SEPSA – NOWE ZAGROŻENIE CZY LEPIEJ DEFINIOWANA STARA JEDNOSTKA CHOROBOWA
[SEPSIS – A NEW LIFE-THREAT OR BETTER DEFINED OLD DISEASE ENTITY]

Streszczenie.

W pracy przedstawiono problemy dotyczące sepsy w aspekcie klinicznym oraz mikrobiologicznym. Przedstawiono wyniki pięcioletniej współpracy zespołu Oddziału Intensywnej Terapii USK nr 1 w Łodzi oraz Pracowni Mikrobiologii mającej na celu zmniejszenie zakażeń szpitalnych, walkę z alertpatogenami co przekłada się na redukcję zakażeń krwi.

Abstract.

The presence of multiresistant pathogens in a hospital leads very often to a severe sepsis that threatens the patients’ life. For this reason, in the interests of the patients in the Intensive Care Unite (ICU) of the Lodz Medical University Hospital No.1, a wide monitoring of the epidemiological situation and the rational antibiotic therapy, taking the resistance mechanisms of pathogens into account, have been started since 2002. Restrictive procedures of the insertion of central venous and dialysis
catheters were elaborated as well as the permanent monitoring of the MRSA carrier state among the
medical staff was undertaken. A procedure of the primary bacteriological examination for all new patients in the ICU was also introduced. All these actions resulted in a considerable, statistically significant (p=0,043), decrease in bloodstream infections from 14.2 infections per 100 patients in 2002 to 2.0 infections per 100 patients in 2006. A drop in the number of infections of central venous catheters was also observed: from 4.3 infections per 100 patients in 2002 to 1.9 infections per 100 patients in 2006 (p=0.025). Administration of ceftazidime and clavulanic acid, which are MRSA inductors, only
in the events of guided therapy when other therapeutic options were failed as well as the reduction of
the MRSA carrier state among the medical staff brought about a radical elimination of MRSA from the bloodstream infections. The obtained results show that the severe infections caused by multiresistant pathogens in hospitals can be effectively reduced due to cooperation between clinicians and microbiology laboratories.