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Srpski arhiv za celokupno lekarstvo
2019, vol. 147, br. 7-8, str. 410-415
jezik rada: engleski
vrsta rada: originalan članak
objavljeno: 15/08/2019
doi: 10.2298/SARH180510051G
Prikaz inicijalne bakteriologije uzoraka respiratornog trakta i osetljivosti bakterijskih izolata prema antimikrobnoj terapiji kod urgentno intubiranih odraslih osoba sa hroničnom opstruktivnom bolešću pluća - dvogodišnje iskustvo jednog centra
Univerzitet u Beogradu, Medicinski fakultet, KBC 'Zemun'

e-adresa: zorangluvic@yahoo.com

Projekat

Hormonska regulacija ekspresije i aktivnosti azot oksid sintaze i natrijum-kalijumove pumpe u eksperimentalnim modelima insulinske rezistencije, dijabetesa i kardiovaskularnih poremećaja (MPNTR - 173033)

Sažetak

Uvod/Cilj Pogoršanje hronične opstruktivne bolesti pluća (HOBP) najčešće je uzrokovano infektivnim agensima, značajno kompromituje kvalitet života obolelih i pretkazuje loš ishod bolesti. Kada postoje kliničko-laboratorijski znaci verovatne bakterijske infekcije kao uzroka pogoršanja, neophodno je kod intubiranog bolesnika odmah započeti inicijalni antimikrobni tretman. U zavisnosti od rezultata kultura respiratornih uzoraka, inicijalni antibiotski tretman može biti promenjen ili nastavljen. Cilj ovog rada je predstavljanje lokalnog vodiča za primenu inicijalnog antimikrobnog tretmana hitno intubiranog bolesnika sa pogoršanjem HOBP koja je verovatno bakterijskog porekla, uzimajući u obzir bolničko ili vanbolničko okruženje. Metode Studija preseka obuhvatila je 51 ispitanika, koji su po prijemu u Jedinicu internističke intenzivne nege KBC Zemun tokom 2015. i 2016. godine odmah intubirani i mehanički ventilirani. Ispitanici su podeljeni u dve grupe: grupu 1 (26 ispitanika), koji su imali verovatnu bakterijsku egzacerbaciju iz vanbolničkog okruženja, i grupu 2 (25 ispitanika) - iz bolničkog/domskog okruženja. Uzorci respiratornih tečnosti (sputum, aspirat) obrađeni su u Mikrobiološkoj laboratoriji. Rezultati U obe grupe ispitanika najčešće izolovane bakterije su Acinetobacter i Pseudomonas spp., dok se kao treća najčešća izolovana bakterija u grupi 1 izdvaja Staphylococcus aureus, a u grupi 2 Klebsiella spp. Kombinacija tigeciklina i aminoglikozida pokriva mikrobni spektar kod 52% ispitanika u grupi 1, odnosno kod 32% ispitanika u grupi 2. Zaključak Na osnovu sprovedene studije, preporučuje se inicijalna antimikrobna terapija istovremenom primenom tigeciklina i aminoglikozida kod intubiranih odraslih osoba sa verovatnom bakterijskom infekcijom kao uzrokom egzacerbacije HOBP.

Ključne reči

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