| Abstract | Ciljevi: Ciljevi ovog istraživanja bili su istražiti i usporediti epidemiološke i kliničke osobitosti bolesnika oboljelih od infektivnih proljeva uzrokovanih s Cl. difficile s onima uzrokovanima C.jejuni/coli; utvrditi i usporediti vrijednosti laboratorijskih nalaza oboljelih; istražiti mogućnosti sestrinske skrbi u bolesnika oboljelih od infektivnih proljeva uzrokovanih s Cl. difficile i C. jejuni/coli.
Ispitanici i metode: Provedeno je retrospektivno istraživanje, kojim je obuhvaćeno 94 bolesnika. U istraživanje su uključeni podaci iz povijesti bolesti bolesnika hospitaliziranih zbog infektivnih proljeva uzrokovanih s Cl. difficile i C. jejuni/coli u KBC–u Split, u razdoblju od 1. siječnja do 31. prosinca 2013. godine. Demografski, epidemiološki, klinički i laboratorijski podaci o bolesnicima uneseni su u upitnik (Prilog 1) koji je napravljen za potrebe ovog istraživanja. Upitnik je bio anoniman.
Rezultati: Bolesnici s Campylobacter spp. češće su imali bolove u trbuhu i značajno veću izmjerenu tjelesnu temperaturu u odnosu na bolesnike s Cl. difficile infekcijom. Bolesnici s Campylobacter spp. zaprimani su na bolničko liječenje značajno ranije tijekom bolesti u odnosu na bolesnike s Cl. difficile infekcijom. Bolesnici s Cl. difficile infekcijom imali su statistički značajno duže trajanje hospitalizacije, u prosjeku 23,5 dana u odnosu na 6,3 dana u bolesnika s Campylobacter spp. (p < 0,001). U prosjeku je skupina bolesnika s Cl. difficile infekcijom bila starija 24,9 godina u odnosu na skupinu bolesnika sa Campylobacter spp. Statistički je bila značajna i češća upotreba antibiotika, podvrgnutost kirurškim zahvatima prije proljeva, kao i prisutnost kroničnih bolesti u bolesnika s Cl. difficile infekcijom u odnosu na bolesnike s Campylobacter spp. (p < 0,001). Statistički je bilo značajno duže trajanje proljeva u bolesnika s Cl. difficile infekcijom u odnosu na bolesnike s Campylobacter spp., 12,7 dana nasuprot 4,4 dana (p < 0,001). Bolesnici s Cl. difficile infekcijom statistički su imali značajno više recidiva infekcije u odnosu na bolesnike s Campylobacter spp. (p = 0,004). Bolesnici s Cl. difficile infekcijom statistički su značajno bili slabije pokretni, češće inkontinentni, i češće su imali prisutan urinarni kateter i nazogastričnu sondu u odnosu na bolesnike s Campylobacter spp. (p < 0,001). U 28,7% (27) bolesnika bolest se pojavila kao bolnička infekcija, dok je 9,6% (9) bolesnika umrlo.
Zaključci: Bolest uzrokovana s Campylobacter spp. bila je teža u početnom stadiju. Bolesnici s Cl. difficile infekcijom bili su zahtjevniji u daljnjem tijeku bolesti u odnosu na bolesnike s Campylobacter spp., kako u liječenju tako i u zdravstvenoj njezi. Prevencija bolničkih infekcija uzrokovanih s Cl. difficile iznimno je važna mjera smanjenja bolničkog morbiditeta i mortaliteta, što skraćuje trajanje hospitalizacije te smanjuje troškove bolničkog liječenja. |
| Abstract (english) | Goals: Goals of this research were to explore and compare epidemiological and clinical characteristics of patients suffering from infectious diarrhea caused by Cl. Difficile with ones caused by C. jejuni/coli; determine and compare values of laboratory reports of patients; examine possibilities of nursing care in patients suffering from infectious diarrhea caused by Cl. difficile and C. jejuni/coli.
Respondents and methods: There was a retrospective survey which covered 94 patients. There was data included in research from the medical history of patients hospitalized for infectious diarrhea caused by Cl. difficile and C. jejuni/coli in KBC Split, in period from 1st of January to 31st of December 2013. Demographic, epidemiological, clinical and laboratory data about patients were entered in the questionnaire (Annex 1) which was made for need of this research. Questionnaire was anonymous.
Results: Patients suffering from Campylobacter spp. had abdominal pain more often and significantly higher body temperature compared to patients suffering from Cl. difficile infection. Patients suffering from Campylobacter spp. were hospitalized noticeably earlier during the disease compared to patients suffering from Cl. difficile infection. Patients suffering from Cl. difficile infection had significantly longer length of hospitalization, in average 23,5 days compared to 6,3 days which is the case in patients suffering from Campylobacter spp. (p < 0,001). Group of patients suffering from Cl. difficile infection was older in average 24,9 years compared to group of patients suffering from Campylobacter spp. Also, it was of statistical significance more frequent use of antibiotics, undergoing surgeries before diarrhea, as well as the presence of chronic diseases in patients suffering from Cl. difficile infection compared to patients suffering from Campylobacter spp. (p < 0,001). It was of statistical significance longer duration of diarrhea in patients suffering from Cl. difficile infection compared to patients suffering from Campylobacter spp., 12,7 days versus 4,4 days (p < 0,001). Patients suffering from Cl. difficile infection statistically had more relapses of infection compared to patients suffering from Campylobacter spp. (p = 0,004). Patients suffering from Cl. difficile infection were statistically less mobile, more often incontinent, and had more frequent urinary catheter and nasogastric tube compared to patients suffering from Campylobacter spp. (p < 0,001). In 28,7% (27 patients) cases this disease appeared as clinical infection while 9,6% (9 patients) died.
Conclusion: Disease caused by Campylobacter spp. was more difficult at the beginning. Patients suffering from Cl. difficile infection were more demanding in further stages of disease compared to patients suffering from Campylobacter spp.; in treating the disease as well as in health care. Prevention of clinical infection caused by Cl. difficile is extremely important measure of reducing clinical morbidity and mortality, which reduces the length of hospitalization and the costs of hospital care. |
