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  • Nadzor i sprječavanje bolničkih infekcija uzrokovanih meticilin-rezistentnim stafilokokom (MRSA) : magistarski rad
    Kotnik-Kevorkijan, Božena
    Measures for control and prevention of infectious diseases are complex and demand permanent team work which are directly involved with great costs. However, deficiency at any level has multiple ... negative feedback on appearance of heavy, and not seldom mortal infections, among which infections caused by resistant S. aureus are especially dangerous. Therefore, one of the most important indicator of the work quality in the field of prevention of hospital infections is the number of MRSA patients per 100 admissions. In the year 1999 and 2000 the first, major MRSA epidemic broke out at Maribor Teaching Hospital with 187 registered patients. Aim of this work is entire and detail study of the epidemic and estimation of the effectiveness of undertaken prevention and control procedures. Retrospective and prospective following up was used for all more important epidemiological, clinical and laboratory indicators, as well as the risk factors for acquiring, spreading, seriousness and outcome of MRSA infection. For all MRSA isolates antibiogram was carried out and 61 isolates were typed by PFGE (pulsed-field gel electrophoresis) method. Data processing was carried out on personal computer and descriptive method applied. Disease caused by MRSA was registered in 46 and colonozation in 141 patients. There were 119 (63.6 %) male and 68 (36.4 %) female patients. Their average age was 59.5, 74.2 % were more than 50 years old. Risk factors for acquiring MRSA infections, apart from old age, were also chronic diseases, previous hospitalization, treatment in the Surgical Intensive Care Unit and afterwards on the Neurosurgical and Neurological units in the Maribor Teaching Hospital . Most patients (60) were found on the Surgical Intensive Unit. Altogether 49 patients with MRSA died (19 or 41.3 % infected and 30 or 21.3 % colonized). Typing enabled discovery of eight MRSA types, but three of them were dominant in Maribor Teaching Hospital. All MRSA isolates were sensitive to vancomycine. Half of the patients (95/187) were isolated, 48 of them according to the procedure of contact isolation. Decolonisation was carried out in only 15 patients, but was effective only in seven. Confrontation with such great epidemic demanded enforced measures of permanent control, discovery, registration and following up of MRSA, as well as education of all medical and other staff. However, real results were achieved not before applying very strictly controlled procedures. So we introduced active searching for the carriers (screening of the patients at risk on admission or transfer to the other units), daily visitof the members of the Infection Control Team (ICT), who helped with isolation and patients' treatment procedures to be carried out, cooperation of the leader of the Infection Control Team (infectologist) in the treating of each patient with MRSA. Promptly report on each new MRSA isolate in the Microbiological Laboratory is sent to the Infection Control Team. Computer data base for following up of MRSA patients was created and continuous looking for MRSA carriers is carried out. Finally, we estimate that the most important controlling procedures for major epidemic were additionally introduced strictly supervised measures.
    Type of material - master's thesis ; adult, serious
    Publication and manufacture - Zagreb : [B. Kotnik Kevorkijan], 2006
    Language - croatian
    COBISS.SI-ID - 2508863

Library/institution City Acronym For loan Other holdings
MF, Central Medical Library, Ljubljana Ljubljana CMK outside loan 1 cop.
Maribor General Hospital Maribor SBMB outside loan 1 cop.
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