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Carbapenemases and their molecular genetic detection in bacteria causing severe hospital acquired infections
Vavrová, Jolana ; Dřevínek, Pavel (advisor) ; Zikánová, Blanka (referee)
The aim of this study is to characterize β-lactamases that hydrolyze carbapenems. They belong to molecular classes A, B and D and their new variations are still being identified. The production of enzymes hydrolyzing β-lactam antibiotics is common among Gram-negative bacteria which include also serious nosocomial pathogens such as Pseudomonas aeruginosa, Acinetobacter baumannii or members of Enterobacteriaceae family. The importance of the carbapenemases in clinical practice underlines the fact that carbapenems are broad-spectrum antibiotics, which are considered the reserve antibiotics. An increase in the number of cases of the carbapenem resistance is caused mainly by spread of genes encoding carbapenemases. Detection of carbapenemases and surveillance of their occurrence are both essential not only for optimal management of patients' care, but also for control of the spread of bacterial strains producing carbapenemases.
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Incidence of resistant bacterial strains isolated from patients of Thomayer Hospital in Prague - pilot study.
JEŽKOVÁ, Natálie
Purpose of my thesis was to determine presence of the most notable bacterial agents of patients in Thomayer hospital in Prague and possibilities of usage of aquired data for nosocomial infections prevention. Data from microbiological examinations throughout years 2015-2017 were analyzed. Resistance of individual bacterial strains was determined and based on results of sensibility of antibiotics and determination of beta-lactamase production. Software of laboratory information system was used for data processing, which allowed elimination of identical findings of the same patient. Data of the most present pathogens in Thomayer hospital was aquired, their distribution within clinics and presence of fenotypical resistence. Most common pathogens were E. coli and strains of genus Klebsiella. Highest numbers of resitatnt genes were found within klebsiellas. During three years time horizon rising tendecies of resistant genes were found on children's clinic and geriatric unit. Presence in other clinics, had either constant or in some cases decreasing tendencies. Most notable decrease was recorded in case of resistant genes of klebsiellas in pulmonary clinic and urology clinic. Quite interresting is total low presence of acinetobacters and significant decrease of its resistance. Spectrum of detected genes responds to results of similar studies realized in Czech Republic. Resluts indicate quite beneficial state of presence of resistent genes in Thomayer hospital, which testifies to successful implementation principles of actions against nosocomial infections.
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Problem of hospital infections such as scabies
Kováříková, Pavla ; Hošťálková, Monika (advisor) ; Eislerová, Iva (referee)
v AJ The main goal of this thesis is to define the aspects of the disease scabies as a nosocomial infection. This disease belongs to the most common skin infestations ever and that is why its introduction into the medical facilities often threatens. Nosocomial infections are one of the most important indicator of the quality of provided medical care and for this reason medics pay great attention to prevent any kinds of contagion. My thesis is divided into two parts. The theoretical part is devoted to the disease scabies itself, epidemiological situation, occupational diseases and legislation. In the research part of this thesis i deal with the availability of personal protective equipment, which is important for the prevention of nosocomial infections. Further i follow the health prefesionals knowledge and thein obtaining of necedssary information. The occurrence of nosocomial infection among questioned persons and the percentage of disease scabies are being evaluated as well. From the obtained results i tis obvils that scabies is a common parasitic disease and even that the sings and symptoms are well known, not always this disease is properly diagnosed. Due to the high hygiene standard sof the clients scabies is often confused with other itchy noninfectious disease and that is the reason why...
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Treatment of Peripheral Venous Input
Černohorská, Jitka ; Hošťálková, Monika (advisor) ; Ulrych, Ondřej (referee)
The bachelor thesis deals with the treatment of peripheral venous catheters. The theoretical part is devoted to basic terms such as nursing care, peripheral venous catheter and complications associated with it. A lot of attention in this thesis is focused on nursing care prior to, during and after the application of the catheter. Furthermore, the thesis introduces us to complications of catheter sepsis resulting from nosocomial infections. In the practical part the quantitative method was used in the form of anonymous questionnaires and hidden observations. The survey was conducted at the Military University Hospital Prague at different intensive care units. The obtained results show that 50,00 % of the respondents use non-woven fabric for re-bandaging the peripheral venous catheter and 50,00 % of the respondents use a foil. Furthermore, it was found that 88,10 % of the respondents use gloves by the application of peripheral venous catheter and 82,14 % by re-bandaging.
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Nursing Care of Infusion Lines
Šulcová, Martina ; Hošťálková, Monika (advisor) ; Hocková, Jana (referee)
The bachelor thesis deals with issues of handling an infusion line. The thesis describes the infusion line, its components and an extra chapter is devoted needleless connectors. It also includes procedures of using infusion lines and needleless connectors which are recommended not only by The International Association of Infusion Nurses (INS), but also by The Centers for Disease Control and Prevention (CDC). The work also describes complications of nosocomial infections that are related to handling the infusion line. In the practical part, I have made the results of the survey, which was aimed at the servicing infusion lines. The questionnaire was completed by nurses and midwives at Podřipský hospital and the health centre in Roudnice nad Labem. From the obtained data, I have found out that 81.82% of respondents use when working with the infusion line needleless connectors. On the contrary bacterial filters in the catheter sepsis prevention are not used at all. Next I have found out that 98.18% of respondents carry out the hygienic disinfection of hands before using the infusion line.
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Carbapenemases and their molecular genetic detection in bacteria causing severe hospital acquired infections
Vavrová, Jolana ; Dřevínek, Pavel (advisor) ; Zikánová, Blanka (referee)
The aim of this study is to characterize β-lactamases that hydrolyze carbapenems. They belong to molecular classes A, B and D and their new variations are still being identified. The production of enzymes hydrolyzing β-lactam antibiotics is common among Gram-negative bacteria which include also serious nosocomial pathogens such as Pseudomonas aeruginosa, Acinetobacter baumannii or members of Enterobacteriaceae family. The importance of the carbapenemases in clinical practice underlines the fact that carbapenems are broad-spectrum antibiotics, which are considered the reserve antibiotics. An increase in the number of cases of the carbapenem resistance is caused mainly by spread of genes encoding carbapenemases. Detection of carbapenemases and surveillance of their occurrence are both essential not only for optimal management of patients' care, but also for control of the spread of bacterial strains producing carbapenemases.
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Issues of Students' Awareness of Bachelor and Master Fields of Health Education at the University of South Bohemia in the Czech Budejovice: Issue of Nosocomial Infections
VAVŘINOVÁ, Petra
Thesis deals with ?the issue of awareness of nosocomial infections from undergraduate students of Bachelor and Master degree from Health education field at the University of South Bohemia in the Czech Budejovice.? This is very timely topic as nosocomial infections are a global economic and clinical problem not only for the present time but also for the future. Thesis is divided into two parts. Details of nosocomial infections, epidemic processes, agents of these infections, hand hygiene, prevention, health education, healthy lifestyle, immunity and support options for immune system are described in the theoretical part. The practical part describes the research problem, formulates hypothesis and shows statistical methods for research. The aim of this thesis was to find out the awareness of nosocomial infections from students of Bachelor and Master degree of VKZ at JU in the Czech Budejovice. Further I tried to compare this knowledge with respect to the age, education and field in which they act. I am trying to find out the possible way of prevention, personal protection against nosocomial infections moreover subjective perception of information related to this problem from respondents. I used the basic way of collecting data for achievement the given aim such as questionnaire in the aim group. There were used basic statistical methods suitable for analysis of categorical data. These results are illustrated in pie chart and bar chart for better interpretation. Test of the main hypothesis and working hypotheses are statistically made by 2 ? test. There was used Fisher factorial test in case there would be break prerequisite for correct usage of the previous test. The results of these tests are interpreted on the base of , with 95 % of reliability. I set this hypothesis in my thesis: ? Better knowledge will have students whose high school education was connected with the problems of health care. ? The result shows better knowledge for these students than for students from other high school however this difference was not statistically important. From all tests was found out that all students know the right definition of nosocomial infection however they have significantly less information related to the prevention against nosocomial infection. This thesis should give us food for thought about this problem and should change the attention to the health and the health of others and the possibility of further education.
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Point prevalence survey of healthcare-associated infections in the specialized surgical facility
CHMELAŘOVÁ, Šárka
My thesis is focused on the healthcare associated infections. This area is under considerable control in the developed countries and their health systems, whether in terms of medical, organizational, social, economic, or political. Epidemiology is the world's fastest growing field which knowledge can be applied very soon into everyday practice. The results of that have effect on the patients, whose visit in the hospital is becoming safer. It has also have effect on the healthcare that becomes a better and more professional. In our country, you can still meet the lack of awareness of professional and especially the current context, which accompanies this issue during the contact with the staff of health facilities. Nowadays, we are trying to implement the issue in our laws according to the requirements of the European Union. I try to outline this new European perspective on infections related to the healthcare in the theoretical part. We need to realize the main idea that these infections from healthcare facilities never disappear completely. In the interests of healthcare providers and their staff, it should be to get these infections under the control and to try to minimize the impact of these infections on the patients' health. The meaning of the term healthcare-associated infections or outdated nosocomial infections, and possible types of them, their most common cause and the process of their spread is explained at the outset of work. Afterwards I focused on explanation of the meaning of the prevalence survey as one of the methods of active surveillance. Thanks to the results of the Point Prevalence Survey, which was conducted in the European Union, Norway, Iceland, and Croatia in 2012, it was found that the European prevalence of healthcare associated infections is equal to 5.7%. These results are also commented in the thesis. This prevalence corresponds to every inflectional 18th patient hospitalized in the European acute care hospitals. The European Union Council Recommendation worked out the Infection Prevention and Control Programme in the healthcare facilities to reduce this prevalence. This programme with its details and requirements is described at the end of the theoretical part. In the next part I am aimed to the research, whose implementation is one of my goals. I conducted the Point Prevalence Survey according to the methodology, which was developed by European Centre for Disease Prevention and Control (ECDC). I chose specialized surgical facility for my research. My control sample is consisted of departments that have the same focus as my facility. They are focused only on plastic and reconstructive surgery. The departments were selected from the all Czech hospitals, where the Point Prevalence Survey was conducted in 2012. I received the data from the previous survey thanks to the National Institute of Public Health. I intend to provide the thesis to the specialized surgical facility as a feedback to the research which was carried out in there. Not only for me, but also for the local staff, the benefits are to familiarize with the prevalence survey and to realize that the healthcare-associated infections may still be an actual issue.
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The prevention of nosocomial infections at central venous catheters in standard inpatient departments and intensive care units.
PAŽOUTOVÁ, Petra
Nosocomial infections are one of serious problems of modern medicine and nursing also nosocomial infections mean real serious problems for future. Prevention of nosocomial infections, applied together with pointed and meaningful antimicrobial therapy is the only causal solution now. This work was aimed primarily at a comparison of knowledge of common nurses working in intensive care wards and common nurses in standard wards. In general, it could be said that the aim of this work was to map the scope of knowledge of common nurses as for nosocomial infections as well as aseptic care for central venous catheters including catheter sepses. The found deficit in knowledge of common nurses pointed out the occurrence of mistakes in nursing practices. Quality of nursing is connected closely with standardisation of nursing procedures. Quantitative research inquiry was realised in 4 medical facilities: Regional hospital Liberec, a.s., Masaryk city hospital in Jilemnice, Hospital České Budějovice, a.s. and Hospital with polyclinic in Semily. As the research method there was chosen a non-standardised questionnaire. The sample of respondents was chosen as an intentional selectionand and in to statistic processing included 290 relevantly filled out forms. The research investigation also included a comparison and quantification of nursing standards. In view of the performed comparison of standards in nursing we concluded that creation of incomplete or even inconsistent standards occurs here. We have prepared a "Proposal on a standard of nursing care for inserted venous catheter", of which form could enable to implement it in medical care facilities within the Czech Republic and define clearly basic nursing procedures within the scope of these problems.
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Qualitative research in the aplication of desinfection and sterilization of nursing unit
KARBÁČOVÁ, Marika
Abstract The thesis focuses on the application of disinfection and sterilization in the surgical unit. These methods are an integral part of nursing care and they prevent creation, transmission and spread of infection. The qualitative research was carried out in the surgical department in the Hospital Prachatice a.s.. The method used in the research is an unstandardized in-depth interview, in the second phase extended to a structured observation. There were set three objectives. Objective 1: to determine the ways of application of disinfection in the surgical unit, Objective 2: to determine the ways of application of sterilization in the surgical unit, Objective 3: to determine whether nurses observe the principles of disinfection and sterilization in the surgical unit. On the basis of these objectives, there were formed three research questions: What types of applications are used for disinfection in the surgical unit? What types of sterilization applications are used in the surgical unit? What principles of disinfection and sterilization are observed in the surgical unit? From the results of the in-depth interview and observation, it was discovered that physical and chemical disinfection is applied in the surgical unit. The employees use the services of central sterilization. In the surgical unit, there is not used any type of sterilization, except of the pre-sterilisation preparation. While disinfection, the employees follow the correct procedure, but they do not always use the correct amount of disinfectant. As the possibility of improvement, I would suggest to carry out training and remind that the recommended concentrations of disinfectants are sufficiently effective. There is no need to increase their amount hence it increases the financial costs of the surgical unit.
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