Improvement the Monitoring System for Post-Injection Infectious Complications

Abstract

Relevance. The high intensity of the therapeutic and diagnostic process in medical organizations is accompanied by an increase in the manipulation load on patients and, accordingly, an increase in the risk of post-injection infectious complications. In the Russian Federation, in the structure of infections associated with medical care, post-injection complications in the last ten years before the pandemic of a new coronavirus infection occupied 7.0–11.0% [1]. The question of the impact on the prevalence of post-injection complications of medical care conditions that changed during the COVID-19 pandemic remains open for discussion and study. The purpose of this study is to give an epidemiological characterization of post–injection infectious complications in medical organizations, to determine their place in the structure of patient health losses in order to improve the monitoring system for infections associated with medical care. Materials and methods. The forms of statistical observation No. 1, 2 «Information on infectious and parasitic morbidity», No. 30 «Information on medical organizations» for the period 1994–2022, 101 forms of epidemiological investigation of cases of post-injection complications for the period 2015–2022 are analyzed. Epidemiological and statistical research methods were used in the work. Conclusions. During the study period, the prevalence of post-injection complications in outpatient polyclinic organizations of the Khanty–Mansiysk autonomous okrug – Ugra was 0.10 per 100 thousand visits and 3.85 per 100 thousand treated in hospital. The risk groups for post–injection complications were persons of older age groups, and the place of risk was procedural, vaccination rooms, and neurological departments. Abscesses prevailed in the structure of post-injection complications (85.4%), with the most frequent localization of post-injection complications in the gluteal region (47.7%). During laboratory examination of the material, gram-positive microorganisms were isolated from the focus of infection in 72.9% of cases, the largest proportion of which was Staphylococcus aureus (74.3%), including MRSA. In 80.5% of cases of post-injection complications, surgical intervention was required, including 77.8% in a hospital setting. The prerequisites for the occurrence of post-injection complications were excessive manipulation load, prescribing more than 5 drugs to patients and non-compliance with the instructions for injections in 4.8%. The complexity of monitoring post-injection complications is due to the lack of a standard definition of the case in most nosological forms, deliberate concealment of cases of infectious complications and imperfection of laboratory diagnostics.

Keywords

• post-injection infectious complications
• structure
• etiology
• prerequisites
• circumstances of occurrence
• risks
• standard case definition
• monitoring system