Značenje karbapenem - rezistentnih enterobakterija u bolničkoj sredini

master's thesis

• Title (english): The importance of carbapenem - resistant enterobacteria in the hospital care settings
• Author: Martina Hostić
• Mentor: Zrinka Bošnjak (mentor)
• Committee member: Ana Budimir (predsjednik povjerenstva)
• Committee member: Goran Tešović (član povjerenstva)
• Committee member: Zrinka Bošnjak (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Medical Microbiology and Parasitology); Zagreb
• Defense date and country: 2020-09-30, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Public Health and Health Care

Abstract

Sve veći problem diljem svijeta stvaraju infekcije uzrokovane multirezistentnim bakterijama među koje ubrajamo enterobakterije otporne na karbapeneme. Karbapenemi su antibiotici koji se često koriste kao zadnja terapijska opcija za liječenje infekcija koje uzrokuju multirezistentne gram-negativne bakterije. Pokazuju stabilnost prema većini β-laktamaza gram-negativnih bakterija. Međutim, stabilnost prema β-laktamazama nije potpuna jer podliježu hidrolizi karbapenemazama iz grupe A, B i D. Rezistenciji može pridonijeti i pojačana aktivnost efluksnih pumpa te gubitak porina vanjske membrane. U enterobakterija se može razviti smanjena osjetljivost na karbapeneme i zbog gubitka porina vanjske membrane u kombinaciji s produkcijom ESBL ili AmpC β-laktamaza. Karbapenemaza producirajući izolati enterobakterija su otporni na većinu β-laktama, a nerijetko se otpornost javlja i na druge skupine antibiotika. Stoga, liječenje infekcija uzrokovanih ovim izolatima predstavlja izazov koji tek treba nadići. Pojava i širenje karbapenemaza producirajućih enterobakterija značajno pridonosi povećanom pobolu i smrtnosti pacijenata te povećanim troškovima liječenja. Širenje CRE danas predstavlja globalnu prijetnju s obzirom da su u većini zemalja široko rasprostranjene. Često uzrokuju manje ili veće epidemije u zdravstvenim ustanovama. Kako bi se spriječilo širenje infekcija karbapenem-rezistentnim enterobakterijama u zdravstvenim ustanovama, prijeko je potrebno poduzeti učinkovite mjere prevencije i kontrole. Praktična primjena programa upravljanja propisivanja antibiotika i provedba mjera kontrole infekcija dva su ključna područja u prevenciji i kontroli MDR gram-negativnih bakterija u zdravstvenim ustanovama.

Abstract (english)

Infections caused by the multidrug-resistant bacteria, including carbapenem-resistant enterobacteria, are a growing problem worldwide. Carbapenems are often used as a last therapeutic option to treat infections caused by multidrug-resistant gram-negative bacteria. They show stability to most β-lactamases of gram-negative bacteria. However, their stability to β-lactamases is not perfect as they are subject to hydrolysis by carbapenemase groups A, B and D. Increased efflux pump activity and loss of outer membrane porin may contribute to resistance. Decreased susceptibility to carbapenems may also develop in enterobacteria due to loss of outer membrane porin in combination with the production of ESBL or AmpC β-lactamases. Carbapenemase-producing isolates of enterobacteria are resistant to most β-lactams and resistance to other groups of antibiotics often occurs. Therefore, treating infections caused by these isolates is a challenge that has yet to be overcome. The occurrence and the spread of carbapenemase-producing enterobacteria significantly contributes to increased morbidity and mortality of patients and increased treatment costs. The spread of CREs today poses a global threat as they are widespread in most countries. They often cause smaller or larger epidemics in healthcare facilities. In order to prevent the spread of carbapenem-resistant enterobacteria infections in healthcare facilities, it is essential to take effective prevention and control measures. The practical application of antibiotic prescribing management programs and the implementation of infection control measures are two key areas in the prevention and control of MDR gram-negative bacteria in healthcare facilities.

• Keywords: enterobakterije; β-laktamski antibiotici; antimikrobna rezistencija; bolnička infekcija
• Keywords (english): enterobacteria; β-lactam antibiotics; antimicrobial resistance; nosocomial infection
• Language: croatian
• URN:NBN: urn:nbn:hr:105:997338
• 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: 2021-05-13 11:33:58