29 research outputs found
Global spread of carbapenemase-producing bacteria
KliniÄki znaÄaj enzima karbapenemaza oÄituje se u njihovoj sposobnosti hidrolize karbapenema, zbog Äega bakterije koje ih proizvode razvijaju otpornost na ovu podskupinu Ī²-laktamskih antibiotika Å”irokog spektra, kao i na veÄinu ostalih pripadnika iste skupine (penicilini, cefalosporini). Karbapenemaza producirajuÄi sojevi gram-negativnih bakterija od velikog su epidemioloÅ”kog znaÄaja, buduÄi da trend Å”irenja ovih Ī²-laktamaza meÄu bolniÄkim, ali i izvanbolniÄkim izolatima postaje ozbiljna globalna prijetnja. Äesto uzrokuju manje ili veÄe epidemije u zdravstvenim ustanovama. Geni koji kodiraju karbapenemaze obiÄno se prenose na druge bakterije zajedno s genima koji su odgovorni za rezistenciju na ostale skupine antibiotika, kao Å”to su kinoloni i aminoglikozidi. MeÄu najproÅ”irenijim karbapenemazama nalaze se metalo-Ī²-laktamaze IMP, VIM i NDM-tipa, a poÄetkom treÄeg milenija postali smo svjedoci globalne krize zbog eksplozivnog Å”irenja viÅ”estruko otporne Klebsiella pneumoniae koja proizvodi KPC Ī²-laktamazu. Zabrinjava Äinjenica da pojava i Å”irenje enterobakterija, pseudomonasa i acinetobaktera otpornih na karbapeneme znaÄajno pridonosi poveÄanom pobolu i smrtnosti pacijenata. Za probir karbapenemaza producirajuÄih sojeva u mikrobioloÅ”kom laboratoriju koriste se klasiÄne fenotipske metode zasnovane na kultivaciji, nakon Äega je neophodno potvrditi produkciju enzima primjenom potvrdnih (fenotipskih i/ili molekularnih) metoda. Identifikacija specifiÄnih gena koji kodiraju enzime temelji se na molekularnim tehnikama. Dijagnostiku i interpretaciju dobivenih laboratorijskih rezultata otežava neprepoznavanje rezistencije nižeg stupnja koja se može javiti u odreÄenom postotku karbapenemaza producirajuÄih sojeva. Zbog vrlo ograniÄenog izbora djelotvornih antibiotika vrlo je znaÄajno rano otkrivanje producirajuÄih sojeva te sprjeÄavanje njihova prijenosa. Pravovremeno otkrivanje inficiranih pacijenata, ali i zdravih kliconoÅ”a kljuÄan je korak u prevenciji Å”irenja rezistentnih sojeva bakterija.Carbapenemases are clinically important enzymes because they hydrolyse and inactivate the broad-spectrum Ī²-lactam antibiotics carbapenems. Carbapenemase-producing strains are resistant to carbapenems and to most of the other classes of Ī²-lactams (penicillins, cephalosporins). The growing trend of the carbapenemase-producing strains between inpatient and outpatient isolates of gram-negative bacteria is becoming a global health threat. Infections caused by carbapenemase-producing strains often occur as outbreaks. In addition, carbapenemase- encoding genes are frequently transferred to other bacteria along with the genes responsible for resistance to other classes of antibiotics, such as quinolones and aminoglycosides. The most widespread carbapenemases are metallo-Ī²-lactamase IMP, VIM and NDM-types. At the beginning of the third millennium we witnessed the global spread of KPC-producing, multidrugresistant Klebsiella pneumoniae. The emergence and spread of carbapenem-resistant Enterobacteriaceae, Pseudomonas and Acinetobacter strains leads to an increase in morbidity and mortality rates. Phenotypic methods based on cultivation are used for screening of carbapenemase- producing strains, however, enzyme production must be confirmed by phenotypic or molecular methods. Identification of specific carbapenemase-encoding genes is mainly based on molecular techniques. Low level resistance that can occur in a certain percentage of carbapenemase-producing strains complicates detection and laboratory tests interpretation. Due to the very limited choice of effective antibiotics early detection of carbapenemase-producing strains becomes of paramount importance. Strict infection control measures, including active surveillance for timely detection of colonised patients and prompt isolation of carriers are key steps for preventing the transmission of these bacteria in healthcare settings
Izazovi odreÄivanja antimikrobnog uÄinka polifenola
As multidrug resistance gains momentum, the last two decades have seen an ever-growing interest in the antimicrobial properties of plant extracts and plant-derived compounds. Most of the focus is on polyphenols ā a large and diverse group of phytochemicals with strong antibacterial activity. Testing methods provide reliable results as long as they follow standard procedures. However, methods and procedures used in antimicrobial susceptibility testing (AST) are often too diverse to allow comparison of results. The lack of uniformity and comparability is much owed to the absence of guidelines. The focus of this review is to give a critical overview of different methods used in the assessment of polyphenols antimicrobial efficacy and to highlight the importance of their standardisation.Istraživanje antimikrobnih uÄinaka biljnih ekstrakata i spojeva u proteklih nekoliko desetljeÄa zaokuplja interes brojnih znanstvenika zbog sve veÄe otpornosti bakterija na antibiotike. NajÄeÅ”Äi i najviÅ”e prouÄavani sekundarni biljni metabolite su polifenoli ā brojna i raznolika skupina fitokemikalija s dokazanim antibakterijskim djelovanjem. MeÄutim, istraživaÄi koji prouÄavaju antimikrobni uÄinak prirodnih spojeva biljnoga podrijetla susreÄu se s brojnim preprekama, koje je potrebno prepoznati i izbjeÄi. Na rezultate ispitivanja antimikrobne osjetljivosti mogu utjecati brojni Äimbenici, a izbor odgovarajuÄe metode ispitivanja od presudnog je znaÄaja. Nepostojanje postupnika/smjernica za testiranje antimikrobnog uÄinka bioaktivnih prirodnih spojeva uvelike utjeÄe na ujednaÄenost, analizu i usporedbu brojnih objavljenih rezultata. U naÄelu, samo primjena standardiziranih metoda osigurava dobivanje pouzdanih rezultata. Cilj je ovoga preglednog rada sustavno i kritiÄki prikazati razliÄite metode koje se koriste za ispitivanje antimikrobnog uÄinka polifenola te istaknuti potrebu za njihovom standardizacijom
Educiranost primalja o cijepljenju protiv gripe tijekom trudnoÄe
Gripa je potencijalno ozbiljna zarazna bolest, posebno za odreÄene skupine kao Å”to su trudnice, koje imaju poveÄani rizik od obolijevanja i smrtnosti. Osjetljivost trudnica na infekciju virusom gripe objaÅ”njava se fizioloÅ”kim promjenama koje nastaju u trudnoÄi. Prevencija gripe cijepljenjem kljuÄna je strategija za sprjeÄavanje nastanka bolesti i razvoj moguÄih komplikacija u trudnica i novoroÄenÄadi. Primalje trebaju biti pouzdan i pravovremen izvor informacija o cijepljenju s obzirom na to da rade u izravnom doticaju s trudnicama. Cilj ovog istraživanja je ispitati znanje i stavove primalja u Hrvatskoj o cijepljenju trudnica protiv gripe.
Rezultati anketnog istraživanja kojim su obuhvaÄene 82 primalje iz cijele države pokazali su ograniÄena znanja ispitanika o cijepljenju protiv gripe tijekom trudnoÄe. Manje od polovine ispitanika smatra da je cijepljenje protiv gripe u trudnoÄi uÄinkovito, a samo Äetvrtina ispitanika smatra da je cjepivo sigurno. TreÄina ispitanih primalja zna da se trudnicama u Hrvatskoj preporuÄuje inaktivirano cjepivo protiv gripe, a manje od Äetvrtine zna da se cjepivo može primijeniti u bilo kojem tromjeseÄju. Velika veÄina primalja ukljuÄenih u istraživanje (93%) navela je da ne pružaju trudnicama informacije o cijepljenju protiv gripe, a kao vodeÄi razlog navode manjak educiranosti. Nije utvrÄena statistiÄki znaÄajna razlika u znanju i stavovima ovisno o stupnju obrazovanja i duljini radnog staža. PoboljÅ”anje procijepljenosti trudnica protiv gripe uvelike ovisi o preporukama zdravstvenih djelatnika. Ova studija pruža vrijedan uvid u znanja, stavove i praksu hrvatskih primalja ukazujuÄi na potrebu dodatne edukacije primalja o sigurnosti cjepiva protiv gripe i potencijalnoj koristi za majku i dijete
The listeriosis triangle: Pathogen, host and the environment
Listeria monocytogenes is a foodborne pathogen well known for its adaptability to diverse environment and host niches and its high fatality rate among infected immunocompromised populations. Infection in the immunocompetent host occurs but risk factors for the disease primarily points to abnormalities in cell-mediated and innate immunity as major predispositions to listeriosis. After ingestion of contaminated food, this pathogen is able to cross the intestinal, blood-brain and placental barrier and leads to gastroenteritis, meningitis and maternofetal infections which may result in abortion and spontaneous stillbirth. Despite the extensive use of this bacterium in the study of cell-mediated immunity and intracellular growth, our understanding of the host, pathogen and environmental factors that impact the pathogenesis of listeriosis is still incomplete. This review will summarize current knowledge, including our own efforts, about pathogen, host and environmental factors that influence, and contribute to the pathogenesis of Listeria monocytogenes infection
The Listeriosis Triangle: Pathogen, Host and the Environment
Listeria monocytogenes is a foodborne pathogen well known for its adaptability to diverse envirnoment and host niches and its high fatality rate among infected immunocompromised populations. Infection in the immunocompetent host occurs but risk factors for the disease primarily points to abnormalities in cell-mediated and innate immunity as major predispositions to listeriosis. After ingestion of contaminated food, this pathoge is able to cross the intestinal, blood-brain and placental barrier and leads to gastroenteritis, meningitis and maternofetal infections which may result in abortion and spontaneous stillbirth. Deispite the extensive use of this bacterium in the study of cell-mediated immunity and intracellular growth, our understanding of the host, pathogen and environmental factor that impact the pathogenesis of listeriosis is still inclomplete. This review will summarize current knowledge, including our own efforts, about pathogen, host and environmental factors that influence, and contribute to the pathogenesis of Listeria monocytogenes infection
The Listeriosis Triangle: Pathogen, Host and the Environment
Listeria monocytogenes is a foodborne pathogen well known for its adaptability to diverse envirnoment and host niches and its high fatality rate among infected immunocompromised populations. Infection in the immunocompetent host occurs but risk factors for the disease primarily points to abnormalities in cell-mediated and innate immunity as major predispositions to listeriosis. After ingestion of contaminated food, this pathoge is able to cross the intestinal, blood-brain and placental barrier and leads to gastroenteritis, meningitis and maternofetal infections which may result in abortion and spontaneous stillbirth. Deispite the extensive use of this bacterium in the study of cell-mediated immunity and intracellular growth, our understanding of the host, pathogen and environmental factor that impact the pathogenesis of listeriosis is still inclomplete. This review will summarize current knowledge, including our own efforts, about pathogen, host and environmental factors that influence, and contribute to the pathogenesis of Listeria monocytogenes infection
ESKAPE ā bacteria that alert the world
Rezistencija na antimikrobne lijekove ugrožava kvalitetu medicinske skrbi u zajednici i bolniÄkom okruženju. Bakterijska rezistencija prisutna je od samog poÄetka antibiotskog doba, ali je u proteklih dvadesetak godina poprimila zabrinjavajuÄi trend porasta. PriroÄena rezistencija je stalna, genetski zadana osobina nekog mikroorganizma. SteÄena rezistencija nastaje neoÄekivano, u prethodno osjetljivoj bakteriji, mutacijom ili ÄeÅ”Äe horizontalnim prijenosom gena putem plazmida. Rezistencija Äesto nije u potpunosti genetski odreÄena, veÄ može biti heterogena unutar populacije, ovisna o okoliÅ”u, strukturi bakterijske populacije ili o fizioloÅ”kom stanju bakterijske stanice. Selekcijski pritisak antibiotika važan je Äimbenik u odabiru i Å”irenju rezistentnih bakterija. Pojava viÅ”estrukorezistentnih bakterija kao uzroÄnika bolesti posebno je alarmantna. Takvi mikroorganizmi se uobiÄajeno nazivaju āsuperbakterijeā, ali ne zato Å”to su virulentnije, nego zato jer zbog suženog izbora antibiotika konaÄni ishod lijeÄenja takvih infekcija može biti neizvjestan i Äesto nepovoljan. Stoga je cilj ovog preglednog Älanka prikazati saznanja o rezistenciji, mehanizmima bakterijske otpornosti prema antibioticima i onim viÅ”estrukorezistentnim bakterijama koje danas predstavljaju najveÄu prijetnju globalno i lokalno, a udružene su pod akronimom ESKAPE.Resistance to antimicrobial drugs jeopardizes the quality of medical care in the community and in the hospital environment. Bacterial resistance has been present since the beginning of the antibiotic period, but over the last twenty years it has a worrying increasing trend. Innate resistance is a permanent, genetic predetermined feature of some microorganism. Acquired resistance occurs unexpectedly, in a previously sensitive bacterium, by mutation, or more often by horizontal genes transmission by plasmids. Resistance does not always have to be completely genetically defined, but can be heterogeneous within the population, depending on the environment, bacterial population structure and physiological state of bacterial cell. Antibiotic selection pressure is an important factor in the selection and spread of resistant bacteria. Appearance of multiple resistant bacteria as a cause of the disease is particularly alarming. Such microorganisms, are commonly referred to as "super-bacteria", not because they are more virulent, but due to the narrowed choice of susceptible antibiotics. The final outcomes of infections caused by these microorganisms are uncertain and often disadvantageous. Therefore, the aim of this review article is to provide insights into bacterial resistance, resistance mechanisms to antibiotics and multi-resistant bacteria that present the greatest threat globally and locally, and are associated under the acronym ESKAPE
Helicobacter pylori resistance to antibiotics in Primorsko-goranska county
Cilj: Niti za jednu bakterijsku infekciju ne postoji toliko razliÄitih terapijskih opcija kao za infekciju koju uzrokuje bakterija Helicobacter pylori za koju joÅ” uvijek nije pronaÄen optimalan terapijski pristup. PreporuÄene terapijske sheme koje se primjenjuju u empirijskom lijeÄenju ovise o otpornosti helikobaktera na antimikrobne lijekove u odreÄenoj regiji. No, empirijsko lijeÄenje infekcije uz sve veÄi porast otpornosti helikobaktera na antibiotike Äesto ima za ishod terapijski neuspjeh. Cilj ovog rada bio je utvrditi proÅ”irenost i trend otpornosti helikobaktera na antibiotike na podruÄju Primorsko-goranske županije (PGŽ) u petogodiÅ”njem razdoblju. Metode: StatistiÄki su obraÄeni i interpretirani rezultati testiranja osjetljivosti H. pylori na antibiotike u razdoblju 2013-2017. godine. Podatci su dobiveni iz arhiva KliniÄkog zavoda za kliniÄku mikrobiologiju KliniÄkog bolniÄkog centra Rijeka te MikrobioloÅ”kog odjela Nastavnog zavoda za javno zdravstvo PGŽ. Rezultati: Zabilježena je visoka stopa otpornosti H. pylori na klaritromicin i metronidazol, niska stopa otpornosti na levofloksacin i sporadiÄna otpornost na rifampicin i amoksicilin. U petogodiÅ”njem razdoblju nije izoliran niti jedan soj otporan na tetraciklin. ZakljuÄci: Visoka stopa rezistencije na klaritromicin i metronidazol, uz dvojnu rezistencija na oba antibiotika koja je pronaÄena u Äetvrtini izolata ograniÄava koriÅ”tenje ovih antibiotika u empirijskim terapijskim shemama. UoÄena je i zabrinjavajuÄa pojava viÅ”estruke otpornosti na antibiotike prisutna u 10% izolata koja dodatno otežava izbor odgovarajuÄe terapije. PraÄenje i poznavanje antimikrobne otpornosti lokalnih izolata H. pylori je neophodno radi izrade odgovarajuÄih terapijskih smjernica.Aim: There is no bacterial infection with so many different therapeutic options as for infection caused by Helicobacter pylori for which an optimal therapeutic approach has not yet been found. Recommended therapeutic schemes depend on H. pylori resistance to antimicrobial drugs in a particular region, however, empirical treatment of infections along with increasing resistance to antibiotics often results in a therapeutic failure. The aim of this study was to determine the trend and the prevalence of helicobacter antibiotic resistance in Primorsko-goranska county during the five-year period. Methods: This study presents the results of H. pylori antimicrobial susceptibility testing from year 2013 to 2017. Data were obtained from the archives of the Department of Clinical Microbiology, Clinical Hospital Centre Rijeka and the Department of Microbiology, Teaching Institute of Public Health of Primorsko-Goranska County. Results: High-level resistance to clarithromycin and metronidazole was noticed. Rare resistance to levofloxacin was observed whereas resistance to rifampicin and amoxicillin was found sporadically. Resistance to tetracycline was not detected. Conclusions: The high resistance rate to metronidazole and clarithromycin as well as high dual resistance to both antibiotics observed in about a quarter clinical isolates can impair the efficacy of these antimicrobials in empirical eradication treatment. In addition, worrying appearance of multiple resistance to antibiotics in 10% of isolates was observed. Surveillance of local antimicrobial resistance is necessary in order to establish the relevant treatment guidelines