Title Mikrobiološki i klinički aspekti sepse
Title (english) Microbiological and clinical aspects of sepsis
Author Marijana Lopac
Mentor Maja Abram (mentor)
Committee member Darinka Vučković (predsjednik povjerenstva)
Committee member Marina Bubonja Šonje (član povjerenstva)
Committee member Vlatka Sotošek Tokmadžić (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Microbiology and Parasitology) Rijeka
Defense date and country 2023-07-14, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Medical Microbiology
Abstract Sepsa se definira kao životno ugrožavajuća disfunkcija organa uzrokovana neadekvatnim imunološkim odgovorom domaćina na infekciju. Sepsa se može pojaviti u svim životnim razdobljima, no incidencija sepse je veća u krajnjim dobnim skupinama, u novorođenčadi i starijih osoba. U pacijenata kod kojih su uzročnici sepse otkriveni, bakterije su se pokazale dominantnim uzročnicima.
U patogenezi sepse, najznačajnija oštećenja javljaju se na razini mikrocirkulacije. Sepsa, odnosno sindrom sistemskog upalnog odgovora (SIRS) razvija se kada je oslobađanje proupalnih čimbenika veće nego li je potrebno. Takav upalni odgovor koji se zbiva za vrijeme sepse maligne je prirode, budući da nije niti kontroliran niti reguliran.
Tresavica, vrućica, tahipneja i tahikardija ubrajaju se među osnovne kliničke simptome i znakove sepse. Do sindroma višeorganskog zatajenja može progredirati sepsa koja se ne liječi ili sepsa koja ne reagira na primijenjenu terapiju. O teškoj sepsi se govori kada su uz simptome sepse prisutni i znakovi hipoperfuzije ili poremećaja funkcije organa. Teška sepsa može napredovati do septičkog šoka koji označava perzistentnu hipotenziju, usprkos primijenjenoj terapiji.
Klinička, laboratorijska i radiološka dijagnostika, kao i praćenje bolesnika nužno je postupanje u evaluaciji septičnog bolesnika. Hemokultura se smatra najvažnijom mikrobiološkom pretragom u dokazivanju uzročnika sepse. Liječenje septičnog bolesnika započinje intravenskom primjenom tekućine. Antimikrobno liječenje potrebno je primijeniti intravenski i započinje se odmah po uzimanju uzoraka za mikrobiološku analizu. O primjeni antimikrobnog liječenja ovisi ishod bolesti, a kasno započinjanje terapije povećava smrtni ishod u pacijenata.
Abstract (english) Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host's immune response to infection. Sepsis can occur at any age, but the incidence of sepsis is higher in the extreme age groups, including newborns and the elderly. Bacteria are the most common causative agent of sepsis.
In the pathogenesis of sepsis, the most significant damage occurs at the level of microcirculation. Sepsis, or systemic inflammatory response syndrome (SIRS), develops when the release of pro-inflammatory factors is greater than required by the condition of inflamed tissues. Such an inflammatory response is considered malignant since it is neither controlled nor regulated.
Chills, fever, tachypnea and tachycardia are among the basic clinical symptoms and signs of sepsis. Untreated sepsis or sepsis that does not respond to the applied therapy can progress to multiple organ failure syndrome. Patient has severe sepsis when there is, in addition to sepsis symptoms, hypoperfusion or organ dysfunction present as well. Severe sepsis can progress to septic shock, which means persistent hypotension, despite adequate therapy.
Patient monitoring and clinical, laboratory and radiological diagnostics are necessary procedures in the evaluation of a septic patient. Blood culture is considered the most important microbiological examination in proving the causative agent of sepsis. The treatment of a septic patient begins with the intravenous administration of fluids. Antimicrobial treatment must be administered intravenously and should be started immediately after taking blood samples for microbiological analysis. The final outcome depends on the early use of antimicrobial treatment, because late initiation of therapy increases the patient death rate.
Keywords
hemokultura
mikrocirkulacija
sepsa
septički šok
sindrom višeorganskog zatajenja
SIRS
teška sepsa
upalni odgovor
Keywords (english)
blood culture
inflammatory response
microcirculation
multiple organ failure syndrome
sepsis
septic shock
severe sepsis
SIRS
Language croatian
URN:NBN urn:nbn:hr:184:448950
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
Terms of use
Created on 2023-06-29 14:59:15