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Vojnosanitetski pregled
2006, vol. 63, br. 2, str. 124-131
jezik rada: srpski
vrsta rada: originalan članak
doi:10.2298/VSP0602124S


Osnovne epidemiološke karakteristike bolničkih infekcija krvi i njihovih uzročnika
Vojnomedicinska akademija

Sažetak

Uvod/Cilj. Bolničke infekcije krvi (BIK) predstvaljaju aktuelan i jedan od najtežih problema u savremenoj medicini zbog svoje učestalosti, produženja hospitalizacije i povećanja troškova lečenja. Cilj ove studije bio je da prikaže osnovne karakteristike BIK i njihovih uzročnika u jednoj bolnici tokom jednogodišnjeg perioda. Metode. Rutinskim epidemiološkim nadzorom nad bolničkim infekcijama u jednogodišnjem periodu, prospektivno su registrovani svi bolesnici sa BIK prema kriterijumima Centra za prevenciju i kontrolu bolesti iz Atlante. Ispitanici su svrstani u dve grupe. U prvoj su bili bolesnici hospitalizovani u jedinicama intenzivne nege (JIN), a u drugoj bolesnici hospitalizovani u jedicinicama obične nege (JON). Upoređeni su i bolesnici sa BIK u JON i JIN, kao i preživeli i umrli bolesnici sa BIK u JON. Obrada hemokultura rađena je standardnim mikrobiološkim metodama, a rezistencija na antibiotike utvrđena je diskdifuzionim testom, uz primenu standarda i preporuka Američkog nacionalnog komiteta za laboratorijske standarde (NCCLS). Rezultati. Ukupna incidencija BIK u JON je 2,2 na 1 000 prijema, odnosno 17,4 na 1 000 prijema u JIN. Registrovan je i letalitet od 44,9%. Kod naših bolesnika bilo je 60,3% primarnih BIK. Gram-negativni mikroorganizmi bili su izolovani u 50% epizoda BIK, gram-pozitivni u 44,9, a gljive u 4,1 %. Koagulaza negativne stafilokoke (KNS) bile su najčešće registrovani uzročnici BIK (21,4%), a slede ga S. aureus (14,3%), Klebsiella spp. (13,3%), P. aeruginosa (8,2%) i Acinetobacter spp. (7,1%). Rezistencija na meticilin uočena je u 64,3% izolata S.aureusa i 100% izolata koagulaza negativnih stafilokoka. U peridu izvođenja studije nije registrovana rezistencija enterokoka i stafilokoka na vankomicin. Na ceftazidim bilo je rezisteno 92% K. pneumoniae. Zaključak. Ova studija je doprinela upoznavanju karakteristika BIK, kao i karakteristika njihovih uzročnika, pre svega rezistencije koagulaze negativnih stafilokoka i S. aureusa na meticilin i K. pneumoniae na ceftazidim.

Ključne reči

infekcija intrahospitalna; krv; sepsa; epidemiologijaklinička; infekcije izazvane protezama; bakterije; kandidijaza

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