Zakażenia szpitalne, w tym także zakażenia miejsca operowanego, to istotny problem kliniczny współczesnych systemów ochrony zdrowia. Szacuje się, że zakażenia miejsca operowanego występują jako powikłanie ok. 3 proc. wszystkich procedur chirurgicznych przeprowadzanych w Europie. Jakie są najczęstsze czynniki etiologiczne ZMO?
Drobnoustroje, które odpowiadają za rozwój infekcji w ranie pooperacyjnej, mogą pochodzić zarówno z własnej flory bakteryjnej chorego (drobnoustroje endogenne), jak i ze środowiska zewnętrznego (drobnoustroje egzogenne). Wśród drobnoustrojów patogennych, które stanowią najczęstsze czynniki etiologiczne zakażeń miejsca operowanego, wymienia się m.in. szczepy gronkowca złocistego (Staphylococcus aureus), , w tym szczep metycylinooporny (methicillin-resistant Staphylococcus aureus – MRSA), oraz enterokoki wankomycynooporne (vancomycin-resistant enterococcus – VRE).
Gronkowiec złocisty
Gronkowiec złocisty to to powszechnie występująca bakteria, która kolonizuje skórę i błony śluzowe człowieka. Nosicielstwo tego patogenu w populacji dorosłych osób, które nie są związane ze służbą zdrowia, ocenia się na 30-40 proc.
Gronkowiec złocisty ma zdolność wywoływania różnorodnych zakażeń, w tym między innymi zakażeń skóry, krwi, kości i tkanek miękkich. Patogen ten może być także przyczyną zakażeń narządowych takich jak zapalenie płuc, zapalenie opon mózgowo-rdzeniowych, zapalenie mięśnia sercowego, zakażenie układu moczowego. Metycylinooporne szczepy gronkowca złocistego są jednym z najczęstszych czynników etiologicznych zakażeń szpitalnych. Bakterie Staphylococcus aureus w warunkach szpitalnych mogą być przenoszone bezpośrednio (na rękach personelu) lub pośrednio, w trakcie zabiegów diagnostycznych, leczniczych i pielęgnacyjnych.
Istotny problem kliniczny stanowi narastanie oporności szczepów Staphylococcus aureus na antybiotyki, w tym na penicylinę oraz metycylinę. Lekooporność tych drobnoustrojów utrudnia ich eradykację ze środowiska szpitalnego i stwarza znaczące trudności w procesie terapeutycznym.
Enterokoki wankomycynooporne
Bakterie z rodzaju Enterococcus należą do naturalnej flory w organizmie człowieka. Kolonizują głównie ostatni odcinek przewodu pokarmowego i jamę ustną. Enterokoki mogą stanowić czynnik etiologiczny zapalenia wsierdzia, zakażeń układu moczowego, zapalenia dróg żółciowych, zapalenia otrzewnej, ropni wewnątrzbrzusznych oraz zakażeń krwi. Zakażenia na podłożu tego patogenu stwierdza się także w przypadku odleżyn i ran oparzeniowych. Za zakażenia pooperacyjne odpowiedzialne są przede wszystkim szczepy Enterococcus faecium i Enterococcus faecalis.
Enterokoki wankomycynooporne to szczepy bakterii, które wykształciły oporność na antybiotyki glikopeptydowe, takie jak wankomycyna i teikoplanina. i. Dotychczas poznano osiem fenotypów nabytej oporności na glikopeptydy (VanA, VanB, VanD, VanE, VanG, VanL, VanM i VanN) oraz jeden fenotyp oporności naturalnej (VanC).
Zakażenia tymi szczepami stanowią istotny problem kliniczny i terapeutyczny. Enterokoki wykazują znaczną tolerancję na czynniki fizyko-chemiczne – są odporne na ekstremalne temperatury, wysokie pH i stężenie soli. Enterokoki najczęściej kolonizują powierzchnie znajdujące się w bezpośrednim otoczeniu pacjenta, np. oparcia łóżek, szafki, podłogi i klamki w sali chorych. Mogą się utrzymywać na takich powierzchniach od 5 dni do nawet 4 miesięcy, natomiast na skórze do 60 minut. Zapobieganie transmisji VRE w środowisku szpitalnym opiera się przede wszystkim na wykonywaniu badań mikrobiologicznych u pacjentów, prawidłowej dekontaminacji sprzętu oraz przestrzeganiu procedur izolacyjnych w przypadku pacjentów skolonizowanych lub zakażonych tym patogenem.
Źródła:
- Szczypta, K. Talaga, M. Bulanda, „Enterokoki oporne na wankomycynę jako czynniki etiologiczne zakażeń związanych z opieką zdrowotną – chorobotwórczość i metody kontroli”, „Hygeia Public Health” 2016, 51(2): 134-140.
- Sobieraj-Garbiak, M. Drożdżyńska, „Wybrane zakażenia bakteryjne – nieuniknione zagrożenia zdrowia i życia człowieka”, „Pomeranian Journal of Life Sciences” 2015, 61, 1, 99–107.
- Gospodarek, J. Szopiński, A. Mikucka, „Zakażenie miejsca operowanego – postaci kliniczne, czynniki ryzyka, profilaktyka, etiologia, diagnostyka”, „Forum Zakażeń” 2013;4(5):275–282.
Przeczytaj także: SNLR: stanowisko dot. postępowania z raną podczas epidemii COVID-19
Przeczytaj bezpłatnie pokrewny artykuł w czasopiśmie „Forum Zakażeń”:
Definicje i kryteria rozpoznania zakażenia szpitalnego stosowane w różnych populacjach pacjentów
Your method of explaining the whole thing in this piece of writing is
genuinely fastidious, all be capable of effortlessly know it, Thanks a lot.
I appreciate your feedback buy cialis online canadian pharmacy
I’m looking for a sketchy website that can hook me up with
some Metformin without any pesky prescriptions Online pharmacy for Glipizide
cheap Metformin online Can I order diabetes medication online without a
prescription and with no hassles?
Buy Metformin online at a discounted price without a prescription for diabetes Looking for an online pharmacy that sells diabetes medication at a discount without a
prescription.
Order diabetes meds without a prescription Order diabetes medication without prescription
These proteins are devoid of intrinsic catalytic activity but they are involved in regulating the specificity of the p38 cascade by enabling interaction between the cascade members, by regulating the conformational changes necessary for their activation and by securing their cellular localization 22, 43 Figure 2 cialis online india Hyponatremia can be classified into hypo hyper and euvolemic and the classification is based on simple clinical signs Box 4
The 40 year old woman and 39 year old man she was found with have been detained pending trial on charges of abducting a minor para que sirve levitra 20 mg Dibromochloropropane induced reduction of the sex ratio in man
cheap cialis no prescription 2003, 26 4 977 980
Wow, fantastic blog structure! How long have you been blogging for?
you made blogging glance easy. The entire glance of your web site is
great, as smartly as the content material!
At this moment I am going to do my breakfast, after having my
breakfast coming again to read other news.
chills may be severe, low blood pressure hypotension, increased heart rate, fever, nausea, vomiting, shortness of breath bronchospasm, rash, and itching cialis professional
mafia rap 2023
japanese lofi mix
background music
classical music
happy november jazz
yoga music
310453 816798This douche bag loves his illegal bretheren because hes a itiaen with the world and we should be ashamed of ourselves I got news for you Asswipe get your asswiping ass back towards the craphole where you came from with all of your illegal beaners 550049
518770 495089I adore foregathering useful info, this post has got me even much more info! . 822646
Undeniably imagine that that you said. Your favorite justification seemed to be on the net the simplest factor to be aware of. I say to you, I definitely get irked at the same time as people consider concerns that they plainly don’t realize about. You managed to hit the nail upon the top and also defined out the whole thing with no need side-effects , people can take a signal. Will likely be back to get more. Thank you
Hi , I do believe this is an excellent blog. I stumbled upon it on Yahoo , i will come back once again. Money and freedom is the best way to change, may you be rich and help other people.
248210 322047Real wonderful data can be identified on web blog . 390148
smooth jazz
291923 316888This internet web site is normally a walk-through its the info you wished about this and didnt know who ought to. Glimpse here, and youll undoubtedly discover it. 1702
I wanted to thank you for this great read!! I definitely enjoying every little bit of it I have you bookmarked to check out new stuff you post…
Thanks a lot for giving everyone such a spectacular chance to read from here. It is usually very nice and also full of amusement for me and my office co-workers to visit the blog at the very least 3 times in one week to read the fresh items you will have. And indeed, I’m just at all times pleased with the effective things you give. Certain 1 facts in this article are in fact the finest we have ever had.
You should take part in a contest for one of the best blogs on the web. I will recommend this site!
Excellent read, I just passed this onto a colleague who was doing some research on that. And he just bought me lunch as I found it for him smile So let me rephrase that: Thanks for lunch!
fantastic post, very informative. I wonder why the other specialists of this sector don’t notice this. You must continue your writing. I am confident, you have a great readers’ base already!
I’m not that much of a online reader to be honest but your sites really nice, keep it up! I’ll go ahead and bookmark your site to come back later on. Many thanks
You are a very intelligent person!
145317 74217There is evidently a good deal to know about this. I consider you made certain good points in features also. 382171
Scrap metal regeneration center Ferrous metal scrap Iron scrap reclamation operations
Ferrous material risk management, Iron and steel scrapping and recycling yard, Metal handling services
Metal waste reclaiming and reprocessing Ferrous material recycling ecosystem preservation Iron recycling solutions
Ferrous material recycling rates, Iron reclamation plant, Metal recycling methodologies
It’s actually a nice and useful piece of info. I am glad that you simply shared this useful info with us. Please stay us informed like this. Thank you for sharing.
This website is my aspiration, very great design and perfect written content.
Wow, wonderful weblog structure! How lengthy have you been blogging for?
you make blogging look easy. The full look of your web site is great, as
smartly as the content! You can see similar here sklep internetowy
Metal waste reclaiming yard Ferrous scrap reclamation Iron recycling and reclaiming center
Ferrous material industrial recycling, Iron recovery and reclaiming, Metal recuperation yard
This really answered my problem, thank you!
Regards for this wondrous post, I am glad I discovered this site on yahoo.
Greetings I am so grateful I found your web site, I really found you by accident, while I was browsing on Askjeeve for something else, Nonetheless I am here now and would just like to say thanks a lot for a incredible post and a all round entertaining blog (I also love the theme/design), I don’t have time to look over it all at the minute but I have bookmarked it and also added in your RSS feeds, so when I have time I will be back to read more, Please do keep up the fantastic job.
Hey there! Do you know if they make any plugins to help with SEO?
I’m trying to get my website to rank for some targeted keywords
but I’m not seeing very good results. If you know of
any please share. Many thanks! I saw similar blog here:
Scrapebox AA List
Hi there! Do you know if they make any plugins to help with Search Engine Optimization? I’m trying to
get my site to rank for some targeted keywords but I’m not seeing
very good success. If you know of any please share. Thanks!
I saw similar text here: Scrapebox AA List
You can definitely see your skills within the paintings you write. The world hopes for even more passionate writers like you who are not afraid to say how they believe. At all times go after your heart. „No man should marry until he has studied anatomy and dissected at least one woman.” by Honore’ de Balzac.
I love it when people come together and share opinions, great blog, keep it up.
Hello there, I found your site by way of Google at the same time as looking for a comparable subject, your web site got here up, it appears to be like great. I have bookmarked it in my google bookmarks.
Great – I should definitely pronounce, impressed with your web site. I had no trouble navigating through all tabs as well as related info ended up being truly easy to do to access. I recently found what I hoped for before you know it at all. Quite unusual. Is likely to appreciate it for those who add forums or something, site theme . a tones way for your client to communicate. Nice task.
Sweet internet site, super design and style, very clean and apply genial.
Hello my family member! I wish to say that this article is awesome, great written and come with almost all vital infos. I?¦d like to peer extra posts like this .
Appreciating the commitment you put into your blog and detailed information you provide. It’s great to come across a blog every once in a while that isn’t the same outdated rehashed material. Great read! I’ve bookmarked your site and I’m adding your RSS feeds to my Google account.
Tonic Greens, a natural health supplement, is designed to enhance immune function.
What Is FitSpresso? The 100 natural formula is formulated using a potent blend of 6 ingredients
My brother recommended I might like this website. He used to be entirely right. This publish actually made my day. You can not consider simply how so much time I had spent for this information! Thank you!
Wow, wonderful weblog layout! How lengthy have you been running a blog for? you made running a blog look easy. The whole glance of your web site is great, let alone the content material!
I have not checked in here for a while as I thought it was getting boring, but the last several posts are good quality so I guess I will add you back to my everyday bloglist. You deserve it my friend 🙂
Awesome blog! Is your theme custom made or did you download it from somewhere? A design like yours with a few simple adjustements would really make my blog jump out. Please let me know where you got your design. Thanks
그런데 개인이 직접 사이트에 가입하여 일일이 경험해볼 수 없기 때문에, 카지노사이트 공식 에이전시인 저희를 통해 가입하시는 것이 가장 안전합니다.
What is Leanbiome? LeanBiome is a dietary supplement that is formulated with nine critically-researched lean bacteria species.
Ikaria Lean Belly Juice is a dietary supplement that helps in losing weight.
Prodentim: What is it? Some of the finest and highest quality ingredients are used to produce Prodentim, an oral health supplement
It’s hard to find knowledgeable people on this topic, but you sound like you know what you’re talking about! Thanks
You made some good points there. I did a search on the topic and found most people will approve with your website.
이로 인해 많은 카지노는 수백 대의 슬롯머신을 운영하고 있습니다.
But a smiling visitor here to share the love (:, btw great design. „Everything should be made as simple as possible, but not one bit simpler.” by Albert Einstein.
This post was incredibly informative and well-organized. I learned so much from reading it. Thank you for your hard work and dedication!rendingnicheblog
Great V I should certainly pronounce, impressed with your site. I had no trouble navigating through all tabs and related info ended up being truly easy to do to access. I recently found what I hoped for before you know it at all. Reasonably unusual. Is likely to appreciate it for those who add forums or anything, website theme . a tones way for your customer to communicate. Excellent task..