The article is devoted to the review existing in the world practice of perceptions of safety of medical care, especially biosafety. The authors defined and outlined the general epidemiological safety of medical care. Definition and general provisions of epidemiological safety of medical care was given by authors. The most actual tasks which are required for development and deployment in practice of health care of epidemiological safety as making system of ensuring quality and safety of medical care are defined.

The article gives the characteristics of the current state of the problem legionellosis, features of pathogen ecology and features of the epidemiology of legionellosis. There is insufficient knowledge about the epidemiological features of infection in health care and implementation of epidemiological surveillance. Shows the results of epidemiological studies on the legionellosis in the Nizhny Novgorod region: there is a representation of Legionella pneumophila in the etiology of community-acquired and nosocomial pneumonia, the level of contamination and colonization of various departments in medical institutions. Studied the sensitivity of the Legionella pneumophila to disinfectants. High risk objects of colonization and the most likely reservoirs for L.pneumophila in medical institutions are detected. Identified three types of hospital departments, depending on the probability of infection in patients and the possibility of admission of patients with Legionella infection. Proposed parameters of epidemiological and microbiological surveillance system for monitoring and control with a differentiated approach depending on the type of departments. Developed approaches to improve epidemiological surveillance and control of Legionella infection in the Nizhny Novgorod region.

This article shows the modern views of the resistance of microorganisms to disinfectants and mechanisms of its formation. Different versions of the impact of subbactericidal concentrations of disinfectants, which can be replicated in laboratory conditions. The results of experiments on the formation of induced acquired resistance by the test strain of E.coli to disinfectants from the group of quaternary ammonium compounds (QAC) in the laboratory. The estimation of changes in the microbiological properties, sensitivity to antibiotics and disinfectants, performed electronic microscopy of bacteria in the process of resistance appearance. Any evidence of the possibility of microbial resistance to QAC-containing disinfectants under the influence of repeated impacts of subbactercidal concentrations in laboratory conditions, the time frame of its appearance.

The article presents the technique to evaluate the sensitivity of microorganisms-causative agents of infections isolated from patients, carriers and environment to the disinfectants. The proposed technique gives a possibility to detect the condition of microorganism resistance to disinfectant and to evaluate the degree of its sensitivity. The evaluation of sensitivity, specificity, accuracy, positive and negative prognostic value, reproducibility of developed technique was made.

In the article analyzes the results of a pilot project on monitoring of microbial resistance to disinfectants, implemented in the Nizhny Novgorod region for 3 years. The data obtained by the Monitoring Centre for Preventive Medicine Research Institute of Nizhny Novgorod State Medical Academy in cooperation with medical facilities in the Nizhny Novgorod city and the Nizhny Novgorod region in 2009-2011 in the dynamics. Analyzed some of the performance indicators for monitoring of microbial resistance to disinfectants, number of cultures of microorganisms and their species composition, state of the sensitivity of the microflora in health care to different groups of chemical compounds and certain disinfectants, the tendencies of their change, resistance profiles of different species of bacteria, identified groups of disinfectants based on the frequency of detection of resistant strains. Established the prevalence of resistance to disinfectants microflora in medical facilities in the Nizhny Novgorod region in according whith regional monitoring.

Modern problems of the laboratory diagnostics of healthcare-associated infections (HAIs) at the present stage developments of a science existing and public health services and a way of their decision are discussed. The opinion of authors of the national concept of prophylaxis of HAIs (edition 2010) about priority directions of activity on perfection of laboratory diagnostics of the HAIs caused by conditional-pathogenic microorganisms as a basis of system of HAIs surveillance is presented.

The article contains results of the regional marketing research of disinfectants which are used in healthcare institutions. Authors evaluated a disinfectant assortment due to groups of chemical substances, manufactures and they analyzed some features of disinfectant usage. The necessity of the researches to define possibilities of choose and rotation of the different disinfectant was demonstrated.

The article presents basic principles of the developed concept aimed at improvement of system of epidemiological surveillance over hospital infections. The results of personal studies of ecologo-epidemiological peculiarities of hospital infections at multi-type hospitals, at outpatient-polyclinic institution and in case of interclinic spreading are given in the article. Characteristics of polygenic infections and the received data on microbial resistance to disinfectants used as scientific grounding of the proposed concept are presented. Epidemiological surveillance over hospital infections should be carried out on a case-by-case basis at medical and prophylaxis establishments and on the territory and should have adapted parameters in case of various types of medical care for population (in-patient and outpatient-polyclinic) depending on specialization (multi-type hospitals and specialized departments/clinics).

Epidemiological and microbiological peculiarities of hospital purulo-septic infections of neonates are given in the article. The role of coagulase-negative staphylococcus in etiology of these infections is shown. Wide spectrum and specific variety of staphylococcus are demonstrated. Resistance of hospital strains of coagulase-negative staphylococcus towards antibacterial preparation is studied. Comparative characteristics of adhesiveness and decolonial capacity of different staphylococcus is given.