RESUMO
AIM: To investigate efficacy of the extended complex of preventive and antiepidemic measures for reduction of nosocomial infections incidence in patients treated in critical and intensive therapy (CIT) surgical units. MATERIAL AND METHODS: From 2003 to 2005 CIT units of N.N. Burdenko Central Military Hospital conducted a study with participation of 200 patients aged 50 to 77 years after extended abdominal operations. The patients were divided into 2 groups. Group 1 (n = 100) received standard prophylaxis of infectious complications, group 2 (n = 100) received an extended complex of prophylactic and antiepidemic measures. First-line antibacterial therapy in all the patients included cephalosporines of the third generation and metronidasol. The extended complex included air decontamination with application of the system "Clean room complex"; prevention of nosocomial, particularly ventilator-associated pneumonia (VAP); prevention of catheter-associated sepsis; use of disposable sterile items. RESULTS: Group I patients developed sepsis in 30%, septic shock and polyorganic insufficiency (POI)--in 16% cases; lethality due to infectious complications was 13%. Gram-negative microflora was dominating. In group 2 sepsis was diagnosed in 22%, septic shock and POI--in 11%, lethality was 11%. CONCLUSION: The extended complex ofpreventive and antiepidemic measures significantly reduced the rate of severe infectious complications and related lethality. Among the agents of nosocomial infection the percentage of staphylococci and blue pus bacillus decreased while that of enterococci and E. coli increased. Contamination of the ambient air and CIT units reduced significantly.
