatitis B;
• measles;
• chickenpox;
• bacteria - staphylococci and streptococci.

Those who choose to travel should avoid food and drink that may be contaminated, in particular raw fruits and vegetables, raw or undercooked meats and seafood, tap water, ice made with tap water, milk and water. unpasteurized dairy products and products offered by street vendors. Among the foods and drinks that are generally safe from the point of view of infections are very hot foods, fruits that the traveler himself removes the skin or peel, bottled drinks, coffee and hot tea, beer, wine and water when boiled for one minute. . Although treating water with iodine or chlorine is not as effective as boiling water, this method can be used when it is not possible to boil water. Generally, preventive antimicrobials are not recommended for travelers, but your doctor may advise you to take certain medications with you. The effectiveness of these agents depends on local antimicrobial properties that are rarely known. Consult your doctor's decisions based on your level of risk of infection, as well as the region and duration of your trip. If you're feeling good, you can dust, scrub, clean windows, mop floors, and clean bathrooms in the usual way. However, avoid cleaning or removing dust from places where a lot of precipitation can be filmed. Use common sense and avoid cleaning areas that haven't been touched in years. In general, construction or renovation sites should be avoided due to the possibility of fungi or mold scattered in the dust. If this cannot be avoided, an immunocompromised person can reduce the risk of infection by using a special respirator that filters particles tightly attached to the face. Wear gloves when washing heavily soiled areas and toilets. . There are a few cases where a mask is appropriate, such as if an immunosuppressed person has to enter an area under construction or renovation, or be exposed to heavy emissions of dust or debris.

Infection of a child can also occur during childbirth and during lactation, so HIV-infected and syphilis-infected women are strictly prohibited from breastfeeding their children from the first days of their lives.

artificial or artificial

• hepatitis B, C, D;
• toxoplasmosis;
• malaria;
• syphilis;
• listeriosis.

There are two types of such a source of infection - hemocontact and inhalation.

In addition, if it is necessary to have close contact with other people suffering from a respiratory infection, the mask reduces the risk of infection. Drugs that your doctor or health care provider may prescribe or recommend to you.

• Filgrastim Pegfilgrastim Sargrast.
• Sulfamethoxazole - trimethoprim Acyclovir ® Fluconazole ® Intraconazole ®.

When to Call Your Doctor or Provider medical services due to possible infection. Call immediately if you have.

• Chills or tremor.
• Sudden onset of new pain without explanation.

Blood contact includes such methods of infection:

• Transfusion. Infection occurs during the transfusion of blood or its components. This may be due to poor quality donor examination, reuse of disposable instruments, missing or wrong procedure sterilization reusable surgical instruments, storage violations biological material- blood and its components.
• Transplant. Infection during transplantation of donor organs.
• Parenteral. Microorganisms enter the body when the integrity of the skin or mucous membranes is damaged during surgery, injections or diagnostic measures. Infection can occur if non-sterile surgical instruments are used, re-use of disposable instruments, when an infected specialist works without gloves or a mask.

Blood in the urine. You need to urinate more often than usual.

• Sore throat.
• Sores in the mouth.
• White coating on the mouth, especially on the tongue.
• Signs of a bladder infection.
• Burning when urinating.

The main symptom of infection is intoxication of the body, which manifests itself in the form of:

• weaknesses;
• dizziness;
• nausea;
• vomiting;
• rashes;
• elevated body temperature;
• flow from the nose.

Symptoms vary depending on the type of pathogen, but if you can try to protect yourself from some infections transmitted by airborne, fecal-oral or contact routes, then with an artificial route of infection, nothing depends on a person.

Do you want to be tested for gonorrhea? Find a Health Center →

But if you see signs of gonorrhea, get it tested immediately. Here we will explain what to look for.

Gonorrhea doesn't always have symptoms

Prevention

• during epidemics of viral infections, large crowds of people are avoided;
• wear a multilayer gauze bandage that needs to be changed frequently - every 2 hours;
• temporarily refuse, if possible, to communicate with people who have signs of the disease;
• indoors, the air is disinfected using ultraviolet lamps or other disinfection devices (even daily ventilation reduces the number of germs in the air);
• when they come from the street, they wash their hands with soap, be sure to rinse their face, and after going to the clinic or hospital they wash their nose.

• do not use other people's personal hygiene products;
• wet cleaning is carried out in the room;
• if there is a patient at home, then in places common use an antiseptic is used to wash floors, toilets, bathrooms and kitchens;
• they try to isolate a sick person for the duration of the illness.

Gonorrhea can cause more serious health problems and even cause infertility if left untreated. However, it is usually easily treated with medication. Most people with a vagina who get gonorrhea have no symptoms. If they show symptoms of gonorrhea, they appear about a week after contracting this infection.

Abnormal vaginal discharge, which may be yellowish or bloody bleeding between menstrual periods. People with a penis are more likely to have symptoms if they get gonorrhea. Symptoms usually appear a week after infection.

• wash their hands - before and after eating, when preparing food, after going to the toilet and outside;

  Petted a pet or played with it? Don't forget to wash your hands with soap!

• vegetables and fruits are washed thoroughly under running water; for best effect, use a soft sponge or brush;
• dishes are brought to full readiness, avoiding eating uncooked meat, steaks with blood;
• water and milk are boiled, since at high temperatures the bulk of the pathogenic microflora dies.

Keep an eye on your pets - use flea collars and wash your pets regularly with flea shampoos.

Yellow, white, or green discharge from the penis Pain or burning when urinating Pain or swelling in the testicles Gonorrhea can also infect the anus if you have anal sex, or you can spread the infection to your anus from another part of your body. Anal gonorrhea usually does not show symptoms. However, signs of gonorrhea in the anus may include.

Itching in or around the anus Discharging from the anus Pain in bowel movements. . Throat infections caused by gonorrhea also usually do not cause symptoms. If symptoms appear, it's usually just a sore throat. If you or your sexual partners have any of these symptoms, contact your nurse, or doctor.

What factors, other than the ability of the immune system to resist the attack of viruses, further increase the likelihood of infection is not known exactly. For example, if out of four children playing together in the same conditions, one has a streptococcal infection, then not all three, but only two, may become infected. The third has a chance to become a carrier of an infection that will or will not manifest itself in his body in the future. The probability of infection, in a word, is determined by antibacterial resistance and type-specific immunity.

Biological warfare is the use of microbiological agents for hostile purposes. It is not clear if other countries or dissident groups have the resources for biological warfare. For various reasons, experts consider the use of biological agents unlikely in formal warfare. However, biological agents are considered by some to be ideal weapons for terrorists. These agents may be provided clandestinely and may have delayed effects, allowing the user to remain undetected.

Potential biological agents include carbuncle, botulinum toxin, brucellosis, hemorrhagic fever virus, plague, smallpox, and tularemia. Each is potentially fatal and, with the exception of carbuncle, botulinum toxin, and tularemia, can be passed from one person to another. Direct human-to-human transmission of brucellosis is extremely rare.

An infection of the same type in the organisms of different people can manifest itself in different ways. One child will have rhinitis, another will have tonsillitis, and the third will have otitis media. The fight against streptococcal infection is complicated by the fact that many strains practically do not respond to treatment. hot water their habitats. That is why washing toys and dishes in warm water, even with the use of chemicals, does not give a positive result in the destruction of bacteria. At a temperature of 70 degrees, microbes also continue to live, but 90% of them die after one hour. Exposure to negative temperatures will also not give an effect: if the blood is frozen, streptococci can live in it for several months. Exposure to strong disinfectants can be effective.

Anthrax spores are relatively easy to prepare and, unlike most other agents, can be airborne, creating the possibility of spread by aircraft. Theoretically, 1 kg of anthrax could kill up to 1,000 people, although technical difficulties in preparing the spores as a fine enough powder may actually limit the number of deaths to a fraction of that number.

Most people have been infected with anthrax without developing the disease, possibly due to the widespread use of the antibiotic ciprofloxacin. However, there was extreme public concern about these incidents. The number of false threats of anthrax was very high. More false alarms, both rumors and reports of anxious citizens who confused harmless materials with anthrax, have been reported since the carbuncle attack.

Infection of healthy people can only occur through contact with a sick person. These bacteria are not transmitted by any other living organisms. Both a simple carrier of viruses and an already sick person can infect. Bacteria easily spread in the air when communicating with the patient, get and retain their activity on toys, dishes, and other objects. Even in a dried state, the bacteria continue to be in the air or on surfaces, and when it enters the body, they begin to damage.

The bacterium was introduced by a religious cult that tried to influence the results local elections. No one died and the elections were not affected. Chicken soup, toasted slices, fruit, liquids only: we all have our own way deal with a cold, flu or stomach upset. But scientists now understand that there is actually a link between the food we eat when we are sick and recovery time, and that, depending on the infection, it is better to eat or not eat at all.

A study that has just been done on mice has shown that eating more food when fighting a viral infection like the common cold and flu can help speed up recovery, but on the other hand, if we fight a bacterial infection like a food poisoning, food intake can seriously worsen the situation.

The most susceptible to streptococci are small children who are not yet accustomed to the rules of personal hygiene and constant hand washing. However, it cannot be said that bacteria will not settle in the human body of an adult. The chances of catching an infection decrease only after the age of forty. Exacerbation and growth of morbidity occur in the autumn-winter time.

When animals are infected, they stop eating, which switches their metabolism to starvation. The question is, is there any benefit from this and is it also important for people? - lead researcher Ruslan Maizhov. Before moving on to the survey results, let's first take a look at how our body reacts to various infections. We basically know two types of infections: bacterial and viral.

Bacterial infections, which include bronchitis and pneumonia, are caused by single-celled organisms that can develop and multiply in our bodies. Fortunately, most bacterial infections are treatable with antibiotics to limit their colonies. Viral infections, such as the flu or a cold, on the other hand, are not self-replicating like bacteria. Instead, they take our cells and make them make more copies of the virus and therefore spread throughout the body. Viral infections usually do not respond to antibiotic treatment, but some antiviral agents can prevent their spread in intact cells. When we are infected with harmful bacteria or viruses, our immune system is instantly activated, the first defensive response is an increase in inflammatory processes in different areas body.

For introduction and vital activity in the human body, streptococci choose the surface of the tonsils, as well as lymphoid tissue on the respiratory organs. There are cases, but much less often, when an infection in the human body appears through the skin, on which there are wounds and cracks, burns or diaper rash. In the place where streptococci are introduced, a primary focus is formed, from where the inflammatory process originates. From it, in the future, microbes also enter other tissues of the internal organs, causing severe general intoxication. Microbes are active, multiply, release toxic products and components resulting from protein breakdown. Often streptococcal infection progresses to necrosis - purulent damage tissues and their subsequent death.

Streptococcal infection has a striking property fast speed spread in tissues and organs. At the initial stages of their impact, phlegmon and periadenitis develop. With further entry of microbes into the Eustachian tubes, inflammation is localized in the middle ear, which causes otitis media, sinusitis, ethmoiditis, mastoiditis. The advanced stage of the disease may result in the formation of purulent metastases and septicopyemia. Timely started and competently prescribed treatment is a guarantee that the spread of infection can be stopped and the onset of irreversible pathological changes can be prevented.

It is impossible to recognize a streptococcal infection on your own. For this, clinical examinations and analyzes are necessary so that doctors can isolate streptococci in the group of bacteria present in the body. The earlier the patient goes to the doctor, the higher the likelihood that the diagnosis will be carried out correctly.

Endogenous and Exogenous Infections- When discussing the problems of nosocomial infection, the terms " endogenous" and " exogenous» infection. However generally accepted definition these concepts do not yet exist.

In infectious pathology, endogenous infection is currently understood as a violation of persistence, activation of latency - an exacerbation of an infection that had previously been asymptomatic. The causes of exacerbation are various stressful effects on the body, the nature of which is individual for each nosological form, prone to a latent course.

A different meaning is given by some authors to the concept of endogenous infection in relation to postoperative hospital infection of wounds. In this case, we are talking about whether the pathogen is brought into the wound from the foci of carriage of the patient himself or other carriers from among the staff or patients. However, to define this concept, the old surgical term " self-infection» (self-infection) or autoinfection a counterweight " cross infection» (cross-infection).

On the question of how often the patient's own microorganism or another microorganism enters the wound, no. consensus. Some studies indicate that autoinfection is essential (Williams et al., 1959; Calia et al., 1969), while others express the opposite opinion (Moore and Gardner, 1963; Henderson et al., 1967). The evaluation was carried out mainly in relation to staph infection based on a comparison of the pathogen isolated from the wound and data on nasal carriage detected before surgery or at the time of surgery. If the types of the microbe coincided, autoinfection was allowed, if there was a mismatch, exogenous infection was allowed.

However, such a comparison is not enough to resolve this issue. When describing ecology Staphylococcus aureus it was pointed out that in some cases an independent carriage of staphylococcus in other places, in addition to the nasal one, is possible. Intermittent carriage is also possible.

Given these circumstances, Bruun (1970) spent more than detailed analysis. The author, over a two-year period, regularly took samples from the nose of the staff, as well as from the nose, perineal region, and all wounds of patients in the surgical department. Typing of staphylococci was carried out by phages and resistance to antibiotics.

Autoinfection was considered if the same strain was isolated from the wound as in the place of carriage recorded at the time of surgery or after surgery, but before colonization of the surgical wound.

A possible autoinfection was considered if the same type of staphylococcus found in the surgical wound was detected at the carrier site simultaneously with the detection in the surgical wound.

Cross-infection was considered when the patient was not a carrier or was a carrier of another type of staphylococcus when colonizing the surgical wound with staphylococcus aureus.

The results of the study showed that 158 ​​of 304 staphylococcal colonizations of surgical wounds (52%) were most likely associated with autoinfection. An additional 56 colonizations (18.4%) were classified as possible autoinfections. The remaining 90 colonizations (29.6%) were considered to be due to cross-infection.

If only nasal carriage at the time of surgery were taken into account in the study, then only slightly more than 30 infections would be classified as autoinfections. Taking into account the results of samples from all possible places of carriage, more than 2/3 infections are regarded as an autoinfection or a possible autoinfection. The author believes that in this study there may have been an underestimation of the frequency of autoinfections due to the unforeseen isolation of several different strains in the samples.

Thus, the results of this study indicate that autoinfection was the main way of infection of surgical wounds with staphylococci. True, in this case, self-infection of the wound and the place of carriage by the same type of staphylococcus is not excluded. However, it is unlikely that such coincidences would be so frequent. Rather, it should be considered that patients became carriers of the hospital strain in the preoperative period and subsequently contributed in one way or another to the entry of their staphylococcus into the wound.

Both autonification and cross-infection can occur during or after surgery. The specific significance of operating room and ward infections by different authors evaluated differently. Some authors believe that operating room infections are less common than ward infections (Shooter, 1956), while others, on the contrary. Such inconsistency in the estimates may be due to the peculiarities of the conditions under which the observation was carried out. However, methods of differentiation of sites of infection are of undoubted importance.

Bruun (1970) applied the following criteria for this purpose. It was considered that there was no infection if the wound had healed. by primary tension or only with serous discharge. A possible infection was taken into account when there was moderate redness or swelling of the wound edges without isolation of bacteria in the samples. This category also included cases of mild reddening of the edges of the wound and serous discharge with the growth of bacteria from the samples. Moderate infection was classified when undoubted signs of infection were observed: redness and swelling of the edges of the wound, their divergence and purulent discharge. The same group included wounds with signs of possible infection, bacterial growth and delayed healing. Severe closed infection included infections of the peritoneal or pleural cavities in connection with surgical wounds, but the latter do not have undoubted signs of infection. Severe infection was considered undoubted evidence of wound infection with a general reaction.

Clinical criteria were used to differentiate between operating room and ward infections. The operating room included all infections that, according to the clinical assessment, were considered to have originated deep in the wound. This also included infections that clinical assessment were "possibly deep" and in which the pathogen was sown in the first postoperative sample taken from the wound. Other infections were classified as possible ward infections.

With this approach, less than half of all infections were classified as operating room infections. However, staphylococcal infection in the operating room was detected in less than 1/4 of all staphylococcal infections. 75.6% of all infections with this pathogen were associated with wards. As for non-staphylococcal infections, 50.4% of them were classified as operating room infections. These are mainly infections caused by Gram-negative bacteria. The author thinks that perhaps a large number of operating room infections among them are associated with surgical wound during abdominal operations and infection with autobacteria from the intestinal tract (Cole, 1963).

As for the actual endogenous infection, as an exacerbation of latency, this variant of the development of an infectious disease in relation to the problem of nosocomial infection has practically not been studied. Snider (1968) calls endogenous infection such remote postoperative infectious complications in which the same microbe is released as in the wound. The author confines himself to this general definition.

In principle, an endogenous infection (staphylococcal, for example) is possible, since the experiment shows the persistence of this pathogen. And the very fact of widespread staphylococcal carriage is one of the manifestations of such a condition. However clinical manifestations staphylococcal infections are usually the result of exogenous auto- or cross-infection through damaged skin or mucous membranes. Numerous factual materials testify to the legitimacy of such an explanation. Meanwhile, systematic blood tests in operated patients are often accompanied by inoculation of the pathogen without any signs of an infectious complication. In our observations, after heart surgery, the culture of staphylococcus was sown from the blood of 39 patients. 18 of them then developed a picture of endocarditis. These questions require more in-depth study. Probably, the true manifestation of an endogenous infection is a relatively very rare suppuration postoperative scars, sometimes observed months and years after the successful outcome of the operation. From this point of view, operations with dissection of scar tissue cannot be considered obviously aseptic.

Nosocomial infection is mainly an exogenous infection. However, the pathogen can get into the wound (or other lesion) from the foci of the carriage of the patient himself (autoinfection). The exogenous nature of this infection is also important to emphasize because the microbe that causes the pathological process is rarely brought into the clinic by the patient himself. Most often it is acquired by patients during the hospital stay. Another variant of exogenous infection is the penetration of a microbe isolated by carriers from among the staff or other patients. In some cases, an actual endogenous infection is also possible. However, this issue requires further study.
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infectious diseases are usually accompanied by disturbances in the body's homeostasis and its physiological functions. Many interacting parameters in the system specific pathogen-specific organism are reflected in various forms of the infectious process and its variants. In other words, depending on the epidemiological situation, the type and properties of the pathogen (for example, infectious dose, virulence, etc.), the state of human homeostasis parameters, as well as on the specific features of the interaction between the pathogen and the organism infected person, infectious process can take various forms(from clinically expressed to asymptomatic, from superinfections to bacteriocarrier). Below are the main forms of infectious processes.

exogenous infections. endogenous infections.

Exogenous infections develop as a result of penetration into the body of pathogenic microorganisms from the external environment.

endogenous infections usually develop as a result of activation and, less often, penetration of opportunistic microorganisms normal microflora from non-sterile cavities internal environment organism (for example, skidding intestinal bacteria in urinary tract during their catheterization). A feature of endogenous infections is the absence of an incubation period.

Regional infectious diseases. Generalized infections

Regional infectious diseases- the infectious process takes place in some limited, local focus and does not spread throughout the body.

Generalized infectious diseases develop as a result of dissemination of the pathogen from the primary focus, usually through the lymphatic tract and through the bloodstream.

Monoinfections. Mixed infections (mixed)

Monoinfections- diseases caused by one type of microorganism.

Mixed infections (mixed infections, mixed infections) develop as a result of infection with several types of microorganisms; similar states characterizes a qualitatively different course (usually more severe) compared to monoinfection, and the pathogenic effect of pathogens does not have a simple total character. Microbial relationships in mixed (or mixed) infections are variable:

If microorganisms activate or aggravate the course of the disease, they are defined as activators, or synergists(for example, influenza viruses and group B streptococci);

If microorganisms mutually suppress the pathogenic action, they are designated as antagonists(For example, coli inhibits the activity of pathogenic salmonella, shigella, streptococci and staphylococci);

indifferent microorganisms do not affect the activity of other pathogens.

Forms of the infectious process are classified according to certain criteria.

The nature of the pathogen distinguish bacterial , viral , fungal , protozoan infections.

Origin infections are divided into exogenous and endogenous.

Exogenous infection occurs as a result of human infection with pathogenic microorganisms coming from the environment with food, water, soil, air, secretions of a sick person, convalescent or microcarrier.

endogenous infection caused by representatives of the normal microflora - conditionally pathogenic microorganisms of the person himself. It often occurs when immunodeficiency states organism.

Autoinfection - a kind of endogenous infection that occurs as a result of self-infection by transfer (usually by the hands of the patient himself) from one biotope to another. For example, from the mouth or nose to the wound surface.

According to the number of pathogens infectious diseases caused by one type of microorganism are called monoinfection , but two or more species (many respiratory infections) - mixed (mixed) infection .

By duration The course of an infectious disease is divided into acute and chronic. Acute infections are characterized by a relatively short-term (from one week to a month) course, chronic - a protracted course (for months, years). Chronic infections characterized by a prolonged stay of the microorganism in the body or persistence.

According to the nature of localization pathogens in the body are distinguished focal infection , in which microorganisms are localized in a local focus and do not spread throughout the body, and generalized infections , in which pathogens spread throughout the body by lymphogenous or hematogenous routes. At slightest violation balance between micro- and macroorganism, focal infection can turn into a generalized form. Generalized infections include:

- bacteremia , viremia when the pathogen circulates in the blood, but does not multiply in it, since the blood is only a mechanical carrier;

- toxinemia - circulation in the blood of the toxin;

- sepsis (septicemia) when the pathogen not only circulates in the blood, but also multiplies in it due to a decrease in immune mechanisms;

- septicopyemia - formation as a result of sepsis of purulent foci in various bodies;

- bacterial or toxic-septic shock develop with a massive intake of bacteria or their toxins into the blood.

By manifestation along with clinically expressed - manifest - infectious diseases, when all the main clinical symptoms are present, infectious diseases often occur with an incomplete set of symptoms - abortive or atypical infection, or symptoms may be mild - inapparent form (asymptomatic).

One of the forms of interactions between the pathogen and the human body is microcarrier (bacteriocarrier, virus carrier, etc.). Modern representation about carriage is that it is considered as an infectious process that is asymptomatic either in acute (up to 3 months) or in chronic (years, decades) form. This is confirmed by the identification of immunological changes in the human body, as well as typical for this disease functional and morphological changes in organs and tissues. Expressed to a small extent, they do not lead to manifestation pathological process, outwardly, a person remains healthy. It is formed more often after an illness, when clinical recovery occurs, but the pathogens continue to remain in the body of the ill person and are released into environment(for example, carriage of typhoid, dysentery sticks). Microcarriers can develop in healthy people with a low level of immunity, in contact with a sick person or a carrier of pathogenic microorganisms.

Often the main infection gets complicated secondary infection caused by another microbe (for example, influenza is often complicated by bacterial pneumonia).

relapse - return of symptoms of the disease due to pathogens remaining in the body (for example, relapsing fever, malaria).

reinfection - reinfection the same kind of microbe after recovery.

Superinfection - infection with the same pathogen until recovery.

Infectious diseases to which a person is susceptible are called anthroponoses (gonorrhea, syphilis, typhoid fever, dysentery). Man is immune to pathogens that cause disease only in animals, the so-called zoonoses . Infectious diseases that affect animals but can also affect humans are called anthropozoonoses (plague, tularemia, brucellosis, anthrax).

EXAM PROGRAM

(medical Faculty)

ASEPSIS

Nosocomial infections: sources of infection of the patient, sources of endo- and exogenous infection, ways of transmission of infection from the patient to the medical staff.

As defined by the WHO Expert Committee: “Accompany-acquired infections are any clinically recognizable diseases of microbial etiology that affect the patient as a result of his stay in the hospital or contacting it for medical care/ regardless of the onset of symptoms of the disease before or during the stay in the hospital /, or a hospital employee due to his work in this institution.

Nosocomial infections are divided into:

Traditional infections\ influenza, dysentery \;

Hospital purulent - septic infections.

Sources of infection of the patient / carriers and vectors pathogenic microflora/ are

People: medical staff, patient, persons in contact with the wound, persons in contact with the patient, his relatives;

medical instruments, suture material, surrounding objects / mattresses, blankets, etc. /;

Ambient air polluted with dust or moisture droplets.

Thus, the sources of infection of the patient are everything that surrounds him and the patient himself.

Sources of infection can be located inside the body / endogenous or internal infection / and outside the body / exogenous or external infection /.

MAIN SOURCES OF ENDOGENOUS INFECTION

Chronic diseases outside the operation area / dormant infection /. From the primary focus, the infection spreads by the hemato- or lymphogenous route;

Acute inflammatory diseases in the organs on which the operation is performed. Infection occurs by contact;

Saprophytic microflora of the skin, oral cavity, gastrointestinal tract. Infection occurs mainly by contact.

MAIN SOURCES OF EXOGENOUS INFECTION

Bacillus carriers /medical staff and patients/. The spread of infection by them occurs by airborne droplets;

Patients with purulent-inflammatory diseases. The infection is spread by airborne dust and by contact;

Hospital strains of antibiotic-resistant microorganisms /hospital infection/. Infection occurs by airborne dust;

Iatrogenic infection /infection by medical staff/;

spread by contact, implantation and

by airborne droplets.

Thus, the ways of transmission of endogenous infection are contact, hematogenous, lymphogenous; exogenous infection - airborne, airborne, contact, implantation.

Ways of transmission of infection from the patient to the medical staff

Contact route: the hands of medical personnel with skin lesions or their mucous membranes come into contact with microbial-contaminated or infected secretions, or biological fluids patient, microbial-contaminated medical equipment, patient care items;

Through the blood: the patient's blood comes into contact with the blood of the medical staff when they damage the skin of the hands with sharp or stabbing objects;

Fecal-oral: hands, water, food can be contaminated with the fecal microflora of patients, which can occur when caring for the sick or handling care items /vessels, pads, etc./;

Inhalation: inhalation of pathogenic microbes that have entered the air from patients and settled on dust particles and liquid droplets.

Prevention of the development of nosocomial infections is achieved by aseptic methods, and the treatment of already existing nosocomial infections and community-acquired infections is achieved by antiseptic methods.

2. Methods of prevention of air - dust infection.

Special layout operating block and dressings;

Wearing overalls and special footwear by medical staff;

Working hours of the operating room and dressing rooms;

Restriction of movement in the operating room;

UFO dressing rooms and operating room;

Cleaning the operating room and dressing rooms;

Air filtration;

Laminar air flow in operating rooms;

Reduction of pre- and postoperative periods.