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HBV'de Tedavi - EKMUD

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Sonuç olarak; Acinetobacter özellikle yoğun<br />

bakımlarda çevresel yüzeylerde uzun süre yaşama<br />

kapasitesine sahip bir mikroorganizma olup<br />

tüm dünyada özellikle yoğun bakımlarda yatan<br />

hastalar için önemli bir tehdit olmaya devam<br />

etmektedir. Ulusal ve uluslararası koruma,<br />

önlem önerilerinin yanı sıra bu mikroorganizmaların<br />

epidemiyolojik özellikleri ve risk faktörleri<br />

her hastane ve her yoğun bakımda tekrar<br />

tekrar gözden geçirilerek korunma için gerekli<br />

önlemler alınmalıdır. Bu önlemlerin başında<br />

sürveyans, kaynağın erken saptanması, el hijyeninin<br />

iyileştirilmesi ve çevresel kontaminasyonun<br />

önlenmesi ve alınacak önlemlerin uygulanımının<br />

denetlenmesi ve devamlılığının sağlanması<br />

gelmektedir. Aşı çalışmaları henüz yeni<br />

başlamış olup sonuçları yakından izlenmelidir.<br />

KAYNAKLAR<br />

1. Aygün G, Demirkan O, Utku T, et al. Environmental contamination<br />

during a carbapenem-resistant Acinetobacter<br />

baumannii outbreak in an intensive care unit. J Hosp<br />

Infect 2002;52:259-62.<br />

2. Castro Romanelli RM, Jesus LA, Clemente WT, et al.<br />

Outbreak of resistant Acinetobacter baumannii-measures<br />

and proposal for prevention and control. The Brazil J<br />

Infect Dis 2009;13:341-7.<br />

3. Cohen AL, Calfee D, Fridkin SK, et al. Recommendations<br />

for metrics for multidrug-resistant organism in healthcare<br />

settings: SHEA/HICPAC position paper. Infect Control<br />

Hosp Epidemiol 2008;29:901-13.<br />

4. Enoch DA, Summers C, Brown NM, et al. Investigation<br />

and management of an outbreak of multidrug-carbapenem-resistant<br />

Acinetobacter baumannii in Cambridge,<br />

UK. J Hosp Infect 2008;70:109-18.<br />

5. Falagas ME, Koterides P. Risk factors for the isolation of<br />

multidrug-resistant Acinetobacter baumannii and<br />

Pseudomonas aeruginosa; a systematic review of the<br />

literature. J Hosp Infect 2006;64:7-15.<br />

Elif Doyuk Kartal<br />

6. Fournier PE, Richer H. The epidemiology and control of<br />

Acinetobacter baumannii in health care facilities. Clin<br />

Infect Dis 2006;42:692-9.<br />

7. Garcia-Ortega L, Arch O, Perez-Canosa C, et al. Control<br />

measures for Acinetobacter baumannii: a survey of<br />

Spanish hospitals. Eferm Infecc Microbiol Clin<br />

2010;29(Epub ahead of print).<br />

8. La Forgia C, Franke J, Hacek DM, et al. Management of a<br />

multidrug-resistant Acinetobacter baumannii outbreak in<br />

an intensive care unit using novel environmental disinfection:<br />

a-38-month report. Am J Infect Control 2010;38:<br />

259-63.<br />

9. McConnell MJ, Doniguez-Herrera J, Smani Y, Lopez-Rojas<br />

R, Docobo-Perez F, Pachon J. Vaccination with outher<br />

membrane complexes elicits rapid protective immunity to<br />

multidrug-resistant Acinetobacter baumannii. Infect<br />

Immun 2011;79:518-26.<br />

10. McConnell MJ, Pachon J. Active and passive immunization<br />

against Acinetobacter baumannii using an inactivated<br />

whole cell vaccine. Vaccine 2011:1-5.<br />

11. Pimentel JD, Low J, Styles K, Haris OC, Hughes A, Athan<br />

E. Control of an outbreak of multidrug-resistant<br />

Acinetobacter baumannii in an intensive care unit and a<br />

surgical ward. J Hosp Infect 2005;59:249-53.<br />

12. Rose L, Rogel K, Redl L, Cade JF. Implementation of a multimodal<br />

infection control program during an Acinetobacter<br />

outbreak. Intens Crit Care Nurs 2009;25:57-63.<br />

13. Siegel JD, Rhinehard E, Jackson M, Chiarelllo L; Healthcare<br />

Infection Control Practices Advisory Commitee.<br />

Management of multidrug-resistant organism in healthcare<br />

setting, 2006. http//www.cdc.gov/ncidod/dhqp/<br />

pdf/ar7mdroGuideline2006<br />

14. Towner KJ. Acinetobacter: an old friend, but a new<br />

enemy. J Hosp Infect 2009;73:355-63.<br />

15. Villegas MV, Harstein AI. Acinetobacter outbreaks, 1077-<br />

2000. Infect Control Hosp Epidemiol 2003;24:284-95.<br />

16. Wilks M, Wilson A, Warwick S, et al; Healthcare Infection<br />

Control Practices Advisory Commitee. Control of an outbreak<br />

of multidrug-resistant Acinetobacter baumannii-calcoaceticus<br />

colonization and infection in an intensive care<br />

unit (ICU) without closing the ICU or placing patients in<br />

isolation. Infect Control Hosp Epidemiol 2006;27:654-8.<br />

3. Türkiye <strong>EKMUD</strong> Bilimsel Platformu 261

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