Postantimikrobni proljev odnosno čimbenici rizika i klinički ishod

master's thesis

• Title (english): Antibiotic-associated diarrhoea: risk factors and clinical outcome
• Author: Mirjana Dumančić
• Mentor: Rok Čivljak (mentor)
• Committee member: Dalibor Vukelić (predsjednik povjerenstva)
• Committee member: Goran Tešović (član povjerenstva)
• Committee member: Rok Čivljak (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Infectious Diseases); Zagreb
• Defense date and country: 2014-09-30, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Infectology

Abstract

Postantimikrobni proljev (AAD) je komplikacija povezana s primjenom
antibiotika. Incidencija AAD je različita s obzirom na vrstu antibiotika i
čimbenike rizika u bolesnika i varira izmeĎu 5–25%. Clostridium difficile (C.
difficile) je najčešći uzročnik AAD koji se pojavljuje u oko 25% slučajeva
AAD, a od ostalih uzročnika spominju se još i Clostridium perfringens,
Staphylococcus aureus, Candida spp., Klebsiella oxytoca i Salmonella spp.
Poremećaj fiziološke crijevne flore koja dovodi do razmnoţavanja patogenih
mikroorganizama, toksični i alergijski učinci na sluznicu crijeva te
farmakološki učinci na pokretljivost crijeva, mehanizmi su kojim antibiotici
mogu dovesti do nastanka AAD. Postantimikrobni proljev moţe izazvati svaki
antibiotik no najčešće se kao uzročnici spominju antibiotici širokog spektra
kao što cefalosporini, penicilini, klindamicin i fluorokinoloni. Čimbenici rizika
koji pogoduju nastanku postantimikrobnog proljeva su: različita stanja
imunodeficijencije, starija ţivotna dob, kirurški zahvati (posebno
abdominalni), dugotrajna upotreba antibiotika, smanjeno izlučivanje ţelučane
kiseline te duljina hospitalizacije. Klinička slika varira i najčešće se prikazuje
kratkotrajnim proljevom bez većih znakova upale koji nakon prestanka
uzimanja terapije spontano prolazi, no u teţim slučajevima moţe doći i do
razvoja po ţivot opasnog kolitisa. U ovom radu prikazane su epidemiološke i
kliničke osobitosti odraslih bolesnika hospitaliziranih zbog postantimikrobnog
proljeva i bolesti uzrokovane s C. difficile u Klinici za infektivne bolesti “Dr.
Fran Mihaljević” u Zagrebu tijekom dvogodišnjeg razdoblja.

Abstract (english)

Antibiotic-associated diarrhea (AAD) is a complication related to the use of
antibiotics. The incidence of AAD is different, depending on the type of
antibiotic and risk fators, and varies between 5–25%. Clostridium difficile (C. difficile) is the most common cause in 25% of AAD cases, while other causes include Clostridium perfringens, Staphylococcus aureus, Candida spp., Klebsiella oxytoca and Salmonella spp. Disturbed composition and function of normal intestinal flora leads to the overgrowth of pathogen
microorganisms, toxic and allergic effects on the intestinial mucosa and
pharmacological effect to gut motility are mechanisims which can, with the
use of antibiotics lead to AAD. Antibiotic-associated diarrhea can be caused
by any antibiotic, but the most frequent causes are broad-spectrum
antibiotics, such as cephalosporins, penicillins, clindamycin, and
fluoroquinolones. Risk factors that benefit the occurence of AAD are: different types of immunodeficiency, older age, surgical procedures (esp. abdominal), longterm use of antibiotics, decreased gastric acid secretion, and the length of hospital stay. The clinical picture varies and is most frequently depicted with a short term diarrhea that resolves after quitting the antibiotic intake.In more severe cases it can lead to deadly pseudomembranous colitis. This work shows the epidemiological and clinical characteristics of adult patients hospitalized for AAD and CDAD at the University Hospital for Infectious Diseases "Dr. Fran Mihaljevic" in Zagreb during the two-year period.

• Keywords: antimikrobni lijekovi; postantimikrobni proljev; Clostridium difficile; hospitalizirani odrasli bolesnici; čimbenici rizika; klinički ishod
• Keywords (english): antimicrobials; antibiotic-associated diarrhoea; Clostridium difficile; hospitalized adults; risk factors; clinical outcome
• Language: croatian
• URN:NBN: urn:nbn:hr:105:314374
• 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: 2015-11-05 10:44:17