Javno zdravstveni problem rezistencije bakterije Helicobacter pylori

master's thesis

• Title (english): Helicobacter pylori resistence as a public health issue
• Author: Ivan Bešlić
• Mentor: Neven Ljubičić (mentor)
• Committee member: Mislav Vrsalović (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Neven Ljubičić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Infectology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Eradikacija infekcije Helicobacter pylori prvi je korak u liječenju bolesti koje su povezane s infekcijom. U terapijskim protokolima koriste se uobičajeno kombinacije dvaju antibiotika i jednoga lijeka koji suprimira izlučivanje želučane kiseline (inhibitor protonske pumpe – IPP). Kombinacije lijekova podijeljene su u lijekove prve linije, lijekove druge linije i lijekove treće linije, s tim da se u trećoj liniji izbor lijeka zasniva na testiranju osjetljivosti na antibiotik izoliranoga soja H.pylori. Povećana primjena antibiotika dovela je do porasta rezistencije bakterije te u konačnici do neuspjeha u liječenju. Porast se najviše ogleda u povećanoj rezistenciji na klaritromicin, a novija istraživanja donose podatke o povećanju rezistencije i na levofloksacin, lijekove prve odnosno druge terapijske linije. Obzirom da sama bakterija posjeduje izrazitu otpornost na čimbenike okoline, sužen je izbor antibiotika koji bi potencijalno došli u obzir kao lijekovi za eradikaciju. H.pylori je bakterija koja se pojavljuje većim dijelom u nerazvijenim zemljama, u kojima ne postoji učinkovit sustav kontrole nad povećanjem rezistencije. Zbog toga, kao i zbog široke primjene antibiotika uopće, javlja se izazov koji na jednu stranu stavlja eradikaciju infekcije kod zaraženih, a na drugu stranu sve veći postotak rezistencije i samim time neuspješnost liječenja infekcije.

Abstract (english)

Eradication of infection Helicobacter pylori is the first step in curing diseases connected to the infection. The usual combinations of two antibiotics and one drug which supresses the gastric acid secretion (Proton-pump inhibitors - PPI) are used in treatment protocols. Combinations of drugs are divided into first-line drugs, second-line drugs and third-line drugs, taking into account that the choice of drugs in third-line is based on sensibility testing to the antibiotic of isolated strain H.pylori. Increased usage of antibiotics has resulted in greater resistance of the bacteria and finally to failure in treatment. The rise is most evident in increased resistance to clarithromycin, and recent studies show data of increased resistance also to levofloxacin, drugs of first, i.e., second-line of treatment. Considering that the bacteria itself has an extremely high resistance to environmental factors, the choice of antibiotics which could potentially be considered as drugs for eradication is significantly narrowed. H.pylori is a bacteria which is predominant in underdeveloped countries where there is no efficient control system regarding the increase of resistance. Because of that, and because of the wide usage of antibiotics in general, there is a challenge which places eradication of the infection in the already infected patients on one side, and the ever growing resistance which leads to failure of the treatment of the infection on the other side.

• Keywords: Helicobacter pylori; eradikacija; rezistencija; antibiotici
• Keywords (english): Helicobacter pylori; eradication; resistance; antibiotics
• Language: croatian
• URN:NBN: urn:nbn:hr:105:313362
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-08-10 06:59:25