Antibakteriālā rezistence un tās ietekme uz stacionēto pacientu ārstēšanas ilgumu, izmaksām un mirstību
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Date
2020
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Darba nosaukums: ‘antibiotiku rezistence un tās ietekme uz mirstību stacionārā, stacionēšanas ilgumu un izmaksām’. Literatūras apskata mērķis: Literatūras apskata mērķis ir atspoguļot antibiotiku rezistences negatīvo ietekmi uz stacionārā ārstētiem pacientiem, analizējot rezistences ietekmi uz pacientu mirstību, stacionēšnas ilgumu un izmaksām. Materiāli: Literatūras apskats ir zinātnisko publikāciju apkopojums, kas galvenokārt iegūtas no Pub-med un Elsevier datu bāzēm. Literatūras apskats veidots izmantojot literatūŗas avotus, kas publicēti laika periodā no 2001. līdz 2019. Gadam. Secinājumi: Lielākā daļa pētījumu norāda, ka pacienti, kuriem attīstās MDRO (multirezistentu mikroorganismu) izraisītas infekcijas, mirstības risks palielinās par 1.5-4.0 RR, hospitalizācijas ilgums pagarinās par 2.0-12.7 dienām, un izmaksas palielinās 1.2-1.5 reizes, salīdzinot ar tām, kuras izraisa pret antibiotikām jutīgi celmi. Pētījumu rezultātos vērojamas būtiskas atšķirības, ja tiek salīdzināti pacienti ar antibakteriāli rezistentu mikroorganismu izraisītām infekcijām un pacienti bez infekcijām. Tā kā šie pētījumi bieži ir vērsti uz infekcijām, kuras izraisa tikai viens mikroorganisms, tikai vienā lokalizācijā, galvenokārt bakterēmija, kā arī bieži vien netiek precizēts vai mirstības iemesls bijusi hospitāla vai sadzīvē iegūta infekcija, tiem ir ierobežots pielietojums. Pētījumi šajā sfērā ir salīdzinoši atšķirīgi, dažkārt savstarpēji pretrunīgi un grūti salīdzināmi. Noslēgumā, iegūtie rezultāti rosina intensificēt pētījumus par šo tēmu.
Title: ‘antibiotic resistance and its impact on hospital settings: cost, length of staying and mortality’. Aim of the literature review: this literature review aims to show the negative impact that antibiotic resistance has on hospital settings. The focus is on cost, mortality rate and length of staying. Materials: Literature review is a collection of scientific publications, mainly taken from Pubmed and Elsevier- in English and Italian- about resistance mechanism, the leading factors involved in the rise and spread of resistance and, more specifically, on its impact on the health care system. Key words used -antibiotic, bacterial resistance, alternatives to conventional antibiotics, economic impact, antibiotic stewardship, WHO global action plan, hospital mortality, length of stay, global resistance, antibiotic history, factors affecting antibacterial resistance, antimicrobial resistance mechanism- Time frame- from 2001 till 2019. Conclusion: The majority of the studies show that patients who developed infections caused by MDRO have a risk in mortality which is increased by 1.5–4.0 RR [risk ratio], an expanded length of hospitalisation of 2.0–12.7 days and higher costs, ranging from 1.2 to 1.5 times than those caused by susceptible strains. Understandably, the expense divergence is more significant in the case in which antimicrobial-resistant infected patients are correlated with patients with no infection. The studies in this field are, however divergent, sometimes conflicting between each other and with reduced space for comparison. Moreover, since these researches are often focused on infections caused by just one microbe, in just one site, mainly bacteremia, and often they do not even discriminate if the source of the morbidity was hospital or community-acquired, they have limited use. In conclusion, the presented results suggest an intensification of research regarding this topic.
Title: ‘antibiotic resistance and its impact on hospital settings: cost, length of staying and mortality’. Aim of the literature review: this literature review aims to show the negative impact that antibiotic resistance has on hospital settings. The focus is on cost, mortality rate and length of staying. Materials: Literature review is a collection of scientific publications, mainly taken from Pubmed and Elsevier- in English and Italian- about resistance mechanism, the leading factors involved in the rise and spread of resistance and, more specifically, on its impact on the health care system. Key words used -antibiotic, bacterial resistance, alternatives to conventional antibiotics, economic impact, antibiotic stewardship, WHO global action plan, hospital mortality, length of stay, global resistance, antibiotic history, factors affecting antibacterial resistance, antimicrobial resistance mechanism- Time frame- from 2001 till 2019. Conclusion: The majority of the studies show that patients who developed infections caused by MDRO have a risk in mortality which is increased by 1.5–4.0 RR [risk ratio], an expanded length of hospitalisation of 2.0–12.7 days and higher costs, ranging from 1.2 to 1.5 times than those caused by susceptible strains. Understandably, the expense divergence is more significant in the case in which antimicrobial-resistant infected patients are correlated with patients with no infection. The studies in this field are, however divergent, sometimes conflicting between each other and with reduced space for comparison. Moreover, since these researches are often focused on infections caused by just one microbe, in just one site, mainly bacteremia, and often they do not even discriminate if the source of the morbidity was hospital or community-acquired, they have limited use. In conclusion, the presented results suggest an intensification of research regarding this topic.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Keywords: antibiotic, bacterial resistance, alternatives to conventional antibiotics, economic impact, antibiotic stewardship, WHO global action plan, hospital mortality, length of stay, global resistance, antibiotic history, factors affecting antibacterial resistance, antimicrobial resistance mecha, Keywords: antibiotic, bacterial resistance, alternatives to conventional antibiotics, economic impact, antibiotic stewardship, WHO global action plan, hospital mortality, length of stay, global resistance, antibiotic history, factors affecting antibacterial resistance, antimicrobial resistance mecha