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Iskalni niz: "avtor" (Milena Kerin) .

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1.
Spremljanje bolnikov z MRSA na Onkološkem inštitutu v Ljubljani
Milena Kerin-Povšič, 2009

Povzetek: Meticilin rezistenten Staphylococcus aureus (MRSA) je pomemben povzročitelj bolnišničnih okužb. Širi se predvsem prek rok zdravstvenega osebja in bolnikov. Možnosti antibiotičnega zdravljenja so omejene. Najpogosteje uporabljamo glikopeptidne antibiotike, ki imajo slab baktericidni učinek. Onkološki bolniki imajo zaradi bolezni in postopkov zdravljenja oslabljene obrambne mehanizme, zato so bolj nagnjeni k okužbam. Dodatni dejavniki tveganja za okužbo so slaba prehranjenost, invazivni diagnostični in terapevtski posegi, pogoste hospitalizacije itd. Pomembno je dosledno izvajanje ukrepov za preprečevanje širjenja MRSA: higiena rok, iskanje bolnikov z dejavniki tveganja za nosilstvo MRSA, izolacija in dekolonizacija bolnika ter racionalna uporaba antibiotikov. Pogostnost pojavljanja MRSA je kazalec uspešnosti bolnišnične higiene. Na Onkološkem inštitutu izvajamo aktivno iskanje bolnikov z dejavniki tveganja od leta 2004. Prisotnost MRSA je bila največkrat ugotovljena v pooperativni ali kronični rani. Najpogostejši dejavnik tveganja je predhodna hospitalizacija, zlasti na kirurških oddelkih. Število bolnikov z MRSA v zadnjih letih upada.
DiRROS - Objavljeno: 31.08.2018; Ogledov: 1326; Prenosov: 277
.pdf Celotno besedilo (112,11 KB)

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Preprečevanje MRSA pri onkoloških bolnikih
Milena Kerin-Povšič, 2005

DiRROS - Objavljeno: 27.01.2020; Ogledov: 556; Prenosov: 194
.pdf Celotno besedilo (296,07 KB)

4.
Prevalence of and factors associated with healthcare-associated infections in Slovenian acute care hospitals : results of the third national survey
Irena Klavs, Mojca Serdt, Aleš Korošec, Tatjana Lejko-Zupanc, Blaž Pečavar, 2019

Povzetek: Introduction. In the third Slovenian national healthcare-associated infections (HAIs) prevalence survey, conducted within the European point prevalence survey of HAIs and antimicrobial use in acute care hospitals, we estimated the prevalence of all types of HAIs and identified factors associated with them. Methods. Patients were enrolled into a one-day cross-sectional study in November 2017. Descriptive analyses were performed to describe the characteristics of patients, their exposure to invasive procedures and the prevalence of different types of HAIs. Univariate and multivariate analyses of association of having at least one HAI with possible risk factors were performed to identify risk factors. Results. Among 5,743 patients, 4.4% had at least one HAI and an additional 2.2% were still treated for HAIs on the day of the survey, with a prevalence of HAIs of 6.6%. The prevalence of pneumoniae was the highest (1.8%), followed by surgical site infections (1.5%) and urinary tract infections (1.2%). Prevalence of blood stream infections was 0.3%. In intensive care units (ICUs), the prevalence of patients with at least one HAI was 30.6%. Factors associated with HAIs included central vascular catheter (adjusted odds ratio [aOR] 4.1; 95% confidence intervals [CI]: 3.1–5.4), peripheral vascular catheter (aOR 3.0; 95% CI: 2.3–3.9), urinary catheter (aOR 1.8; 95% CI: 1.4–2.3). Conclusions. The prevalence of HAIs in Slovenian acute care hospitals in 2017 was substantial, especially in ICUs. HAIs prevention and control is an important public health priority. National surveillance of HAIs in ICUs should be developed to support evidence-based prevention and control.
Ključne besede: healthcare-associated infections, prevalence, survey, risk factors, Slovenia
DiRROS - Objavljeno: 16.10.2020; Ogledov: 278; Prenosov: 132
URL Celotno besedilo (0,00 KB)

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The clinical relevance of oliguria in the critically ill patient : analysis of a large observational database
Jean Louis Vincent, Andrew Ferguson, Peter Pickkers, Stephan M. Jakob, Ulrich Jaschinski, Ghaleb A. Almekhlafi, Marc Leone, Majid Mokhtari, Luis E. Fontes, Philippe R. Bauer, Yasser Sakr, 2020

Povzetek: Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output < 0.5 ml/kg/h) in acutely ill patients and its association with the need for renal replacement therapy (RRT) and outcome. Methods: International observational study. All adult (> 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient-oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged-oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent-oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19%1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97%1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.
Ključne besede: critical care, critical illness, urine, oliguria, kidney, renal insufficiency, kidney diseases, acute kidney failure, mortality, urine output, renal replacement therapy
DiRROS - Objavljeno: 18.11.2020; Ogledov: 190; Prenosov: 165
URL Celotno besedilo (0,00 KB)

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Comparison of European ICU patients in 2012 (ICON) versus 2002 (SOAP)
Jean Louis Vincent, Jean-Yves Lefrant, Katarzyna Kotfis, Rahul Nanchal, Ignacio Martin-Loeches, Xavier Wittebole, Samir G. Sakka, Peter Pickkers, Rui P. Moreno, Yasser Sakr, 2018

Povzetek: Purpose: To evaluate differences in the characteristics and outcomes of intensive care unit (ICU) patients over time. Methods: We reviewed all epidemiological data, including comorbidities, types and severity of organ failure, interventions, lengths of stay and outcome, for patients from the Sepsis Occurrence in Acutely ill Patients (SOAP) study, an observational study conducted in European intensive care units in 2002, and the Intensive Care Over Nations (ICON) audit, a survey of intensive care unit patients conducted in 2012. Results: We compared the 3147 patients from the SOAP study with the 4852 patients from the ICON audit admitted to intensive care units in the same countries as those in the SOAP study. The ICON patients were older (62.5 +/- 17.0 vs. 60.6 +/- 17.4 years) and had higher severity scores than the SOAP patients. The proportion of patients with sepsis at any time during the intensive care unit stay was slightly higher in the ICON study (31.9 vs. 29.6%, p = 0.03). In multilevel analysis, the adjusted odds of ICU mortality were significantly lower for ICON patients than for SOAP patients, particularly in patients with sepsis [OR 0.45 (0.35-0.59), p < 0.001]. Conclusions: Over the 10-year period between 2002 and 2012, the proportion of patients with sepsis admitted to European ICUs remained relatively stable, but the severity of disease increased. In multilevel analysis, the odds of ICU mortality were lower in our 2012 cohort compared to our 2002 cohort, particularly in patients with sepsis.
Ključne besede: intensive care units -- analysis -- epidemiology -- mortality, sepsis, severity of disease
DiRROS - Objavljeno: 30.11.2020; Ogledov: 290; Prenosov: 131
URL Celotno besedilo (0,00 KB)

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