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Nursing Care in Patients with MRSA
Zajacová, Aneta ; Trojánek, Milan (advisor) ; Jirkovský, Daniel (referee)
The bachelor thesis "Nursing Care in Patients with MRSA" deals with the issue of barrier regimen in the context primarily with golden staphylococcus infection. The aim is to assess the attitudes of nursing staff about nursing care in patients with MRSA, analyze the adherence to contact precautions in the clinical practice and to identify the factors associated with potential non-adherence. The theoretical part of the thesis serves as an introduction to the topic, while the empirical part contains the results of the actual investigation and serves to explore the above objectives. The research method was a self-constructed questionnaire with 33 questions, which was distrubuted among the nursing staff in the surgical and internal inpatient wards of the adult part of Motol University Hospital. Responses from 67 respondents were included and the obtained data were statistically processed. The survey resulted in the following findings: Only 13 respondents (19 %) say that everyone on their ward always adheres to barrier measures. The most common situation where barrier measures are not adhered to is 'acute patient condition' with 27 respondents (40 %) and 'at night' with 12 respondents from the standard ward and only 1 from the ICU. The motivation for more consistent adherence to barrier measures is fear...
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Nurses' knowledge and use of personal protective equipment in barrier access to infectious patients
Bubíková, Kateřina ; Jirkovský, Daniel (advisor) ; Trojánek, Milan (referee)
1 Abstract The bachelor thesis entitled "Nurses' Knowledge and Use of Personal Protective Equipment in Barrier Approach to Infectious Patients" deals with the prevention of infection transmission in the hospital environment, emphasizes the importance of using personal protective equipment, and addresses the knowledge and habits of nurses providing nursing care to infectious patients in the hospital. Objective: The aim of the thesis was to determine and evaluate the level of nurses' knowledge in the field of prevention and use of personal protective equipment when working with infectious patients. Within this bachelor thesis, another goal was set to gather information on whether respondents with higher education demonstrate more detailed knowledge in the field of infectious control than respondents with secondary education. The sample of respondents was also compared by age and length of practice, where the correlation between these categories and the depth of knowledge was examined. Sample and methods: The survey was conducted through a questionnaire, the comprehensibility of which was previously verified by a pilot study. Data collection took place at two university hospitals in Prague, at FN Motol and FN Bulovka. The research sample consisted of 163 respondents, 115 respondents from FN Motol and 48 from...
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The effect of salts on the hydrolytic stability of biopolymer carriers with antibacterial substances
Tertinská, Martina ; Brtníková, Jana (referee) ; Vojtová, Lucy (advisor)
Táto diplomová práca sa zaoberá vplyvom soli na stabilitu biopolymérnych nosičov z proteínu a polysacharidu. Teoretická časť sa zaoberá biomateriálmi a materiálmi na prípravu vzoriek a taktiež sa zaoberá momentálnou situáciou liečby infikovaných rán rôznymi materiálmi. V experimentálnej časti boli pripravené nosiče v dvoch rôznych pufroch, s rôznymi koncentráciami chloridu sodného v snahe stabilizovať bioaktívne proteíny, peptidy alebo enzýmy, všeobecne používané a vkladané do nosičov. Boli sledované vlastnosti ako hydrolytická stabilita, botnanie a vplyv rôznych koncentrácii soli na stabilitu vzorku. Keď bola stanovená vhodná koncentrácia soli, do vzoriek bol pridaný antibakteriálny enzým a bolo sledované jeho uvoľňovanie. Zatiaľ čo pri nesieťovaných vzorkách boli sledované významné rozdiely v hydrolytickej stabilite a uvoľňovaní pre vzorky so soľou a bez nej, pri sieťovaných vzorkách boli tieto rozdiely zanedbateľné. Vo všetkých prípadoch sa však enzým uvoľnený zo vzoriek uvoľňoval podľa kinetiky prvého rádu, ktorá závisí na koncentrácii. Na základe výsledkov z difúznych testov robených na rôznych kmeňoch Zlatého stafylokoka bola pre túto prácu vybraná koncentrácia lyzostafínu 325 mg/ml. Pripravené nosiče s antibakteriálnymi enzýmami by mohli byť používané ako kryty rán s krátkodobým alebo dlhodobým uvoľňovaním na rany infikované Zlatým stafylokokom alebo methycilín rezistentným Zlatým stafylokokom (MRSA).
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Global epidemiology of Staphylococcus aureus circulating in healthcare system and community
Mrázková, Pavlína ; Tkadlec, Jan (advisor) ; Balíková Novotná, Gabriela (referee)
Staphylococcus aureus is an important human pathogen responsible for a wide range of infections occurring among patients in the healthcare setting and in the community. Much attention is focused on methicillin-resistant strains (MRSA), but methicillin-sensitive strains (MSSA) also remain the main cause of infections. The epidemiology of S. aureus, especially among MRSA strains, has shown a rapid development in recent years, characterized by the appearance of epidemic lines that dominate in certain geographical areas. Molecular typing techniques have made it possible to identify the main successful lineages of MRSA and MSSA and to track their spread and report the prevalence of certain clones in the area at the same time. To understand the evolution and spread of S. aureus, as well as to deploy effective preventive measures against the spread of this dangerous pathogen, the knowledge of the S. aureus strains epidemiology is absolutely necessary. As part of the bachelor's thesis, a recent overview of the methods used for the clonal analysis of Staphylococcus aureus will first be presented. Furthermore, a literature search will be conducted with the aim of creating an overview of the dominant strains of S. aureus and MRSA circulating in the hospitals and in the community with an emphasis on the...
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Analysis of methicillin resistant Staphylococcus aureus strains from Czech Republic and Slovakia
Brajerová, Marie ; Tkadlec, Jan (advisor) ; Karpíšková, Renáta (referee)
Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen that has spread into the community since the 90s. In general, the community-associated (CA- MRSA) strains are more virulent, but less resistant to antimicrobials than the hospital- acquired strains (HA-MRSA). Some lineages of MRSA such as sequence type 8 have been transmitted more successfully around the world than others and there are situations where a dominant lineage has been replaced by a new one. The factors that are crucial for the selection of dominant lineage are often not clear. As part of this thesis, a longitudinal study of MRSA epidemiology in the Motol University Hospital during the period of 2018-2020 was performed and the occurrence of MRSA clonal complexes was characterized. A multicenter study of the epidemiological situation of MRSA in Slovakia during the period of January - April 2020 was also performed concomitantly. Moreover, several isolates from dominant lineages were further characterized by their phenotype. In the Motol University Hospital study, it was found that the HA-MRSA of the clonal complex 5 dominates and is represented mainly by spa-type t586; a finding that concurs with recent studies from the Czech Republic. In Slovakia, similar to the Czech Republic, MRSA lineages from clonal...
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Vývoj imunologických testů pro detekci nebezpečných bakteriálních patogenů
Šmídová, Lada
The aim of the thesis was to develop an immunoassay for the detection of dangerous bacterial pathogen, methicillin-resistant Staphylococcus aureus (MRSA). MRSA infections cause global problems in health facilities which provide acute and follow-up care in inpatient and outpatient parts. That is why early and rapid diagnosis and targeted thereapies are very important for the subjects. E. coli was purified using the QIAquick PCR kit Purificatin isolated bacterial constructs, which were subsequently purified and dialyzed. The recombinant protein PBP2a in different concentrations was applied to a nitrocellulose membrane in the form of lines. Furthermore was performed optimized blot-line method for the detection of specific antibodies against the recombinant antigen PBP2a in the classes IgG, IgA and IgM. Several different concentrations of the conjugate Goat Anti-human IgG-AP, Goat Anti-human IgA-AP or Goat anti-Human IgM-AP were used for the detection. The color intensity of each line of the strip was evaluated with Immunoblot software. The measured values were used to determine diagnostic sensitivity, specificity and overall diagnostic match. Further testing of precision was carried out under repeatability conditions (intra-assay) and reproducibility (inter-assay). Precision of the method was expressed by coefficient of variation. As the most suitable for the manufacture of a IgG kit was determined the concentration of the antigen PBP2a from 0.30 mg/ml to 0.45 mg/ml and the concentration of IgG conjugate from 1:1500 to 1:1800. For class IgA as the most appropriate antigen was determined concentration PBP2a from 0.40 mg/ml to 0.52 mg/ml and conjugate concentrations of IgA from 1:500 to 1:1000. The coefficient of variation under repeatability conditions for the entire range of the IgG class is 10.09 %, and for IgA is 8.91 %. Variation coefficient reproducibility conditions for the entire range of the IgG class is 9.23 % and for IgA is 9.60 %. Precision of the method under conditions of repeatability and reproducibility for classes IgG and IgA meets the criteria for the manufacture of a diagnostic kit. Titration results showed that particular batch of cards made of nitrocellulose membrane coated with antigen PBP2a must always be verified on the panel of reference samples and the values of concentrations (for both antigen and conjugate) should be set according to the needs, but differently for the class of immunoglobulins IgG and IgA.
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Výskyt a charakteristika meticilin rezistentních stafylokoků v chovu mléčného skotu
Pajtina, Luboš
The focus of this thesis is the confirmation of the presence of the methicillin-resistant Staphylococcus aureus on a selected dairy bovine farm and the following typing of its isolates while using common genotyping and phenotyping methods. After the isolation of this bacteria from the samples, they were tested for the presence of mecA gene and the genes responsible for the production of enterotoxins. It was tested whether the isolates belong to the 398 sequence type and their type of spa gene sequence was determined. Then the resistance against antimicrobial agents was tested. Results of the typing were compared to those of other related articles. Finally, this thesis observes the efficiency of the sanitizing agent used at this farm and suggests further methods to reduce the occurrence of MRSA in this herd.
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The importance of prompt diagnostic of MRSA patients and in the nosocomial environment of the Strakonice Hospital JSC
KUBIČKOVÁ, Andrea
Methicillin-resistant Staphylococcus aureus strains (MRSA) belong among the dangerous agents of nosocomial infections. Bacteremia-related mortality is reported 20-40%. Treatment of nosocomial infections is complicated and financially demanding. To reduce the risk for the patients, the introduction of anti-epidemic measures contributes for the effective searching of MRSA carriers and preventing the spread of resistant clones within the hospital, as well as rapid and reliable diagnosis of MRSA infections. The aim of this bachelor thesis is to describe the occurrence of MRSA strains in the Hospital Strakonice a.s. in 2012-2018 and to verify the usefulness of the Alere PBP2a SA Culture Colony Test for rapid MRSA diagnosis. The overall incidence of MRSA strains in the period of 2012-2018 was 3,27/1000 patients. The highest incidence of MRSA strains in reporting period was reported in 2018 (4,2/1000 patients). The higher incidence was detected in patients over 60 years of age and mainly in male patients. The wards where the highest number of new MRSA cases were recorded were surgical and internal ones, respectively. With the help of targeted screening from 29 up to 51 % new MRSA cases were revealed. The most common specimens were wound specimens (deep as well as superficial). In 2018, 74 isolated Staphylococcus aureus strains from clinically relevant materials such as blood and other body fluid specimens and tracheal aspirates were tested with the help of Alere PBP2a SA Culture Colony Test. 8 isolates were detetected positive for PBP2a protein and 66 were negative. Obtained results were in all cases confimed by the disc diffusion technique with the same results. The results of analysis were known within 6 minutes after the identification of Staphylococcus aureus strain and could have been actively reported to the physician. This lead to the significant speed-up of early initiation of appropriate targered antibiotic therapy. Alere PBP2a SA Culture Colony Test for rapid distinction between MRSA and MSSA Staphylococcus aureus strains reported 100% sensitivity as well as specificity. This test should be included in routine microbiological examination at ÚKMAS.
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Antibiotic resistance in Staphylococcus aureus
Švábová, Tereza ; Vejsová, Marcela (advisor) ; Najmanová, Iveta (referee)
Author: Tereza Švábová Title: Resistance to antibiotics in Staphylococcus aureus Bachelor thesis Charles University in Prague, Faculty of Pharmacy, Hradec Králové Field of study: Medical Laboratory Background: The bachelor thesis aims at dealing with Staphylococcus aureus, describing its basic properties, laboratory diagnostics, antigenic structure and the diseases what it causes. Describe types and mechanisms of resistence, antibiotic therapy including mechanisms of antibiotic action. More attention is paid to the strains of MRSA (Methicillin resistant Staphylococcus aureus), because this is one of the biggest problems associated with resistance. Main findings: In the period before to the discovery of antibiotics, invasive infections caused by S. aureus were mostly fatal. With the introduction of antibiotics into practice, the problem of resistance has multiplied. The occurrence of MRSA was the largest in 2009 at - 14.6% in the Czech Republic. In 2014, the occurrence of MRSA was 13%, and 2 years later, there was again a slight increase - 13.9% in 2016 (ECDC, 2018). The selection of antibiotic and the method of antibiotic treatment of infections depend on the clinical condition of the patient, the agent of the disease including its sensitivity, the underlying disease and the properties of the...
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