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Problem of sepsis in the intensive care unit
Škrabánková, Hana ; Marková, Eva (advisor) ; Jankovcová, Kateřina (referee)
The aim of the thesis was to determine the microbial colonization at the injection site of central venous catheter and its possible influence to maintain the lowest incidence of catheter sepsis. The culture results of skin swabs and taken blood cultures from two groups of patients were compared with each other using qualitative analysis methods. Those were Intensive Care Unit patients with established central venous catheter. The result was the discovery of microbial colonization of the skin and the representation of different pathogenic strains at the site of a central venous catheter for both established groups. Further showed that the higher the risk of microbial colonization with symptoms of catheter sepsis was seen where patients have central venous catheter established for longer period of time and have been treated under home parental nutrition program with stoma. The recommendation is the continuous education of health professionals to act in accordance with the latest preventive treatment recommendations, and the emphasis is mainly placed on hands cleaning and disinfecting as the hands of health professionals are one of the most common and risky way of transmission of pathogenic strains with potential nosocomial infection formation. Aseptic principles must be repeatedly communicated to all...
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An examination (analysis) of susceptibilities to antibiotics of the strain Staphylococcus aureus performed by phenotypic methods in conventional microbiological laboratory and interpretation of its results.
MARIŇÁKOVÁ, Barbora
The aim of bachelor´s thesis is the understanding and the correct interpretation of results of susceptibility to antibiotics of the strain Staphylococcus aureus from serious clinical materials as a hemoculture, a peritoneal fluid from joints and abscesses, a smear from wounds, tissues during infectious total artificial joints, samples of an urine, materials from the lower respiratory tract and another clinical samples. According to data which have been used, my aim also have been to prove or eventually disprove the first hypothesis, that makes sense to collect also hemocultures from patient whose result in the serious clinical material contained the strain of Staphylococcus aureus. Prove or disprove the second hypothesis that with the number of positive results of the strain of Staphylococcus aureus in samples of urine will be in the same time the most positive hemocultures in percentage in comparison with results of the strains of Staphylococcus aureus in other clinical materials. Defined targets were reached by regular practical education in the Department of Clinical Microbiology. I had adopted a methodology of examination of susceptibility in the department and then have practiced under the professional supervision. Before the practical part of my thesis, I have had to elaborate and learn theoretical part of it. In that part is deeply described the kind Staphylococcus aureus, antibiotical treatment of this strain and the list of mostly tested antibiotics in the routine microbiological laboratory. In the practical part of the thesis I am focusing on the determination of sensitivity to antibiotics by the disk diffusion method and a defining minimal inhibition concentration. I have interpreted results and for example, I have depicted mostly occurred antibiograms and equally less occurred or rare ones. Then I have processed results of sensitivity of Staphylococcus aureus. The examined set has been containing 588 samples of positive Staphylococcus aureus. 72 samples from the set have been MRSA positive. A representation of positive hemocultures has been examined too in currently or earlier found positive materials. Positive hemocultures in positive materials have been found in ca 5,2 % of all positive clinical materials. The most positive hemocultures were found in previous positive samples of urine ca 17 %. The second highest positivity of hemocultures was in samples from bones and joints ca 14 %. Then artificial materials ca 13 %, venous catheters ca 10 %, abscess ca 6 %, materials from respiratory tract ca 4 %, soft tissues ca 3 % and wounds ca 2 %. The significant gained finding and conclusion of the thesis is the fact that during serious staphylococcus infections the sampling of hemocultures is indicating as a necessity and as an obligation of the sampling of hemocultures of a patient is finding of the strain of Staphylococcus aureus in the sample of urine.
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Problem of sepsis in the intensive care unit
Škrabánková, Hana ; Marková, Eva (advisor) ; Jankovcová, Kateřina (referee)
The aim of the thesis was to determine the microbial colonization at the injection site of central venous catheter and its possible influence to maintain the lowest incidence of catheter sepsis. The culture results of skin swabs and taken blood cultures from two groups of patients were compared with each other using qualitative analysis methods. Those were Intensive Care Unit patients with established central venous catheter. The result was the discovery of microbial colonization of the skin and the representation of different pathogenic strains at the site of a central venous catheter for both established groups. Further showed that the higher the risk of microbial colonization with symptoms of catheter sepsis was seen where patients have central venous catheter established for longer period of time and have been treated under home parental nutrition program with stoma. The recommendation is the continuous education of health professionals to act in accordance with the latest preventive treatment recommendations, and the emphasis is mainly placed on hands cleaning and disinfecting as the hands of health professionals are one of the most common and risky way of transmission of pathogenic strains with potential nosocomial infection formation. Aseptic principles must be repeatedly communicated to all...
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Current possibilities of laboratory diagnosis of staphylococcal infections
CHRTOVÁ, Lucie
Laboratory diagnostics of Staphylococccal infections is based on direct evidence, like microscopy and cultivation, eventually on molecular genetics methods. The objective of this thesis is the presentation of nowadays possibilities in laboratory diagnostics of coagulase - negative staphylococcal infections and comparsion of two methods of identification used in the routine laboratory practice. First part of the thesis presents the genus Staphylococcus and the difference between it and the genuses Micrococcus and Peptococcus. The following part of this thesis shows the distribution of genus Staphylococcus in two main groups (Staphylococcus coagulase - positive and coagulase - negative), based on the ability to coagulate plasma. The description of these two main groups contains their morphological and cultivation features, antigen structure, virulence factors, pathogenesis and laboratory diagnostics. In the methodical part the pre-analytic and analytic phase is mentioned. The focus of the pre-analytic part the general priciples of collection and transport for microbiological analysis and the collection of material itself. The methodical part was performed in the České Budějovice Hospital - Laboratory of Medical Microbiology - Department of Bacteriology. This part of the thesis presents the differentiation of staphylococci by latex agglutination (PROLEX TM STAPH LATEX KIT) and then specific identification of 52 strains of coagulase-negative staphylococci isolated from central venous catheters , hemocultures and other clinical important materials is following. The specific identification of all the 52 strains of coagulase-negative staphylococci was performed by biochemical identification by STAPHYtest 16 (ErbaLachema) and parallel by mass spectrometry MALDI-TOF (system VITEK MSTM). The correct identification reached 96,2 % by the method of mass spectrometry MALDI-TOF and 67,3 % by biochemical identification STAPHYtest 16. The most frequent species isolated was Staphylococcus epidermidis (64 %), then Staphylococcus hominis ssp. hominis (10 %), Staphylococcus capitis (6 %), Staphylococcus warneri (6 %), Staphylococcus lugdunensis (4 %), Staphylococcus haemolyticus (4 %), Staphylococcus hominis (4 %), Staphylococcus caprae (2 %). The comparsion of both named methods shows the mass spectrometry more reliable, faster and simpler method, and more suitable for routine laboratory work.
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Characterizacion and occurrence of methicilin resistant bacillary species Staphylococcus aureus (MRSA) from blood of patients of CZ and European hospitals.
VOBROVÁ, Renata
The thesis called The Characteristics and the Occurence of Methicillin Resistant Staphylococcus (MRSA) from the Blood of Patients of Hospitals in the CR and Europe is divided into a theoretical and a practical part. In the practical part the methodology at detection and identification of methicillin resistant Staphylococcus aureus (MRSA) is specified in detail {--} exact procedures and principles of particular methods. Further there are the graphically and statistically processed data on MRSA capture in 2007, 2008 (The regions of České Budějovice and Český Krumlov). By the help of these data I was supposed to prove or disprove the stated hypotheses. Hypothesis no. 1: The capture of increased occurence of methicillin resistant Staphylococcus aureus in the course of period of time (2007-2008). The hypothesis was unambiguously disproved. Hypothesis no. 2: The connection of bloodstream infections caused by MRSA to the cannulation of patients. The hypothesis was proved. Hypothesis no. 3: The increased occurence of bloodstream infections caused by MRSA in connection to the higher number of infections caused by MRSA generally (with higher capture of MRSA generally). It is not possible to say if the hypothesis was proved or disproved. In case of the total number the hypothesis was proved. In case of age groups it was not proved. The main objective was to tip the risky departments, risky age groups and so on. I referred to the situation in chosen European states. I achieved the objective thanks to the graphical processing of the gained data.
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