| Title: | Prisotnost bakterije Bacillus cereus v bolniškem oddelku in kužninah, tvorba enterotoksinov ter njena občutljivost za antibiotike |
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| Authors: | ID Godič Torkar, Karmen (Author) |
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| Language: | Slovenian |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: |  ZZBNS - ZSDMSBZTS - Nurses and Midwives Association of Slovenia
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| Abstract: | Izhodišča: Največje tveganje za prenos okužb z mikroorganizmi je v bolnišnicahin drugih zdravstvenih ustanovah. Pomembno vlogo pri preprečevanju bolnišničnih okužb imajo poleg higienskih služb predvsem komisije za obvladovanje bolnišničnih okužb, ki združujejo strokovnjake različnih specialnosti - zdravnike, medicinske sestre, epidemiologe, klinične mikrobiologe, farmacevte in sanitarne inženirje. Namen: Ker je sporotvorna potencialno patogena bakterija Bacillus cereus možna povzročiteljica bolnišničnih okužb, je bil namen poskusa ugotoviti njeno prisotnost v kliničnem okolju. Pri dobljenih kliničnih izolatih in izolatih iz živil je bila testirana občutljivost za antibiotike in sposobnost tvorbe toksinov. Metode: Za izolacijo in identifikacijo sevov B. cereus iz 38 brisov površin naopremi in inštrumentih v bolniških sobah, odvzetih v avgustu 2007, so se uporabile standardne mikrobiološke preiskave. Za 60 bakterijskih sevov B. cereus je bila s Kirby-Bauerjevo difuzijsko metodo z diski preskušena občutljivost za antibiotike in s testom Duopathr GLISA Cereus Enterotoxins sposobnost tvorbe diarealnih enterotoksinov. Rezultati: B. cereus je bil prisoten v šestih (15,8 %) od 38 brisov, in sicer v brisih, odvzetih na površini podstavka za milo, embalaže z razkužilom, pladnja za hrano, posteljnepodloge, uporabljenega tulca za odvzem krvi in koša za perilo. Vseh 60 sevov, osamljenih iz kužnin in živil, je bilo občutljivih za streptomicin in gentamicin, 90 % jih je bilo občutljivih za klindamicin in vankomicin, medtem ko jih je bilo 67 % občutljivih za eritromicin. Vsi izolati so bili odporni proti amoksicilinu s klavulansko kislino, ampicilinu, cefotaksimu, ciprofloksacinu, kloksacilinu, cefotaksimu s klavulansko kislino in penicilinu. Kar 98,3 % preskušenih sevov je tvorilo nehemolitični diarealni toksin, medtem ko jih je 31,7 % tvorilo hemolitični diarealni toksin. V primerjavi z izolati iz hrane je med kliničnimi izolati hemolitični diarealni toksin tvorilo deset odstotkov več izolatov. Nehemolitični diarealni enterotoksin je bil ugotovljen tudi pri psihrotrofnih sevih, inkubiranih pri temperaturi 6,5 °C. Razprava in zaključki: B. cereus je bil najden na površinah in pripomočkih v prostorih kliničnega oddelka v kar 16 % primerov. Bakterijski sevi so bili odporni proti številnim testiranim antibiotikom in sovsi tvorili vsaj enega od diarealnih enterotoksinov. Rezultati tega poskusa so lahko uporabna informacija medicinskim sestram o kritičnih kontrolnih točkah odpornih potencialno patogenih mikroorganizmov. V poskusu sodelujoče medicinske sestre so izrazile potrebo po pogostejšem vzorčenju v bolniških oddelkih, saj bi lahko na osnovi rezultatov mikrobioloških preiskav primerno organizirale strategijo kontrole in obvladovanja bolnišničnih okužb.Introduction: The greatest risk for transfer of infections caused by microorganisms is in hospitals and other medical institutions. Acountable for the prevention of nosocomial infections are not only hygienic services but also special committees for hospital infection prevention and control. The latter is comprised of medical doctors, nurses, epidemiologists, clinical microbiologists, pharmacists and sanitary engineers. Aim: Bacillus cereus is asporeform, potentially pathogenic microorganism which may cause serious infections. The aim of the study was to determine the presence of its isolatesin clinical environments. The antibiotic susceptibility and enterotoxin production of the tested strains was also examined. Methods: Standard microbiological procedures were used in identification and isolation of B. cereus strains from 38 swabs taken from the surfaces of the equipment and instruments in sickrooms in one of the clinical departments in August 2007. The susceptibility of 60 B.cereus isolates from clinical specimens and foods to antibiotics was determined by Kirby-Bauer disc-diffusion method. For establishing the production of diarrhoeal enterotoxins, the Duopathr GLISA Cereus Enterotoxin test kit was used. Results: In 6 (15.8 %) out of 38 collected swabs the presence of B. cereus was determined, namely from the surfaces of the soap saucer, package of the disinfectant, the meal serving, tray, bed lining, dirty linen basket and used syringe container. The second part of the experiment included the estimation of antimicrobial susceptibilityof 60 clinical and food B. cereus isolates. All tested strains were susceptible to streptomycin and gentamycin, 90 % of them to clindamycin and vancomycin, and 67 % of strains to erythromycin. All isolates were resistant to amoxicillin with clavulanic acid, ampicillin, cefotaxime, ciprofloxacin, cloxacillin, cefotaxime with clavulanic acid and penicillin. Non-haemolytic diarrhoeal enterotoxin was produced by 98.3 % of the tested strains, while 31.7 % of them produced the haemolytic diarrhoeal enterotoxin. In comparison to food isolates ten percent more clinical isolates produced thehaemolytic diarrhoeal enterotoxin. Discussion and conclusions: B. cereus was found on equipement surfaces and instruments in almost 16 % of cases. Bacterial strains were resistant to various tested antibiotics, while all of them were capable to produce at least one of the diarrhoeal enterotoxins. The results of the study could serve as useful information source for nurses in defining the critical control points of resistant potential pathogenic microorganisms. The nurses who collaborated in the experiment expressed the need for more frequent sampling in clinical departments. The results obtained through microbiological examinations of these samples would dictate the necessary future actions, surveillanceas well as protection procedures. |
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| Keywords: | Bacillus cereus, občutljivost, antibiotiki, toksini |
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| Publication date: | 01.01.2009 |
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| Year of publishing: | 2009 |
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| Number of pages: | str. 21-29 |
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| Numbering: | Letn. 43, št. 1 |
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| PID: | 20.500.12556/DiRROS-25876 |
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| UDC: | 614.4:579.2 |
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| ISSN on article: | 1318-2951 |
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| COBISS.SI-ID: | 3689323 |
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| Note: | Besedilo samo v slov.;
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| Publication date in DiRROS: | 28.01.2026 |
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| Views: | 303 |
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| Downloads: | 0 |
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