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PL
Przedstawiono wyniki badań, których analiza pozwoliła na zidentyfikowanie dwóch, wieloopornych, epidemicznych szczepów MRSA w Państwowym Szpitalu Klinicznym Nr 2 w Szczecinie.
EN
Over a fivefold increase, from 11% to 58%, in the prevalence of methicillin-resistance was observed in 1994-95 amongst clinical isolates of Staphylococcus aureus in the State Clinical Hospital No 2 in Szczecin, one of the largest hospitals in the West Pomeranian region of Poland. The aim of this study was to see if any one particular strain was responsible for this apparent outbreak. Fifty-six randomly selected isolates were typed by SmaI macrorestriction analysis using PFGE and by analysis of antimicrobial susceptibility patterns. Results indicate the presence of two epidemic multi-drug resistant MRSA strains. Over 85% of typed MRSA belonged to the first strain, which was probably present in the hospital long before 1994. MRSA of this strain were isolated from patients in 8 hospital wards. The second strain was introduced into two wards of the hospital in the last year of the study.
PL
W pracy oceniano przydatności metody redukcji TTC przez żywe bakterie do wykrywania biofilmu tworzonego na powierzchni przyrządów medycznych, wykonywanych z różnych materiałów syntetycznych. Badano adhezję drobnoustrojów do powierzchni biomateriałów in vitro oraz tworzenie przez te drobnoustroje biofilmu podczas zakażenia zwierząt poddanych implantacji. Potwierdzono przydatność badanej metody, wykazując jej wysoką czułość, krótki czas i łatwość wykonania.
EN
This study was performed to assess the value TTC assay in the diagnosis of biomaterial-associated infections. In this assay, soluble colourless TTC is reduced to insoluble red formazan by electron transfer associated with active oxidative bacterial metabolism and is precipitated intracellularly. Microbial adhesion and biofilm formation on the surface of medical prosthetic devices (vescular and urinary catheters) made of various polymers (PTFE, H-PE, PCW, SL), were determined. The microorganisms which are most often isolated in medical device-associated infections: S. aureus, S. epidermidis, E. faecalis, E. coli, P. vulgaris, P. aeruginosa, C. albicans, were included into the study. The obtained results indicate that the assay using TTC as a metabolic indicator of bacterial biofilm presence, is technically simple to conduct with minimal setup time. Even when classical cultures yielded no bacterial growth, TTC assessments demonstrated bacterial biofilms. TTC assay could be recommended as a quick routine method for confirmation of biomaterial device-associated infection.
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tom 52
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nr 4
333-340
PL
Oceniono zmiany fagotypów MRSA występujących w ośrodkach szpitalnych regionu gdańskiego w latach 1990-1998. Gronkowce poddano typowaniu międzynarodowym zestawem fagów eksperymentalnych dla MRSA i określono ich lekooporność. W latach 1997-1998 stwierdzono pojawienie się nowego fagotypu MR25/M5, do którego należała ponad połowa szczepów, przy czym większość z nich charakteryzowała się takim samym antybiogramem. Szczepy MRSA izolowane do 1995 roku wykazywały większe zróżnicowanie fagotypów i lekooporności.
EN
The aim of the study was the assessment of changes in the occurrence of various MRSA phagotypes in hospitals in the Gdańsk area in 1990-1998. The study was carried out on 175 MRSA strains: 45 strains isolated in 1990-1995 and 130 in 1997-1998. The studied staphylococci were obtained from various clinical materials from patients in 18 hospitals. Phagotyping was done with a set of 10 experimental phages from MRSA strains obtained from the Central Public Health Laboratory in London. Drug-resistance was determined by the disc-diffusion method and in case of strains with medium susceptibility to fusidic acid the minimal inhibitory concentration (MIC) was determined by serial dilutions on solid medium. The study showed among MRSA strains isolated in 1997-1998 a new, previously not known strains with phage pattern MR25/M5 predominated (57,7%). Its presence was found in various hospitals in that area. MRSA belonging to MR25/M5 phagotype were mostly resistant to doxycycline, gentamycin, erythromycin, clindamycin, ciprofloxacin, rifampicin and were resistant or only had medium susceptibility tu fusidic acid. The MIC values for strains with medium susceptibility to fusidic acid (4-8 µg/ml) showed an evident decrease of the susceptibility to this antibiotic, formerly common in MRSA. At the same time, in 1997-1998 a considerable decrease was observed of (he number of MRSA strains belonging to MR8/MR12/MR25/30/33/38/M5/622 phagotype (from 31,1% to 0,8%), and disappearance of strains with phagotypes MR25/56B/M3 and MR8/MR25/622, which in 1990-1995 accounted for 15,6% of the studied staphylococci.
PL
Scharakteryzowano pod względem wrażliwości na fluorochinolony oraz występowania czynników związanych z wirulencją 83 szczepy Enterococcus faecalis izolowane z materialu klinicznego od osób hospitalizowanych. Oporność na ciprofloksacynę wykazywało 49 badanych szczepów, a 14 szczepów bylo średnio wrażliwych. Wszystkie oporne na wysokie stężenia ciprofloksacyny (MIC ≥ 32 µg/ml) badane izolaty E. faecalis były również oporne na nowe fluorowane chinolony. Większość badanych szczepów opornych na ciprofloksacynę charakteryzowała się także opornością na gentamycynę. Stwierdzono, że szczepy E. faecalis wykazujące oporność na ciprofloksacynę cechowała zdolność wytwarzania jednego z dwóch badanych czynników związanych z wirulencją hemolizyny/cytolizyny. Natomiast w przypadku żelatynazy nic stwierdzono zależności pomiędzy opornością szczepów na ciprofloksacynę, a wytwarzaniem tego enzymu. Tylko jeden z badanych szczepów E. faecalis wytwarzał obydwa badane czynniki: hemolizynę/cytolizynę oraz żelatynazę.
EN
In presented study we have characterized phenotype of clinical E.faecalis strains, fluoroquinolone susceptibility and the presence of two potential virulence factors - hemolysin/cytolysin and gelatinase. Eighty three of E. faecalis strains were isolated from clinical samples from patients of five Warsaw hospitals. Susceptibility to 18 antibiotics was assessed by the disk diffusion method (acc. NCCLS). The MIC of ciprofloxacin was determineted by agar dilution method and the MIC of Sparfloxacin and moxifloxacin by the E-test (AB BIODISK). Hemolysin production was evaluated on Columbia agar medium supplemented with 5% horse blood. Gelatinase production was determinated by using two different methods: I - on the Todd-Hewitt agar containing gelatin (30 g/l) and II - on the trypticase soy agar supplemented with 1,5% skim milk. Fourty nine (59%) of the 83 isolates E.faecalis were ciprofloxacin resistant and 14 (16,9%) were ciprofloxacin intermediate. The majority of E.faecalis strains (57,8%) were higly resistant to ciprofloxacin (MIC ≥ 32 µg/ml). All of ciprofloxacin resistant E.faecalis isolates were cross - resistant to the other fluoroquinolones, as well. Production of hemolysin was more frequent among ciprofloxacin resistant E.faecalis strains. The dependence between gelatinase production and fluoroquinolone resistance was not observed. Both investigated methods of gelatinase activity detection gave the same results and can be used exchangeably. Hemolytic strains were more frequently isolated from urine (47,8%), however gelatinase producing strains were more frequently isolated from wounds (31,6%).
PL
Badania przeprowadzono na 44 szczepach Staphylococcus haemolyticus pochodzących z próbek materiału klinicznego pobranych od pacjentów hospitalizowanych na Oddziale Chirurgii. Analizowano następujące czynniki warunkujące chorobotwórczość szczepów S. haemolyticus: wytwarzanie śluzu, adhezję do biomateriałów, wrażliwość na antybiotyki oraz profil białek powierzchniowych.
EN
The study have been done on S. haemolyticus strains isolated from patients hospitalized an Surgical Unit. Aim of the study was to determine pathogenic traits of S. haemolyticus: slime producing, adhesion to biomateriale, antibiotics susceptibility and the profiles of surface proteins. Among 44 S. haemolyticus strains, in the test-tube method, there have been 38% labeled as slime producing and 62% as non-producing. In the plate method at 48% slime production was noticed, while 52% strains did not produce slime. It is quite significant that all CNS strains which have an ability to produce mucus, that was proved by means of two methods (test-tube and plate), show a high level of TTC's reduction to formazan. The analysis of resistance to antibiotics in relation to slime production demonstrated more frequent antibiotic resistance of the slime-producing strains.
PL
Oceniono częstość występowania oraz lekowrażliwość drobnoustrojów najczęściej izolowanych z próbek materiału klinicznego pobranych od pacjentów Świętokrzyskiego Centrum Onkologii w Kielcach w 2001 roku, z uwzględnieniem podziału na rodzaje zakażeń. Najczęściej izolowano Escherichia coli i Staphylococcus aureus. Escherichia coli wytwarzające ESBL stanowiły 2,7% ogółu szczepów tego gatunku izolowanych z próbek materiału klinicznego pobranych od pacjentów hospitalizowanych, natomiast gronkowce złociste oporne na metycylinę 27,9% ogółu szczepów Staphylococcus aureus.
EN
The aim of the presented study was the analysis of microbiological data obtained from patients hospitalized in The Holly Cross Cancer Center in Kielce in 2001. The frequency of important nosocomial pathogens in selected specimens and their susceptibility to antibiotics were determined. The strains were identified by using commercial tests (bioMerieux) and their antibiotic susceptibility patterns were performed by disc diffusion technique. The most prevalent bacteria were Gram-negative rods of Enterobacteriaceae family (43%), mainly Escherichia coli. Only 2,7% strains of isolated Escherichia coli isolated from clinical specimens collected from hospitalized patients were ß-lactamase - positive (ESBL+). The second important group of microorganisms were Staphylococci, followed by Enterococcus spp., Pseudomonas aeruginosa and Candida spp. About twenty eight percent of Staphylococcus aureus isolates were resistant to methicillin.
PL
Oceniono częstość występowania oporności typu MLSB wśród szczepów MSSA (n=1682) i MRSA (n=272) izolowanych z próbek materiału klinicznego w latach 2002-2004 w Szpitalu Uniwersyteckim im. A. Jurasza CM w Bydgoszczy UMK w Toruniu. W kolejnych latach szczepy S. aureus MLSB+ stanowiły w populacji MSSA 3,1%, 3,2%, 3,8%, natomiast w populacji MRSA- 22,8%, 25,4% i 19,8%.
EN
The aim of the study was the analysis of frequency of macrolide-lincosamide-streptogramin В (MLSB) resistance among MSSA (n=1682) and MRSA (n=272) strains which were isolated in 2002- 2004 from various clinical materials from patients hospitalized in the University Hospital at the L. Rydygier Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus in Toruń. Susceptibility testing and examination of methicillin-resistant strains were performed by the disc diffusion techniques according to recommendation of NCCLS. Resistance to the MLSB antimicrobials agents was higher among MRSA compared to MSSA isolates. The MLSB constitutive phenotype was more prevalent than the MLSB inducible phenotype among investigated MRSA (65,4%) and MSSA (7,6%) isolates. Inducible resistance had only 2,5% of the MSSA and 2,6% of the MRSA strains. Moreover in 2004 there were found increasing frequency of inducible MLSB resistance from 1,1% to 5,7% and decreasing frequency of constitutive MLSB resistance from 9,2% to 4,7% among MSSA strains, in comparison to 2003. The investigated MSSA MLSB+, MLSB and MRSA MLSB+, MLSB- strains were the most frequently isolated from pus (adequately 5,2%, 28,8% and 30,5%, 10,7%) and also from nosopharynx swabs ( 1,7% MSSA MLSB+ and 22,9% MSSA MLSB-) and biomaterials ( 15,1 % MRSA MLSB+ and 9,6% MRSA MLSB-). They mainly came from patients of the outpatient clinic (2,4% MSSA MLSB+ and 19,9% MSSA MLSB- and patients treated at the neurosurgical ward (20,6% MRSA MLSB+ and 12,1% MRSA MLSB- ).
PL
W regionie gdańskim, w latach 1997-2000, szczepy o wysokiej oporności na mupirocynę stanowiły 4,7% MRSA. Wyizolowano je w 3 spośród 18 szpitali, ogółem u 6 pacjentów. Szczepy te charakteryzowały się wysokim stopniem oporności na metycylinę, były oporne na większość antybiotyków, za wyjątkiem glikopeptydów i bacytracyny i najprawdopodobniej pochodziły z tego samego źródła.
EN
Occurence of high - level mupirocin resistace in methicillin - resistant Staphylococcus aureus (MRSA) strains isolated from 18 hospitals in Gdańsk area was determined. The study was carried out on 190 MRSA isolated in 1997 - 2000 from various clinical samples. The strains were tested for high - level mupirocin resistance by 200 μg mupirocin disc. The minimum inhibitory concentrations (MIC) for methicillin were estimated by agar dilution. Sensivity to other antibiotics was determined in disc - diffusion method and to vancomycin in agar dilution method additionally. The strains were typed by set of 10 experimental phages and compared by the metod of PCR - RFLP analysis of coagulase gen restriction fragment lenght polymorphism. There were low frequency of high - level mupirocin resistance in MRSA strains (4,7%) that were found only in 3 hospitals, in 6 patients. All of them were high - resistant also to methicillin and resistant to doxycyclin, gentamycin, erytromycin, klindamycin, ciprofloksacin, rifampicin, resistant or intermediate sensitive to fusidic acid but sensitive to vancomycin, teikoplanin and bacitracin. The origin all of the MRSA strains high - resistant to mupirocin probably was the same except one strain, because they were belonged to one genetic type and possessed the phage pattern.
PL
Wykazano wysoką wrażliwość na metronidazol i wankomycynę klinicznych szczepów C. difficile wyhodowanych z próbek kału pobranych od dorosłych z biegunką poantybiotykową hospitalizowanych w latach 1998-2002 w PSK Dzieciątka Jezus - Centrum Leczenia Obrażeń AM oraz dzieci hospitalizowanych w warszawskich szpitalach dziecięcych na oddziałach hematologii i gastroenterologii.
EN
The drugs of choice used to treat C. difficile associated diarrhoea (CDAD) are metronidazole and vancomycin. C. difficile strains isolated in most laboratories are sussceptible to metronidazole and vancomycin. Communication about emergence of antimicrobial resistance among C. difficile strains in some countries to metronidazole and intermidiate resistance to vancomycin are alarming. This study was performed to determine the susceptibility to metronidazole and vancomycin of 140 C. difficile strains isolated from patients with CDAD hospitalised in academic hospital between 1999 - 2002. Resistance to metronidazole and vancomycin was not observed.
PL
Przeprowadzono retrospektywną analizę częstości izolacji oraz lekowrażli- wości 775 szczepów Pseudomonas aeruginosa opornych na imipenem i me- ropenem. Szczepy objęte badaniem, pochodzące z materiału od 568 chorych, izolowano w latach 1998-2009 w Zakładzie Mikrobiologii Klinicznej Szpitala Uniwersyteckiego nr 1 im. dr. A. Jurasza w Bydgoszczy. W okresie objętym badaniem odnotowano tendencję wzrostową częstości izolacji szczepów P. aeruginosa o fenotypie oporności na karbapenemy.
EN
P. aeruginosa rods are dangerous pathogens mainly responsible for nosocomial infections of different localization. Resistance to carbapenems, observed among them, is a serious threat due to ability to be transmitted between bacterial species. The aim of our study was to retrospectively evaluate the frequency of isolation and susceptibility to antibiotics of imipenem- and meropenem-resistant P. aeruginosa strains isolated between 1998 and 2009 from patients of University Hospital No 1 of dr A. Jurasz in Bydgoszcz. Study shows increasing number of isolation that type of strains from 19 in 1998 to 144 in 2009. Among all isolated P. aeruginosa strains majority was obtained from patients of the Intensive Care Units, Rehabilitation and Surgery Clinics. Examined strains of P. aeruginosa rods were mainly isolated from urine (20,5%), bronchoalveolar lavage (17,7%) and wound swabs (14,5%) samples. The isolates demonstrated frequently resistance to carbenicillin (≥66,7%), ticarcil- lin (≥72,7%) and cefotaxime (≥75,6%). The lowest rate of resistant strains was observed in case of ceftazidime (≤68,8%), aztreonam (≤47,4%) and Colistin (≤1,7%) suggesting the highest activity of that antimicrobials against infections caused by examined strains.
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nr 2
197-205
PL
Oceniono 9742 wykonane w latach 1993-1998 posiewy krwi pod kątem udziału ważnych klinicznie grzybów drożdżopodobnych jako czynników etiologicznych fungemii oraz aktualnego stanu oporności wybranej grupy patogenów. Stałej tendencji wzrostowej inwazyjnych kandydemii towarzyszyła zwiększająca się różnorodność gatunkowa badanych szczepów oraz ich wzrastająca oporność na leki przeciwgrzybicze.
EN
The study was carried out of 9742 blood cultures obtained in 1993-1998 from patients of selected departments of the University Hospital. The received samples were assessed from the standpoint of the participation of fungi strains of clinical importance as aetiological factors in systemic infections and the resistance status of a selected group of pathogens. Microbiological blood studies were conducted in the system of continuous monitoring of the obtained cultures by means of the automatic ATB system using a commercially available ID 32C set. ATB Fungus tests were used for drug resistance assessment. In all, 95 strains of yeasts (5.1 %) were obtained in cultures, and an increasing variety of these pathogenic species was noted in sepsis. A systematic reduction was noted in the proportion of C. albicans and a steep rise of C. parapsilosis were observed among the aetiological factors of generalized nosocomial fungal infections. A tendency was noted for a continuous rise in the frequency of invasive candidaemias with a most significant rise in their proportion in patients in general surgery and haematology departments. Among the fungi isolated from septic complications the proportion of strains resistant to antifungal drugs has been rising.
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