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Οι λοιμώξεις από την ενδοφλέβια θεραπεία οφείλονται σε αποικισμό του καθετήρα ή μόλυνση του υγρού έγχυσης και αποτελούν ένα υπαρκτό κίνδυνο μικρότερο για τις ανεπτυγμένες και μεγαλύτερο για τις αναπτυσσόμενες χώρες. Τα ενδοφλέβια υγρά (ΕΥ) είναι κυρίως διαλύματα ενυδάτωσης και παρεντερικής διατροφής. Μικροοργανισμοί που μολύνουν συνήθως τα ΕΥ είναι ο Staphylococcus epidermidis, η Klebsiella, τα Enterobacter, Serratia αλλά και η Pseudomonas. Η μόλυνση καλείται ενδογενής όταν συμβαίνει κατά τη διάρκεια παρασκευής του ΕΥ και εξωγενής όταν συμβαίνει κατά τη χορήγησή του στον ασθενή. Η διάκριση των ενδογενών μολύνσεων από τις εξωγενείς μπορεί να γίνει από τα επιδημιολογικά χαρακτηριστικά των λοιμώξεων που προκαλούνται. Οι ενδογενείς μολύνσεις προκαλούν επιδημίες, ενώ οι εξωγενείς σποραδικά κρούσματα. Οι κλινικές εκδηλώσεις από μολυσμένο ΕΥ δεν διαφέρουν από αυτές μιας οποιασδήποτε νοσοκομειακής μικροβιακής λοίμωξης. Η κατάλληλη αντιμικροβιακή αγωγή είναι συνήθως αναποτελεσματική. Ο ασθενής ...
Όλα τα τεκμήρια στο ΕΑΔΔ προστατεύονται από πνευματικά δικαιώματα.
There are several routes that pathogens may potentially follow in the development of catheter - associated infection. Invasion from the surface of the skin along the external surface of the catheter is probably the major route. Contamination of the hub or connecting site presumably plays a great role when catheters are in place for more than 10 days. Contamination of the infusate itself, either on - site or during commercial preparation, has been well documented, and may give rise to clusters of infection involving patients in one or more institutions. Appreciation of this risk leeds to improved quality control. The contamination of intravenous fluids may occur in several ways, including the use of components contaminated during the manufacturing process, inadequate aseptic technique during preparation of the solution, sterilization failures, contamination of the solution during storage, technical problems during the administration or the method of infusion. Infusates contamination mai ...
There are several routes that pathogens may potentially follow in the development of catheter - associated infection. Invasion from the surface of the skin along the external surface of the catheter is probably the major route. Contamination of the hub or connecting site presumably plays a great role when catheters are in place for more than 10 days. Contamination of the infusate itself, either on - site or during commercial preparation, has been well documented, and may give rise to clusters of infection involving patients in one or more institutions. Appreciation of this risk leeds to improved quality control. The contamination of intravenous fluids may occur in several ways, including the use of components contaminated during the manufacturing process, inadequate aseptic technique during preparation of the solution, sterilization failures, contamination of the solution during storage, technical problems during the administration or the method of infusion. Infusates contamination mainly involves Staphylococcus epidermidis and bacteria of the tribe Klebsiella - Enterobacter - Serratia because they are able to grow rapidly in the solutions. Other microorganisms responsible could be Pseudomonas spp, Echerichia coli, Acinetobacter spp, Proteus spp, Aeromonas spp, Staphycoccus aureus, Enterococcus spp and Candida spp. The contamination of intravenous fluids may be intrinsinc or extrinsinc. The clinical manifestations are indistinguishable from those of patients with other nosocomial Gram negative sepsis. Fever, nonspecific respiratory, gastrointestinal and neurologic signs and symptoms are included. Appropriate antimicrobial therapy is usually ineffective until the infusion is removed. The aim of this study was to evaluate: A. The bacterial growth properties in intravenous fluids. For that purpose iv infusates were inoculated with different microorganisms whose growth was studied at room (25ο C) and cold (4 ο C) temperature. The solutions examined were NaCl 0,9%, Dextrose 5% and Total Parenteral Nutrition Fluids (TPNF). The TPNF were fat emulsions and amino acid-glucose solutions suppleme-nted with vitamins, electrolytes and trace elements. The bacteria used were Enterobacter cloacae, Serratia, Pseudomonas, Stenotrophomonas maltophi-lia, Aeromonas, Klebsiella, Acinetobacter, E. coli, Proteus, Enterococcus, Sta-phylococcus aureus and Staphylococcus epidermidis. Β. Τhe contamination risk of the Total Parenteral Nutrition Fluids (TPNF) that are produced in the specific Intravenous Fluid Unit (IVFU) of “Aghia Sophia” Children’s Hospital, Athens. During the first two years since the IVFU started the production of TPNF, 51 out of the 1700 (3%) solutions examined were found contaminated with Gram positive and Gram negative bacteria. During the following twenty years 41.835 TPNF were found sterile. These results are associated with the improvement of the IVFU contitions.
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