Naslov Učestalost i osjetljivost na antibiotike uzročnika proljeva u ljudi iz roda Campylobacter izoliranih u KBC Split
Naslov (engleski) Prevalence and antibiotic susceptibility pattern of human diarrheal causative agents from Campylobacter species isolated at University Hospital Split
Autor Danijel Jozipović
Mentor Marija Tonkić (mentor)
Ustanova koja je dodijelila akademski / stručni stupanj Sveučilište u Splitu Medicinski fakultet Split
Datum i država obrane 2012, Hrvatska
Znanstveno / umjetničko područje, polje i grana BIOMEDICINA I ZDRAVSTVO Kliničke medicinske znanosti Medicinska mikrobiologija
Sažetak Cilj istraživanja:
Cilj ove studije bio je da se ustanovi učestalost bakterija iz roda Campylobacter kao uzročnika
proljeva u KBC-u Split u razdoblju 2006. - 2011. godine. Također smo htjeli ispitati postoje li
među izoliranim sojevima oni koji su rezistentni na empirijsku antibiotsku terapiju.
Ustroj istraživanja:
Ova studija je retrospektivna presječna.
Mjesto istraživanja:
Klinički bolnički centar Split, Klinički zavod za mikrobiologiju i parazitologiju. Spinčićeva 1,
Split.
Sudionici:
U istraživanje su bili uključeni pacijenti liječeni od crijevne kampilobakterioze u razdoblju
2006. - 2011. godine u KBC-u Split. U uzorcima stolice ili brisevima rektuma od ukupno 527
pacijenata, 208 žena i 319 muškaraca, izoliran je Campylobacter spp. Zatim je za 50 sojeva C.
jejuni metodom E-testa ispitivana osjetljivost na ciprofloksacin, gentamicin, tetraciklin i
eritromicin.
Glavne mjere ishoda:
Učestalost Campylobacter spp. kao uzročnika proljeva u razdoblju 2006. - 2011. god. (u
postotcima). Primjereno terapijsko sredstvo (antibiotik na koji su izolirani sojevi osjetljivi).
Rezultati:
Za vrijeme istraživanja, na prisustvo nekog od bakterijskih uzročnika proljeva bilo je
pozitivno ukupno 2227 uzoraka stolica i briseva rektuma bolesnika. Od toga je iz 527 uzoraka
izoliran Campylobacter spp. Stopa izolacije se kretala između 13.8% 2006. i 36.0% 2010.
godine. Među izoliranim sojevima kampilobaktera bilo je 318 (60.34%) sojeva C. jejuni, 35
(6.64%) C. coli te 174 (33.02%) Campylobacter spp. Od 527 izoliranih sojeva kampilobaktera
208 (39.47%) su uzeti od ženskih, a 319 (60.53%) od muških pacijenata. Sojevi
kampilobaktera su najčešće izolirani u skupini djece i mladih starosti 10-19 godina. Učestalost
kampilobaktera kao uzročnika bakterijskih proljeva u ljudi u odnosu na salmonele kao
uzročnike proljeva je u porastu, a 2010. kampilobakteri postaju vodeći uzročnici bakterijskih proljeva u KBC-u Split. Najveći broj kampilobaktera izoliran je tijekom mjeseca lipnja. Za 50
sojeva C. jejuni koji su bili izolirani tijekom 2010. godine određena je osjetljivost na
ciprofloksacin, gentamicin, eritromicin i tetraciklin. Na ciprofloksacin je bilo rezistentno 13
sojeva (26%). Na gentamicin i eritromicin nijedan soj nije bio rezistentan a na tetraciklin su 2
soja bila rezistentna (4%). Među testiranim sojevima bila su dva multiplo rezistentna (4%).
Zaključci:
Campylobacter jejuni postao je glavni uzročnik bakterijskih proljeva u KBC-u Split. Među
izoliranim sojevima postoji značajan postotak sojeva rezistentnih na ciprofloksacin.
Rezistencija na tetraciklin je niska, a još uvijek nema sojeva rezistentnih na gentamicin i
eritromicin. Terapijsko sredstvo izbora u slučajevima koji zahtijevaju antibiotsko liječenje je
eritromicin.
Sažetak (engleski) The aim of the resarch:
The aim of this study was to analyze trends in the number of patients suffering from intestinal
campylobacteriosis between year 2006 and 2011 at the University Hospital Split. The second
aim was to study whether there are strains resistant to the empirical antibiotic therapy, within
the isolated Campylobacter spp.
Study design:
The study was retrospective and cross-sectional.
Setting:
Clinical Institute of Microbiology and Parasitology, University Hospital Split in Split,
Croatia.
Participants:
The study participants were 527 patients, 208 women and 319 men, treated for intestinal
campylobacteriosis at the University Hospital Split between year 2006 and 2011. The
Campylobacter spp was isolated from the stool samples or rectal swabs. The sensitivity to
ciprofloxacin, gentamicine, tetracycline and erythromycin for 50 strains of C. jejuni was
examined by E-test for in vitro antimicrobial susceptibility.
Main outcome measures:
The main outcome measures were:
- frequency of the Campylobacter spp. as a cause of diarrhoea between year 2006 and
2011 (percentage),
- frequency of appropriate antimicrobial therapy (antibiotics which isolated types are
susceptible for).
Results:
During the study 2227 samples of the stools and rectal swabs were positive to one of the
bacterial agents causing diarrhoea in humans. The total number of the samples from which
Campylobacter spp. was isolated was 527. The rate of Campylobacter spp. isolation was
between 13.8% in the year 2006 and 36.0% in the year 2010. Among isolated campylobacters
318 (60.3%) were C. jejuni, 35 (6.6%) were C. coli and 174 (33.0) were Campylobacter spp.
From 527 campylobacters that were isolated. 208 (39.5%) were from female patients and 319
(60.5%) from male patients. According to the age, the largest group of patients were children
and adolescents aged 10-19 years. Incidence of campylobacters as causative agents of
bacterial diarrhoea increased compared to Salmonella and in 2010 the campylobacters became
leading cause of bacterial diarrhoea at the University Hospital Split. The largest number of
patients with diarrhoea caused by campylobacters was registered in June. For 50 strains of C.
jejuni, that were isolated in 2010, susceptibility to ciprofloxacin, gentamicine, erythromycin
and tetracycline was determined. There were 13 (26%) strains resistant to ciprofloxacine.
None of the strains was resistant to gentamicine and erythromycin and 2 (4%) strains were
resistant to tetracycline. Among the tested strains there were 2 (4%) which have shown
multiple resistance.
Conclusion:
Campylobacter spp. has become the main agent causing bacterial diarrhoea at the University
Hospital Split. Within isolated strains there was a significant percentage resistant to
ciprofloxacin. The resistance to tetracycline was low, and there were no strains resistant to
gentamicine and erythromycin. The medication of choice for patients that require antibiotic
treatment should be erythromycin.
Ključne riječi
Campylobacter
Campylobacter infekcije
Antibiotici
Ključne riječi (engleski)
Campylobacter
Campylobacter Infections
Anti-Bacterial Agents
Jezik hrvatski
URN:NBN urn:nbn:hr:171:968678
Studijski program Naziv: Medicina Vrsta studija: sveučilišni Stupanj studija: integrirani preddiplomski i diplomski Akademski / stručni naziv: doktor/doktorica medicine (dr. med.)
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Datum i vrijeme pohrane 2016-04-20 13:00:00