prikaz prve stranice dokumenta Utjecaj primjene antimikrobne terapije na selekciju mikroorganizama koji produciraju beta-laktamaze proširenog spektra (AmpC i ESBL) i ishod liječenja bolesnika
  Download
PDF 5.42 MB
doctoral thesis
Utjecaj primjene antimikrobne terapije na selekciju mikroorganizama koji produciraju beta-laktamaze proširenog spektra (AmpC i ESBL) i ishod liječenja bolesnika
Zagreb: University of Zagreb, School of Medicine, 2012. urn:nbn:hr:105:384491
Erdeljić, Viktorija
University of Zagreb
School of Medicine

Institutional repository: Dr Med - University of Zagreb School of Medicine Digital Repository

Cite this document

Erdeljić, V. (2012). Utjecaj primjene antimikrobne terapije na selekciju mikroorganizama koji produciraju beta-laktamaze proširenog spektra (AmpC i ESBL) i ishod liječenja bolesnika (Doctoral thesis). Zagreb: University of Zagreb, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:105:384491

Erdeljić, Viktorija. "Utjecaj primjene antimikrobne terapije na selekciju mikroorganizama koji produciraju beta-laktamaze proširenog spektra (AmpC i ESBL) i ishod liječenja bolesnika ." Doctoral thesis, University of Zagreb, School of Medicine, 2012. https://urn.nsk.hr/urn:nbn:hr:105:384491

Erdeljić, Viktorija. "Utjecaj primjene antimikrobne terapije na selekciju mikroorganizama koji produciraju beta-laktamaze proširenog spektra (AmpC i ESBL) i ishod liječenja bolesnika ." Doctoral thesis, University of Zagreb, School of Medicine, 2012. https://urn.nsk.hr/urn:nbn:hr:105:384491

Erdeljić, V. (2012). 'Utjecaj primjene antimikrobne terapije na selekciju mikroorganizama koji produciraju beta-laktamaze proširenog spektra (AmpC i ESBL) i ishod liječenja bolesnika ', Doctoral thesis, University of Zagreb, School of Medicine, accessed 07 May 2024, https://urn.nsk.hr/urn:nbn:hr:105:384491

Erdeljić V. Utjecaj primjene antimikrobne terapije na selekciju mikroorganizama koji produciraju beta-laktamaze proširenog spektra (AmpC i ESBL) i ishod liječenja bolesnika [Doctoral thesis]. Zagreb: University of Zagreb, School of Medicine; 2012 [cited 2024 May 07] Available at: https://urn.nsk.hr/urn:nbn:hr:105:384491

V. Erdeljić, "Utjecaj primjene antimikrobne terapije na selekciju mikroorganizama koji produciraju beta-laktamaze proširenog spektra (AmpC i ESBL) i ishod liječenja bolesnika ", Doctoral thesis, University of Zagreb, School of Medicine, Zagreb, 2012. Available at: https://urn.nsk.hr/urn:nbn:hr:105:384491

Metadata
TitleUtjecaj primjene antimikrobne terapije na selekciju mikroorganizama koji produciraju beta-laktamaze proširenog spektra (AmpC i ESBL) i ishod liječenja bolesnika
Title (english)The impact of antimicrobial consumption on the selection of extended-spectrum beta-lactamases producing (ESBL, AmpC) strains and on patients outcomes
AuthorViktorija Erdeljić
VIAF: 5094160668017503560009
Mentor Igor Francetić (mentor)
Committee membernije dostupno (član povjerenstva)
GranterUniversity of Zagreb
School of Medicine
Zagreb
Defense date and country2012-02-20, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Universal decimal classification
(UDC)		61 - Medical sciences
Abstract
Bilježi se značajno povećanje učestalosti infekcija sojevima Escherichia coli i Klebsiella pneumoniae koje produciraju beta-laktamaze proširenog spektra (ESBL), posebno u jedinicama intenzivne skrbi (JIL). Cilj ove studije bio je utvrditi lokalne čimbenike rizika za infekciju ESBL sojem, s naglaskom na definiranje uloge antibiotika . Studija je provedena u 3 JIL na 3 razine: 2) studija slučajeva s kontrolama; 1) ekološka studija, i 3) genotipizacija reprezentativnog uzorka izolata. Ekološka studija utvrdila je povezanost učestalosti izolacije ESBL sojeva s primjenom fluorokinolona i cefalosporina 3.generacije s vremenskim odmakom od 2 mjeseca. Potrošnja karbapenema, cefalosporina, aminoglikozida, glikopeptida i klindamicina također je bila značano povezana s prevalencijom ESBL izolata, bez vremenskog odmaka. Čimbenici rizika utvrđeni u studiji slučajeva s kontrolama bili su: dužina hospitalizacije u JIL, prethodna antibiotska terapija, broj propisanih antibiotika te prethodna primjena makrolida i fluorokinolona. Mortalitet i učestalost primjene neadekvatne antibiotske terapije bili su veći u grupi bolesnika s ESBL infekcijom. Genotipizacija izolata utvrdila je da su i selekcijski pritisak primjene antibiotika i horizontalni prijenos važni čimbenici rizika za infekciju ESBL sojem KP i EC. Rezultati ove studije potvrđuju da je primjena antibiotika najvažniji čimbenik rizika za ESBL infekciju, naglašavaju važnost i potrebu za racionalnom primjenom antibiotika, posebno fluorokinolona, uz strogo pridržavanje mjera kontrole infekcije.
Abstract (english)
There is an increase in infections caused by extended-spectrum beta-lactamases (ESBL) producing strains of Escherichia coli and Klebsiella pneumoniae, especially in intensive care units (ICUs). The aim of this study was to identify local risk factors for ESBL infection, with emphasis on defining the position of antibiotics. This study was conducted in 3 ICUs at 3 levels: 2) case-control study; 1) ecological study, and 3) isolate genotipization. Ecological study demonstrated that the use of fluroquinolones and 3rd generation cephalosporins was significantly associated with the increase in frequency of ESBL strains isolation with a delay of 2 months. The use of carbapenems, piperacillin/tazobactam, cephalosporins, aminoglicosides, glycopeptides and clindamycin was also significantly associated with the frequency of ESBL KP/EC isolates, without delay. Risk factors for ESBL infection identified in the case-control study were: duration of ICU stay, previous antimicrobial therapy, number of prescribed antibiotics, previous use of macrolides and fluoroquinolones. Mortality and inadequate antimicrobial therapy were more frequent in the ESBL group. Isolate genotipization revealed that both selection pressure and horizontal transfer are important factors for ESBL infection. This study confirms that antibiotic consumption is the main risk factor for ESBL infection. Rational use of antibiotics, especially fluoroquinolones, is needed in the control of ESBL infections in ICUs, as well as strict adherence to infection control measures.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:105:384491
Study programmeTitle: Biomedicine and Health Sciences
Study programme type: university
Study level: postgraduate
Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstva (doktor/doktorica znanosti, područje biomedicine i zdravstva)
Type of resourceText
Extent146 str.
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2023-05-05 06:45:55