| Abstract | Uvod: cilj ovog istraživanja je prikazati etiologiju akutnih crijevnih infekcija u bolesnika hospitaliziranih u Klinici za infektologiju KBC Split u razdoblju od 1. siječnja 2015. do 1. kolovoza 2016. godine. Cilj rada također je prikazati kliničku sliku, laboratorijske parametre, terapijske mjere primjenjene u ovih bolesnika te smrtne slučajeve nastale kao posljedica akutnih crijevnih infekcija. Materijali i metode: retrospektivno su prikupljeni podatci o etiologiji bolesti, dobi, spolu, trajanju hospitalizacije, kliničkoj slici, laboratorijskim parametrima, liječenju i ishodu liječenja u 259 bolesnika hospitaliziranih u Klinici za infektologiju KBC Split u razdoblju od 1. siječnja 2015. do 1. kolovoza 2016. godine. Podatci su prikupljeni u programu Microsoft Excell, a u obradi podataka koristili smo 2 (chi-square) test za nezavisne uzorke. Rezultati: u promatranom razdoblju bilo je 259 bolesnika s dijagnozom akutne crijevne infekcije. Prema dobnoj raspodjeli najviše bolesnika bilo je u dobnoj skupini iznad 60 godina (47%). Etiologija bolesti nije dokazana u 33% bolesnika. U skupini bolesnika s dokazanom etiologijom akutne crijevne infekcije najčešći uzročnik bio je Clostridium difficile (32%). U dobnoj skupini do 15 godina najčešći uzročnik je bio Rotavirus (23%). U dobnoj skupini od 15 do 60 godina najčešći uzročnik bio je Campylobacter spp. (27,7%), a u dobnoj skupini iznad 60 godina Clostridium difficile (54,5%). Prosječna duljina hospitalizacije bolesnika iznosila je 7,5 dana. Bolesnici s akutnom crijevnom infekcijom uzrokovanom s C. difficile imali su najdulju prosječnu hospitalizaciju (10,6 dana), dok su bolesnici s akutnom crijevnom infekcijom uzrokovanom Norovirusima imali najkraću prosječnu hospitalizaciju (2,7 dana). U promatranom razdoblju zabilježeno je sedam manjih epidemija. U četiri epidemije uzročnik nije dokazan, dok je Salmonella spp. bila uzročnik u preostale tri epidemije. Patološke primjese krvi i sluzi u stolici bile su najzastupljenije u bolesnika s akutnom crijevnom infekcijom uzrokovanom s Campylobacter spp. Ubrzana sedimentacija eritrocita i povišene vrijednosti leukocita, ureje i kreatinina najčešće su se javljale u bolesnika s akutnom crijevnom infekcijom uzrokovanom s C. difficile. U svih bolesnika primjenjena je dijeta i peroralna ili parenteralna rehidracija, a 60% bolesnika primalo je i antibiotsku terapiju. Od 259 bolesnika njih 245 (94,6%) je uspješno izliječeno, a 14 (5,4%) je preminulo. Svi smrtni slučajevi nastali kao posljedica akutne crijevne infekcije uzrokovani su s Clostridium difficile. 61 Zaključak: najčešći uzročnik akutnih crijevnih infekcija u djece je bio Rotavirus, u odraslih osoba Campylobacter spp., a u osoba starije životne dobi C. difficile. Zabilježeno je sedam epidemija, u četiri epidemije uzročnik nije utvrđen dok je Salmonella spp. dokazana kao uzročnik u preostale tri epidemije. Svi smrtni slučajevi nastali kao posljedica akutne crijevne infekcije uzrokovane su s C. difficile. |
| Abstract (english) | Objective: the aim of this study is to present the etiology of acute intestinal infections in the patients who were hospitalized in the Clinical Department of Infectious Diseases at the Clinical Hospital Center Split in the period from January 1st 2015 until August 1st 2016. The aim of this study is also to present the clinical presentation, laboratory parameters, therapy measures applied in these patients and to present the death cases which were a result of acute intestinal infections. Matherials and methods: retrospectively were collected data on the etiology of the disease, age, gender, duration of hospitalization, clinical presentation, laboratory parameters, treatment and outcome of treatment in the 259 patients who were hospitalized in the Clinical Department of Infectious Diseases at the Clinical Hospital Center Split in the period from January 1st 2015 until August 1st 2016. Data were collected in the Microsoft Excell programme and in the processing of the data we have used the 2 (chi-square) test for indenpendent samples. Results: in the observed period we had 259 patients with the diagnosis of acute intestinal infection. According to the age distribution most patients were in the age group of older than 60 years (47%). Etiology of the disease hasn't been proven in 33% of patients. In the group of patients with proven etiology of acute intestinal infection the most common cause was Clostridium difficile (32%). In the age group under 15 years the most common cause of the disease was Rotavirus (23%). Campylobacter spp. (27,7%) was the most common cause in the age group of 15 to 60 years of age, while in the group aged older than 60 the most common cause was Clostridium difficile (54,5%). The average length of hospitalization was 7,5 days. The patients with acute intestinal infection caused by C. difficile had the longest average length of hospitalization (10,6 days), while patients with acute intestinal infection caused by Norovirus had the shortest average length of hospitalization (2,7 days). There were seven smaller epidemics noted in the observed period. The cause wasn't proven in four epidemics, while Salmonella spp. was the cause in the other three epidemics. The pathological 64 impurities of blood and mucus in the stool were most common in patients with acute intestinal infection caused by Campylobacter spp. The accelerated erythrocyte sedimentation rate and increased values of leukocytes, urea and creatinine were most common in patients with acute intestinal infection caused by C. difficile. The diet and oral or parenteral rehydration were applied in treatment of all patients and 60% of patients received antibiotic therapy. Out of 259 patients 245 (94,6%) were successfully cured and 14 (5,4%) had deceased. All death cases were a result of acute intestinal infection caused by Clostridium difficile. Conclusion: the most common cause of acute intestinal infections in children was the Rotavirus and in adults the Campylobacter spp., while in elderly people it was C. difficile. Seven epidemics were noted; in four epidemics the cause wasn't proven while Salmonella spp. was proven as a cause in three other epidemics. All the death cases incurred as a result of acute intestinal infection caused by C. difficile. |
