Mjere kontrole širenja Klebsiella pneumoniae KPC u bolničkoj sredini

master's thesis

• Title (english): Control measures to prevent the spread of Klebsiella pneumoniae KPC in the hospital setting
• Author: Marija Čulo
• Mentor: Marko Kutleša (mentor)
• Committee member: Bruno Baršić
• Committee member: Goran Tešović
• Committee member: Marko Kutleša
• Granter: University of Zagreb; School of Medicine; (Department of Infectious Diseases); Zagreb
• Defense date and country: 2015-09-25, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Infectology

Abstract

Pojava i širenje karbapenem rezistentnih enterobakterija u svijetu predstavlja ozbiljnu prijetnju javnom zdravlju. Ovi mikroorganizmi su povezani s visokim stopama smrtnosti i imaju veliki potencijal širenja. Suzbijanje njihova širenja zahtijeva koordinirani napor svih sudionika koji pružaju zdravstvene usluge.
KPC K. pneumoniae jedna je od značajnijih uzročnika iz grupe enterobakterija koja se pojavila u Hrvatskoj 2011. godine. U radu je opisano širenje ovog uzročnika među osam bolesnika liječenih u Jedinici intenzivnog liječenja (JIL) Klinike za infektivne bolesti “Dr. Fran Mihaljević”, Zagreb od listopada 2014. do veljače 2015. godine. Indeks bolesnica je bila nizozemska državljanka, kojoj je u Grčkoj izolirana KPC K. pneumoniae. Cilj niza provedenih mjera bilo je sprječavanje daljnjeg širenja među bolesnicima. Mjere su uključivale: kontaktnu izolaciju kliconoša ili inficiranih bolesnika, brzu mikrobiološku obradu, probir bolesnika i osoblja, edukaciju osoblja o higijeni ruku, nadzor suradljivosti u higijeni ruku pomoću alata Svjetske zdravstvene organizacije "5 momenata za higijenu ruku", promociju dezinfekcije ruku alkoholnim utrljavanjem, nabavu alkoholnih pripravaka i držača kako bi suradljivost higijene ruku bila još dostupnija, pravilno korištenje osobne zaštitne opreme te završnu dekontaminaciju površina dezinfekcijom vodikovim peroksidom. Provedena je i privremena mjera zatvaranja užeg dijela JIL-a za prijem novih bolesnika. Sve je to rezultiralo stavljanjem pod kontrolu širenja ovog rezistentnog uzročnika.

Abstract (english)

The emergence and spread of carbapenem-resistant Enterobacteriaceae in the world poses a serious threat to public health. These microorganisms are associated with high mortality rates and have great potential for expansion. Suppressing their spread requires a coordinated effort involving all participants who provide health services. KPC K. pneumoniae is one of the major causes among the Enterobacteriaceae group which appeared in Croatia in 2011. This thesis describes its spread among eight patients treated at the Intensive Care Unit of the University Hospital for Infectious Diseases "Dr Fran Mihaljevic" from October 2014 to February 2015. The index patient was a Dutch woman, in whom KPC K. pneumonia was isolated during her stay in Greece. The aim of implemented set of measures was the prevention of further spread of infection among patients. These measures included: contact isolation of carriers or infected patients, rapid microbiological diagnostics, screening of patients and hospital staff, training staff on hand hygiene, monitoring hand hygiene compliance by using WHO tool "Five Moments for Hand Hygiene", promoting alcohol-based hand disinfection, installing alcohol-based hand rub dispensers to facilitate hand hygiene compliance, proper use of personal protective equipment and final decontamination of surfaces with hydrogen peroxide disinfection. Closure of the ICU to new patients was also carried out as a temporary measure. All these measures resulted in placing the spread of this resistant pathogen under control.

• Keywords: karbapenem rezistentne enterobakterije; KPC K. pneumoniae; probir; kontaktna izolacija; higijena ruku; osobna zaštitna oprema; suradljivost
• Keywords (english): carbapenem-resistant enterobacteriaceae; KPC K. pneumoniae; screening; contact isolation; hand hygiene; personal protective equipment; compliance
• Language: croatian
• URN:NBN: urn:nbn:hr:105:571876
• Study programme: Title: Studies in Nursing; Study programme type: university; Study level: graduate; Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-04-21 10:59:43