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Summary. Pseudomonas aeruginosa is one of the most common nonfermenting aerobic gramnegative microorganisms identified in clinical specimens of hospitalized patients. The emergence of multidrug-resistant (MDR) Pseudomonas

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The aim of the study was to evaluate the prevalence of health care-associated infections, risk factors, and antimicrobial use. Material and Methods. The study was carried out as a point-prevalence study in acute care wards, i.e., intensive care, surgical, and medical wards, at Vilnius University Hospital Santariškių Klinikos in April 2010. The study variables included the patient’s general data, indwelling devices, surgery, infection and its microbiological investigation, and antimicrobial use. All the variables that were logically related or had a P value of <0.25 in the univariate analysis were included in the stepwise logistic regression in order to study the factors potentially associated with health careassociated infections. Results. A total of 731 patients were surveyed. The overall prevalence rate of health care-associated infections was 3.8%. The prevalence of health care-associated infections differed by hospital wards (range 0.0%–19.2%). The lower respiratory tract (32.2%), urinary tract (28.5%), and surgical site infections (32.1%) were the most common health care-associated infections. Moreover, 89.3% of the cases of health care-associated infections were microbiologically investigated. Staphylococcus aureus (28.6%) and Escherichia coli (19.1%) were the most frequently isolated microorganisms. The use of one or more invasive devices was recorded in 332 patients (45.4%). Of the surveyed patients, 20.2% received antimicrobial agents. The most commonly prescribed antimicrobial agents were fluoroquinolones (21.1%), broad-spectrum penicillins (19.1%), and first- or second-generation cephalosporins (18.6%). Conclusions. The prevalence of health care-associated infections was found to be similar to the reported overall prevalence rate of health care-associated infections in acute care hospitals in Lithuania.

ĮvadasMedicinos darbuotojų profesiniai ir biologiniai rizikos veiksniai: sveikatos priežiūros įstaigų darbuotojų sąlytis su kito asmens krauju, jo komponentais ir kitais potencialiai infekuotais žmogaus organizmo skysčiais, audiniais ir t. t. Medicinos darbuotojai dėl kasdienio kontakto su žmogaus organizmo biologiniais skysčiais priskiriami didžiausios biologinių veiksnių rizikos grupei (1). Profesinė darbuotojo ekspozicija biologiniais skysčiais -tai darbuotojų gleivinių ir odos sąlytis su krauju ar kitais skysčiais. Mikrotrauma -tai susižeidimas naudotais aštriais instrumentais, aštriais daiktais, užterštais kito asmens krauju ar biologiniais skysčiais (2). Ekspozicijos biologiniais skysčiais ir mikrotraumų rizika yra susijusi su infekcijomis, plintančio-mis krauju: hepatito B virusu (HBV), hepatito C virusu (HCV), žmogaus imunodeficito virusu (ŽIV), herpetiniais virusais, sifiliu, tuberkulioze ir kt. (3).Žmogaus imunodeficito (ŽIV), hepatitų B ir C virusinės infekcinės ligos, plintančios krauju, atsiradus odos ir gleivinių pažeidimams, vis dažniau tampa medicinos darbuotojų profesinio sergamumo (užsikrėti-mo) priežastimi (4). Užsikrėtimo šiomis ligomis rizika labai įvairi ir priklauso nuo užkrato kiekio, perdavimo būdo, mikroorganizmo jautrumo aplinkos veiksniams ir cheminėms medžiagoms, pačių virusų virulentiš-kumo, jų paplitimo populiacijoje, darbuotojo imuninės sistemos stiprumo, susižalojimo gylio, laikotarpio nuo susižalojimo iki žaizdos antiseptikos bei profilaktikos priemonių naudojimo po mikrotraumos ar ekspozicijos (5, 6). Vienas pagrindinių ir pirminių būdų, kuriais sveikatos priežiūros darbuotojai užsikrečia krauju plintančiomis infekcijomis, yra poodiniai pažeidimai tuščia-viduriais kraujo pripildytais aštriais instrumentais. Tyrimų duomenimis, Europoje adatomis susižalojama milijoną kartų per metus (7,8). HBV infekcija yra vienas pavojingiausių medicinos darbuotojų profesi-

Research background. Hygiene of the surfaces means a clean environment of a hospital, especially that of a patient, which consists of constant basic cleaning and disinfection. The registration, analysis and storage of data on cleaning, disinfecting the surrounding objects is a successful stage in ensuring clean surfaces. The registration of documents and the cleaning and disinfecting schedule help to determine the tender spots in the surface cleaning. It makes easy to establish the surface hygiene violations, participation of the nursing and auxiliary staff in disinfecting the surfaces, problems related to the surface disinfection, and make the analysis of the mistakes made easier. The aim of the study. To assess a 2009–2011 hygienic preparation of medical surfaces, which have an effect on the transmission of the hospital-acquired infection, and the efficiency of the preventative measures. Methods. The survey was conducted in university hospital in 2009–2011. To evaluate the surface hygiene of the environmental objects the test of the remains of biological contamination was chosen using the chemical means HemoCheck-S™. The accuracy of the test is 0.1 µq of the remains of biological contamination on the surfaces under investigation. The results are evaluated by calculating the amount of denatured biological contamination from the highest concentration to 0. The surface contamination is evaluated in points from “0” to “5”, where “0” is no contamination (medical surface is fully prepared for a procedure), and “5” is maximum contamination (100 µq, maximum contamination shown by the HemoCheck-S™ test). Results. Investigation shows that the surfaces belonging to the low-risk group are contaminated most heavily. The analysis of the investigations carried out during three years leads us to the conclusion that during the time of cleaning the surface, the staff fails to observe the sequence and do not change soft inventory (napkins) intended for cleaning. This is testified by presence of biological contamination in the low-risk group: switch-boards on the patients’ beds, cupboards and drip mounts. Conclusions. Insufficient hygiene of high, medium risk and often touched surfaces and surfaces of nursing measures was established. The inadequate preparation of the medical surfaces was most often made in the Intensive Care Intensive Therapy units.Keywords: hygienic preparation; medical surfaces; the hospital-acquired infection.

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