2016, Cilt 46, Sayı 3, Sayfa(lar) 097-104 |
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The Problem of Antimicrobial Resistance in Intensive Care Units in Turkey |
Pınar ÇIRALIGİL |
Çukurova Üniversitesi Eczacılık Fakültesi, Farmasötik Mikrobiyoloji Anabilim Dalı |
Keywords: Antibiotic resistance, Intensive care unit |
Intensive care units (ICU) are parts of the hospitals which
provide multidisciplinary services, and have the highest
incidence of nosocomial infections relative to their bed
occupancy rates.
Especially infections with multidrug-resistant organisms and
intensive use of antibiotics cause serious problems in intensive
care units. Methicillin-resistant Staphylococcus aureus,
vancomycin-resistant enterococci, extended-spectrum betalactamase
and carbapenemase producing Escherichia coli,
Klebsiella species and other members of the Enterobacteriacea,
Acinetobacter species and Pseudomonas aeruginosa are the
resistant organisms responsible from nosocomial infections in
ICUs. Factors such as invasive procedures performed on
patients, severity of the disease and insufficient infection
control measures all accelerate infection rates. Additionally,
use of parenteral, extended spectrum antibiotics such as third
generation cephalosporins, antipseudomonal penicillins,
carbapenems and fluoroquinolones play an important role in
the development of nosocomial infections. Infections due to
antibiotic resistant organisms not only increase morbidity and
mortality, but also lead to prolonged hospital stay, excessive
costs and increase in severe medical complications.
Organisms that cause infections in ICU's and their
antibiotic susceptibility profiles should be monitored and
treatment protocols should be revised accordingly in
order to provide evidence- based and effective empirical
antimicrobial treatment and to take necessary measures
against nosocomial infections in hospitals, especially in
ICU's. By way of performing surveillance studies, actual
problems can be detected and targeted therapies based on
supportive cumulative antibiogram results can be applied
and life-threatening infections in ICU's can be
controlled.
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