diplomsko delo
Anja Vode (Author), Karmen Godič Torkar (Reviewer), Anamarija Zore (Mentor)

Abstract

Pojav bakterijskih bolnišničnih okužb pri novorojenčkih predstavlja izziv na področju zdravstvene nege, ki ga moramo obravnavati, da bi preprečili smrt novorojenčkov. Bakterija Escherichia coli je pomemben patogen, ki lahko povzroči neonatalno sepso prezgodaj rojenih otrok. Zgodnja neonatalna sepsa je pomemben vzrok za obolevnost in smrtnost zlasti pri otrocih z nizko gestacijsko starostjo in zelo nizko porodno težo. Medicinska sestra ima strokovna znanja in lahko odkrije začetne znake sepse pri novorojenčku, saj ima v bolnišnici stalni stik z njim. Namen: Namen diplomskega dela je s pomočjo pregleda literature raziskati in analizirati pojavnost bakterije E. coli pri prezgodaj rojenih otrocih ter okužbe, ki jih povzroča. Metode dela: Uporabljena je bila deskriptivna metoda dela, ki obsega pregled domače in tuje literature. Pregled strokovne literature, recenziranih zbornikov, specializiranih revij, učbenikov s področja zdravstvene nege v neonatologiji in pediatriji, znanstvenih in strokovnih člankov je bil opravljen v obdobju od oktobra 2017 do avgusta 2018 s pomočjo bibliografske baze podatkov COBIB.SI ter podatkovnih baz CINAHL, Medline (PubMed), Science Direct in Wiley Online Library. Rezultati: Po pregledani literaturi je večina okužb z bakterijo E. coli prisotna pri prezgodaj rojenih otrocih, starih manj kot 37 tednov in težkih manj kot 2500 g. Najbolj pogosti patogeni so streptokoki skupine B (58 %) in E. coli (18 %). Večina novorojenčkov se okuži s fekalnimi sevi. Odkrite bakterije naj bi domnevno prenesli na dojenčke njihovi starši, obiskovalci ter zdravstveno osebje. Posredni prenos preko stika z rokami ali s površin je najverjetnejši vzrok za nadaljnje širjenje med nedonošenčki. Pri otrocih, ki umrejo zaradi sindroma nenadne smrti, je pogosto identificirana bakterija E. coli, vendar je zaradi raznolikosti sevov bakterije težko ugotoviti, kateri morebiti povzročajo ta sindrom. Bistvene preventivne strategije za prenos bolnišničnih okužb na neonatalnem oddelku so higiena rok, preprečevanje okužb pri uporabi venskih katetrov, premišljena uporaba antimikrobne terapije in kemoprofilakse, nega kože in zgodnje dojenje oz. hranjenje z materinim mlekom. Razprava in zaključek: Prezgodaj rojeni otroci so dovzetnejši za okužbe zaradi njihovega nerazvitega imunskega sistema. Bakterija Escherichia coli s kapsulo tipa K1 lahko povzroči neonatalno bakterijsko okužbo, najpogosteje meningitis. Incidenca E. coli pri prezgodaj rojenih otrocih se razlikuje od države do države. Glavni dejavniki tveganja za pojav neonatalne sepse zaradi okužbe z E. coli so: nizka gestacijska starost (< 30 oz. < 37 tednov), nizka porodna teža (< 1500 g oz. < 2500 g), odpornost bakterije proti penicilinu in drugim antibiotikom, ocena APGAR < 7 v prvi minuti, zgodnji razpok membran ter okužba urinarnega trakta med nosečnostjo. Premišljeno klinično oceno tveganja za neonatalno okužbo se mora postaviti že pred rojstvom otroka in jo prilagajati glede na okoliščine po njegovem rojstvu.

Keywords

diplomska dela;zdravstvena nega;neonatalna sepsa;nedonošenčki;E. coli;sindrom nenadne smrti dojenčka;

Data

Language: Slovenian
Year of publishing:
Typology: 2.11 - Undergraduate Thesis
Organization: UL ZF - University College of Health Studies
Publisher: [A. Vode]
UDC: 616-083
COBISS: 5586795 Link will open in a new window
Views: 1501
Downloads: 326
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Other data

Secondary language: English
Secondary title: The presence of Escherichia coli in premature babies
Secondary abstract: Introduction: The onset of bacterial nosocomial infections in newborns is a challenge in the field of nursing that needs to be addressed in order to prevent the death of newborns. Bacterium Escherichia coli is an important pathogen in neonatal sepsis of premature babies. Early neonatal sepsis is an important cause of morbidity and mortality, especially in children with low gestational age and very low birth weight. The nurse has the expertise and can detect the initial signs of sepsis in the newborn because she has constant contact with him. Purpose: The purpose of the diploma work is to investigate and analyze the presence of bacteria E. coli in premature babies and the infections that the bacteria E. coli causes. Methods: A descriptive work method was used, which includes a review of domestic and foreign literature. A review of scientific literature, reviewed collections, specialized journals, textbooks in the field of nursing care in neonatology and pediatrics, scientific, and expert articles was carried out in the period from October 2017 to August 2018 with the help of the bibliographic database COBIB.SI, as well as CINAHL, Medline databases (PubMed), Science Direct and Wiley Online Library. Results: According to the reviewed literature, most infections with bacteria E. coli in prematurely born children are present in children who are less than 37 weeks old and weigh less than 2500 g. The most common pathogens are group B streptococci (58 %) and E. coli (18 %). Most newborns get infected with fecal strains. The detected bacteria are supposed to be brought by children’s parents, visitors, and medical staff. Indirect transmission through contact with hands or surfaces is the most likely reason for the further spread between premature babies. In children who die due to sudden infant death syndrome, E. coli is often identified. Due to the variety of bacterial strains, however, it is difficult to determine which may be the cause for this syndrome. The essential preventive strategies for the transmission of hospital infections in the neonatal section are hygiene of hands, prevention of infections in the use of venous catheters, thoughtful use of antimicrobial therapy and chemoprophylaxis, skin care, and early breastfeeding. Discussion and conclusion: Premature babies are more susceptible to infections due to their underdeveloped immune system. Bacteria Escherichia coli with a K1 capsule can cause neonatal bacterial infection, most often meningitis. The incidence of E. coli in premature babies varies from country to country. The main risk factors for the occurrence of neonatal sepsis due to E. coli infection are low gestational age (< 30 and < 37 weeks), low birth weight (< 1500 g or < 2500 g), bacterial resistance to penicillin and other antibiotics, APGAR < 7 in the first minute, an early rupture of membranes, and urinary tract infection during pregnancy. A thoughtful clinical assessment of a neonatal infection must be made prior to the birth of the child and be adapted according to the circumstances after its birth.
Secondary keywords: diploma theses;nursing care;neonatal sepsis;premature babies;E. coli;sudden infant death syndrome;
Type (COBISS): Bachelor thesis/paper
Study programme: 0
Embargo end date (OpenAIRE): 1970-01-01
Thesis comment: Univ. v Ljubljani, Zdravstvena fak., Oddelek za zdravstveno nego
Pages: 38 str.
ID: 11028357