Sprečavanje širenja enterobakterija sa smanjenom osjetljivosti na karbapeneme

master's thesis

• Title (english): Prevention of spread of enterobacteria with reduced susceptibility to carbapenems
• Author: Josipa Kostelac
• Mentor: Ana Budimir (mentor)
• Committee member: Zrinka Bošnjak (predsjednik povjerenstva)
• Committee member: Goran Tešović (član povjerenstva)
• Committee member: Ana Budimir (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2019-07-03, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Medical Microbiology

Abstract

Sama pojava karbapenem rezistentnih enterobakterija u svijetu povezana je s visokim
stopama smrtnosti, ima veliki potencijal širenja te samim time predstavlja ozbiljnu
prijetnju javnom zdravlju. Zbog limitiranih terapijskih mogućnosti, karbapenem
rezistentni sojevi predstavljaju veliki terapijski problem u bolnicama. Jedan od
najznačajnijih uzročnika iz grupe enterobakterija je KPC Klebsiella pneumoniae koja
se u Hrvatskoj prvi put javila 2011. godine. U cilju sprečavanja širenja ovih
enterobakterija provodi se niz mjera koje uključuju racionalnu uporabu antibiotika te
ranu detekciju i identifikaciju sojeva u bolničkim laboratorijima kako bi se na vrijeme
provele mjere kontrole bolničkih infekcija i suzbilo širenje multirezistentnih izolata. Ako
se dokaže da je soj pozitivan na karbapenemazu, bolesnika se smješta u izolaciju te
se provode sve mjere kontaktne izolacije, uključujući redovitu i pravilnu higijenu ruku,
korištenje osobne zaštitne opreme te održavanje bolničke okoline čistom. Higijena
ruku se smatra temeljnom mjerom prevencije širenja multirezistentih patogena. Ove
se mjere moraju provoditi tijekom cijelog vremena boravka inficiranog ili koloniziranog
bolesnika u bolnici. Također, po otpustu bolesnici moraju dobiti upute o postupanju
unutar zajednice u koju odlaze, kako bi se i na taj način spriječilo moguće širenje
multirezistentnih izolata u izvanbolničkom okruženju.
Uz edukaciju o mjerama prevencije, iznimno je bitna suradljivost unutar cijele
zdravstvene ustanove u svrhu suzbijanja širenja bakterija.

Abstract (english)

Globally, the appearance of Carbapenem-resistant Enterobacteriaceae (CRE) is
associated with high mortality rates and spreading potential and thus presents a severe
threat to public health. Due to limited therapeutic treatments, carbapenem-resistant
types of bacteria present a huge therapeutic issue in hospitals. One of the most
significant agents in the Enterobacteriaceae family is Klebsiella pneumoniae
carbapenemase (KPC), which first appeared in Croatia in 2011. In order to prevent the
spread of these Enterobacteriaceae there is a list of precautions that are implemented.
These include the rational application of antibiotics and early detection and
identification of strains of bacteria in hospital laboratories in order to implement hospital
infection control measures in a timely manner and prevent the spread of multi-resistant
isolates. If it is proven that a strain of bacteria is carbapenemase-positive, a patient
shall be placed in isolation and all contact isolation measures shall be conducted,
including regular and proper hand hygiene, the use of preventative and personal
protective equipment and maintenance of a clean hospital environment. Hand hygiene
is considered to be a fundamental measure in prevention of a multi-resistant pathogen
outbreak. These measures must be conducted throughout the entire period of
admission of an infected or colonised patient to hospital. In addition, when discharged
from hospital, patients must receive instructions on how to act within their communities
in order to prevent possible multi-resistant isolate spreading in non-hospital
environments.
In addition to education about preventative measures, co-operation throughout the
entirety of a healthcare institution is extremely important to prevent the spread of
bacteria.

• Keywords: karbapenem rezistentne enterobakterije; prevencija; higijena ruku; kontaktna izolacija
• Keywords (english): Carbapenem-resistant Enterobacteriaceae; prevention; hand hygiene; contact isolation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:524132
• 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: 2023-05-02 08:47:38