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The Epidemiology and Prevention of Nosocomial Infections in Neurosurgical Hospitals


Author: Leu Elena
Degree:doctor of medicine
Speciality: 14.00.30 - Epidemiology
Year:2009
Scientific adviser: Viorel Prisăcari
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Scientific consultant: Grigore Zapuhlih
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution:
Scientific council:

Status

The thesis was presented on the 11 November, 2009
Approved by NCAA on the 17 December, 2009

Abstract

Adobe PDF document – 0.38 Mb / in romanian

Keywords

nosocomial septic-purulent infection, the epidemiological / etiological peculiarities, risk factors, antibiotic resistance, epidemiological surveillance.ь

Summary

The structure of thesis: 107 pages of text, introduction, 5 paragraphs, conclusions, practical recommendations, bibliography includes 207 references, 8 annexes, 32 tables. The results were published in 9 scientific papers.

Domain of research: epidemiology. Goal of research: Optimizing epidemiological surveillance system and control of nosocomial infection in the neurosurgical departments.

Objectives of research: Studying of real morbidity, epidemiological and etiological peculiarities, risk factors, antibiotic resistance; assessment of antibiotics use in prophylaxis and treatment of septic-purulent infections, elaboration of the program for epidemiological surveillance and control of nosocomial infections in the neurosurgical hospitals.

Methodology of research: The epidemiological method of active diagnosis of cases with nosocomial infections was used. There were analyzed 3600 patients’ records hospitalized in two neurosurgical departments during 2 years. There were studied the results of 197 patients laboratory investigations with septic-purulent complications. There was used the methodology of E. Sleahov (1991) and Gh.Obreja, N.Opopol (2002) for the statistical evaluation.

Novelty and originality of research: For the first time, there were determined the real morbidity, epidemiological specific peculiarities, the etiology and the risk factors of septic-purulent nosocomial infections in neurosurgical departments. There was evaluated the phenomenon of “antibiotic sensitivity/resistance” as well as type of microorganism and type of antibiotic. The evolution of these processes was studied in dynamics and elaborated a set of optimization of surveillance and control measures in neurosurgical departments.

Theoretical and applied value: There was described epidemiology of septic-purulent nosocomial infections in neurosurgical patients and the program for epidemiological surveillance and control in the neurosurgical departments was elaborated.

Practical implementation: The study results served for elaboration of the “Guideline on surveillance and control in nosocomial infections” approved by the Order of Ministry of Health of the Republic of Moldova, Nr. 51, from 26.02.2009. The results were used at the seminars within the Society of neurosurgeons for teaching medical staff, residents and students with implication of collaborators from the neurosurgical departments.