On the issue of justification of criteria of health risk in sanitary epidemiological requirements directed at the prevention of infections associated with provision of medical care (literature review)

In the problem of studying hospital microflora, there has arisen a need to standardize the impact of microbiological agents and develop minimum permissible levels of exposure as health risk criteria that allow optimizing the provision of anti-epidemic protection in medical institutions. The proposed indicators, criteria, and norms of control of the hospital environment are indicative, since it is extremely difficult to establish the dependence between the number of microorganisms in the air, at the objects of the hospital environment, and the incidence of patients, due to the lack of threshold levels, reference substitutions, and minimal infected doses of microbial agents. System analysis of scientific literature performed using the databases Web of Science, Scopus, The Cochrane Library, MedLine, PubMed, CyberLeninka, eLibrary.RU, showed that the effect of the microbiological factor, most likely, should be considered threshold-free, taking into account the extensive list of criteria for evaluating the epidemic situation that are not standardized and do not imply a quantitative assessment of microbiological risk. The priority area of ​​optimization of antiepidemic measures, taking into account the methodological basis for analysis of health risk, is the development of requirements for the permissible content of microbial agents in the air of the hospital environment and flushing from surfaces. The subsequent establishment of indicative indicators of the assessment of the nosocomial environment will contribute to the fulfillment of mandatory requirements by medical institutions on the one hand, and on the other hand, the exercise of the powers of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing (Rospotrebnadzor). In this regard, the scientific search in the field of ensuring the safety of the hospital environment should be focused on the problem of developing parameters for the dependence of the incidence of the care-associated infection and the exposition of microbiological agents based on the establishment of the minimum valid levels of exposure and the levels of acceptable health from the effects of hospital strains.