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https://doi.org/10.5937/svs251...
Article . 2025 . Peer-reviewed
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Pravilna interpretacija antibiograma - ključ uspešne terapije u praksi

Authors: Dalibor Todorović; Marko Pajić; Slobodan Knežević; Biljana Đurđević; Bojana Prunić; Jelena Apić; Smiljana Milošević;

Pravilna interpretacija antibiograma - ključ uspešne terapije u praksi

Abstract

Testiranje osetljivosti bakterija na antibiotike (AST) je od suštinskog značaja za vođenje efikasne antimikrobne terapije i praćenje trendova rezistencije. Među široko korišćenim fenotipskim metodama za ispitivanje AST, metoda diskdifuzije (Kirby-Bauer) je standardizovana metoda u veterinarskim laboratorijama kojom se procenjuju zone inhibicije oko antibiotiskih diskova. Laboratorijska identifikacija mehanizama bakterijske rezistencije kod kliničkih izolata je neophodna ne samo za odgovarajuću antibiotsku terapiju, već i za kontrolu nastanka, širenja i održavanja multirezistentnih bakterija. Testovi se sprovode u skladu sa preporukama Evropskog komiteta za testiranje osetljivosti na antibiotike (EUCAST) i Instituta za kliničke i laboratorijske standarde (CLSI). Produkcija beta-laktamaza proširenog spektra (ESBL) kod bakterija iz porodice Enterobacteriaceae (prevashodno Escherichia coli i Klebsiella penumoniae), procenjuje se metodom diskdifuzije sa cefotaksimom i ceftazidimom, sa i bez klavulonske kiseline kao inhibitora beta-laktamaze. Detekcija AmpC beta-laktamaza, koje se ne mogu inhibirati klavulonskom kiselinom, sprovodi se korišćenjem cefoxitin diskova kao skrining metode. Cefoxitin diskovi se takođe koriste za otkrivanje meticilin rezistentnog Staphylococcus aureus (MRSA), dok se meticilin rezistentni Staphylococcus pseudintermedius (MRSP) detektuje korišćenjem oksacilin diska. Prisustvo karbapenemaza procenjuje se korišćenjem meropenem diska, ali je obavezna potvrda pomoću fenotipskog Rapidec Carba NP testa. Zbog nepouzdanosti metode diskdifuzije za detekciju rezistencije na kolistin, preporučuje se metoda mikrodilucije u bujonu, kojom se određuje koncetracija antibiotika koja inhibira rast bakterija (MIC), u skladu sa standardnom metodom ISO 20776-1:2021. Konačna potvrda navedenih fenotipskih testova vrši se molekularnim metodama, pre svega lančanom reakcijom polimeraze (PCR), koja omogućava detekciju ciljnih gena rezistencije na antibiotike.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
Green