Pojavnost proti antibiotikom odpornih bakterij na oblačilih vzgojiteljic v vrtcu

magistrsko delo

Dominika Žagar (Author), Mojca Jevšnik (Reviewer), Karmen Godič Torkar (Mentor)

Abstract

Odpornost bakterij proti antibiotikom je v kliničnem okolju z zdravstvenega vidika zelo problematična in je posledično zelo raziskana. Po drugi strani je bilo doslej precej manj pozornosti namenjene pojavnosti odpornih bakterij izven kliničnega okolja, kot so šole, vrtci, drugi varstveni zavodi, rekreacijske ustanove in domače okolje. Namen: Namen naloge je bil ugotoviti, katere bakterije se pojavljajo na oblačilih vzgojiteljic v vrtcu, proti katerim antibiotikom so odporne in katere gene za odpornost nosijo in potencialno širijo med občutljivimi bakterijami. Cilj naloge je bil dokazati proti meticilinu odporne seve Staphylococcus aureus (MRSA), proti vankomicinu odporne enterokoke (VRE) in seve, ki tvorijo beta-laktamaze s širokim spektrom delovanja (ESBL). Metode dela: Iz brisov oblačil vzgojiteljic, ki smo jih prejeli iz predhodne študije, smo osamili seve na selektivnih in diferencialnih gojiščih. Osamili smo seve enterokokov, stafilokokov, po Gramu negativnih palčk in skupine Bacillus cereus (B. cereus). Po Gramu negativne palčke smo identificirali s komercialno biokemijsko analizo API® ID strip, seve B. cereus z verižno reakcijo s polimerazo in seve stafilokokov z z masno spektrometrijo (MALDI-TOF) ter biokemijsko analizo API® ID strip. Seve enterokokov nismo identificirali do vrste seva. Vsako skupino osamljenih sevov smo testirali za odpornost proti antibiotikom z difuzijsko metodo z diski, metodo s kombiniranimi diski, difuzijsko metodo z gradientom ali mikrodilucijsko metodo. Odpornost enterobakterij in rodu Bacillus smo ugotavljali tudi z verižno reakcijo s polimerazo, pri čemer smo iskali gene za beta-laktamaze in karbapenemaze. Rezultati: Osamili smo dva seva po Gramu negativnih bakterij, ki tvorita ESBL; 21 sevov skupine Bacillus cereus, ki tvorijo ESBL in so odporni proti nekaterim drugim antibiotikom; štiri seve MRSA in VISA; 23 proti meticilinu odpornih stafilokokov (MRS) ter 13 za vankomicin delno občutljivih stafilokokov (VIS); nobenega seva VRE, vendar je bilo nekaj enterokokov, odpornih proti drugim antibiotikom. Pri nobenem testiranem sevu nismo ugotovili večkratne odpornosti proti več kot trem skupinam antibiotikov. Razprava in zaključek: Ugotovili smo pojavnost klinično pomembnih odpornih bakterij (ESBL, MRSA, MRS) na oblačilih vzgojiteljic, ki se lahko prenašajo tudi na njihove varovance. Ti rezultati kažejo na razširjenost odpornih bakterij v nekliničnem okolju in bi kot taki morali biti temelj za ukrepe, s katerimi bi širjenje odpornih bakterij v vrtčevskem okolju preprečili.

Keywords

magistrska dela;sanitarno inženirstvo;oblačila;vrtci;beta-laktamaze s širokim spektrom delovanja;proti meticilinu odporen Staphylococcus aureus;odporne bakterije;

Data

Language:	Slovenian
Year of publishing:	2018
Typology:	2.09 - Master's Thesis
Organization:	UL ZF - University College of Health Studies
Publisher:	[D. Žagar]
UDC:	614
COBISS:	5509483
Views:	1109
Downloads:	483
Average score:	0 (0 votes)
Metadata:

Other data

Secondary language:	English
Secondary title:	ǂThe ǂoccurrence of antibiotic resistant bacteria found on clothes of child care staff members
Secondary abstract:	The antibiotic resistance of bacteria is a widely known issue in clinical environments, thus, it has been researched thoroughly. Less attention has been given to the bacterial resistance in non clinical environment, in communities such as schools, kindergardens, recreational sites and domestic environments. Purpose: The purpose of this study is to detect the presence of resistant bacteria on clothes of childcare workers, to identify them and to which antibiotics they are resistant to, which resistance genes they are carrying and possibly sharing among suscceptable bacteria. This thesis aims to prove the presence of MRSA, VRE and ESBL. Methods: We isolated strains of different bacterial groups on selective or differential mediums from the swabs of a preliminary study. Therefore, we isolated resistant strains of enterococci, staphylococci, Gram-negative bacilli (Enterobacteriaceae) and Bacillus cereus group. Gram-negative bacilli were identified by using commercial kit API® ID strip, strains of B. cereus group by PCR method and staphilococci by MALDI-TOF method and commercial kit API® ID strip. Strain identification was not performed on enterococci. Antibiotic susceptibillity testing was performed for each group by the disc diffusion method, combined disc method, gradient diffusion method or microdilution method. The resistance of th strains was also evaluated through gene sequencing of beta-lactamases and carbapenemases. Results: We managed to isolate two strains of ESBL Gram-negative bacilli, 21 ESBL strains of B. cereus group that also showed resistance to some other antibiotics, four strains of MRSA and VISA, 23 strains of MRS, 13 strains of VIS and no VRE, although some enterococci proved resistant to other antibiotics. No strain proved multiple resistance to antibiotics. Discussion and conclusion: The thesis proves occurrence of clinically important, resistant bacteria (such as ESBL, MRSA, MRS, etc.) on clothes of childcare workers. The results indicate the spread of bacterial resistance out of clinical environment. These findings ought to be a base of concern and necessary measures required to prevent further spreading of resistant bacteria outside clinical environments. Thus, the necessity for further research should not be neglected.
Secondary keywords:	master's theses;sanitary engineering;clothes;kindergartens;extended-spectrum beta-lactamases;methicillin-resistant Staphylococcus aureus;resistant bacteria;
Type (COBISS):	Master's thesis/paper
Study programme:	0
Embargo end date (OpenAIRE):	1970-01-01
Thesis comment:	Univ. v Ljubljani, Zdravstvena fak., Oddelek za sanitarno inženirstvo
Pages:	70 str., [15] str. pril.
ID:	10975892