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2013, vol. 141, br. 7-8, str. 482-489
Epidemiološke odlike bolničkih proliva koje izaziva Clostridium difficile u ustanovi tercijarnog nivoa zdravstvene zaštite u Srbiji
aUniverzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd
bVojnomedicinska akademija, Beograd
cUniverzitet u Istočnom Sarajevu, Medicinski fakultet, Foča, Republika Srpska, BiH

e-adresasuljagicv@yahoo.com
Ključne reči: bolesti povezane sa Clostridium difficile (CDAD); faktor rizika; epidemiologija; prevencija i suzbijanje
Sažetak
Uvod. Danas se među najznačajnije uzročnike proliva u bolničkoj sredini svrstava Clostridium difficile (C. difficile). Širok spektar oboljenja koje ova bakterija izaziva poznate su pod nazivom 'bolesti povezane sa C. difficile' (engl. Clostridium difficile associated disease - CDAD). Razvoju CDAD obično prethode primena antimikrobne terapije i fekalno-oralna infekcija bakterijom C. difficile. Poslednjih godina epidemiološka slika CDAD se značajno promenila. Nedavno je ustanovljen hipervirulentni epidemijski soj BI/NAP1/027, uzročnik teških epidemija u Severnoj Americi i Zapadnoj Evropi. Cilj rada. Cilj istraživanja je bio da se odredi učestalost faktora rizika za nastanak CDAD kod bolesnika operisanih u Vojnomedicinskoj akademiji (VMA). Metode rada. Ispitivanjem su obuhvaćene osobe operisane u VMA od 1. januara do 31. decembra 2010. godine. Primenjena je ugnežđena anamnestička studija. Ispitanici su svrstani u dve grupe: one sa CDAD i one bez CDAD (kontrolna grupa). Ispitanici su klinički praćeni prospektivno, a podaci o njima su prikupljani upitnikom tokom rutinskog epidemiološkog nadzora. Rezultati. Tokom 2010. godine stopa incidencije CDAD u VMA je bila 3,3 na 10.000 bolničkih dana. Univarijantna regresiona analiza je pokazala da su dužina primanja jednog antibiotika i dužina primanja dva antibiotika, kao i istovremeno primanje dva antibiotika, značajno češće uočeni kod bolesnika sa CDAD u odnosu na operisane bolesnike bez CDAD. Nezavisan faktor rizika za nastanak CDAD bila je dužina primanja jednog antibiotika. Zaključak. Smanjenje stope incidencije CDAD postiže se primenom pouzdanih mera prevencije i suzbijanja: racionalnom upotrebom antibiotika, ranim postavljanjem dijagnoze i lečenjem inficiranih osoba, njihovom kontaktnom izolacijom, pravilnom dezinfekcijom, te stalnom edukacijom medicinskog i nemedicinskog osoblja.
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O članku

jezik rada: srpski
vrsta rada: originalan članak
DOI: 10.2298/SARH1308482S
objavljen u SCIndeksu: 13.11.2013.

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