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YOĞUN BAKIM ÜNİTESİNDE HASTA ÖRNEKLERİNDEN İZOLE EDİLEN KANDİDA TÜRLERİNİN VE KANDİDEMİ RİSK FAKTÖRLERİNİN DEĞERLENDİRİLMESİ Evaluation Of Candida Species and Candidemia Risk Factors Isolated From Patient Samples In Intensive Care Unit

Year 2020, Volume: 10 Issue: 4, 55 - 61, 15.12.2020

Abstract

ÖZET
Amaç: Kandida enfeksiyonları ciddi, hayatı tehdit edici hastalıklardır. Böyle bir hastalığın epidemiyolojisini
ve risk faktörlerini anlamak hastalığa daha erken tanı konulmasını ve erken, etkin tedavi planlanmasına yardımcı
olacaktır.
Gereç ve Yöntemler: Çalışmamızda hastanemiz üçüncü basamak yoğun bakım ünitesinde (YBÜ) takip edilen
erişkin hastalarda çeşitli örneklerden üreyen kandida türlerini ve kandidemi risk faktörlerini belirlemeyi
amaçladık. YBÜ’de bir yıl boyunca takip edilen erişkin hastaların verileri retrospektif olarak incelendi.
Bulgular: Hastaların 30’unda kan kültüründe, 58’inde idrar kültüründe, 5’inde yara kültüründe, 32’sinde
trakeal aspirat kültüründe kandida üremesi oldu. Santral venöz katater bulunması, total parenteral nutrisyon
verilmesi ve cerrahi operasyon geçirilmesi kandidemi için önemli bir risk faktörü olarak gözlendi (p=0,019,
p=0,001, p=0,001). Kandidemi gelişen hastaların kandidemi tespit edildiği sırada ve diğer hastalardan mevcut
üremeleri esnasında alınan laboratuvar parametrelerinin karşılaştırılmasında sodyum, magnezyum, CRP,
lökosit, prokalsitonin düzeylerinde kandidemi gelişen hastalarda daha yüksek olmak üzere istatistiksel olarak
anlamlı fark gözlenmişken (p=0,001,0,027,0,001,0,034,0,001), albümin düzeyi kandidemi gelişmeyen hastalarda
istatistiksel olarak anlamlı düzeyde yüksek idi (0,04). Non-C.albicans üremesi olan hastaların yoğun
bakım yatış süreleri C.albicans üreyen hastalara nazaran daha yüksek olarak gözlendi (p=0,032). Tüm nedenlere
bağlı kandidemi sonrası 30 günlük mortalite oranı %57,1 olarak tespit edildi.
Sonuç: Çalışmamız verileri doğrultusunda santral venöz katater kullanımı, total parenteral nutrisyon verilmesi
ve geçirilmiş cerrahi operasyon kandidemi için risk faktörlerinin başında gelmekteydi. Ayrıca non-C.
albicans üremesi olan hastalarda yoğun bakım yatış süresi C.albicans üremesi olanlara nazaran daha uzun
olarak gözlendi.
Anahtar Kelimeler: Kandida; Kandidemi; Yoğun Bakım
ABSTRACT
Objective: Candida bloodstream infection is a serious, life-threatening condition. A better understanding of
the epidemiology and risk factors of this disease would facilitate earlier diagnosis and effective treatment
planning.
Material and Methods: We aimed to identify Candida species in various specimens and the risk factors
for candidemia in adult patients in the level 3 intensive care unit (ICU) of our center. Data of adult patients
treated in our ICU over a period of one year were evaluated retrospectively.
Results: Candida growth was detected in various samples from a total of 72 patients, including blood culture
in 30 patients, urine culture in 58 patients, wound culture in 5 patients, and tracheal aspirate culture
in 32 patients. Presence of a central venous catheter, total parenteral nutrition, and surgical history were
identified as significant risk factors for candidemia (p=0.019, p=0.001, p=0.001). Comparison of laboratory
parameters in patients with candidemia at time of positive blood culture and other patients at time of positive
urine, wound, or tracheal aspirate cultures showed significant differences in sodium (p=0.001), magnesium
(p=0.027), C-reactive protein (p=0.001), leukocyte (p=0.034), and procalcitonin (p=0.001) levels, while
albumin levels were significantly higher in patients who did not develop candidemia (p=0.04). Length of ICU
stay was significantly greater in patients with non-C. albicans growth compared to patients with C. albicans
growth (p=0.032). The 30-day all-cause mortality rate after candidemia was 57.1%.
Conclusion: Our results indicate that central venous catheter, total parenteral nutrition, and surgical history
are the leading risk factors for candidemia. In addition, non-C. albicans growth was associated with longer
ICU stay than C. albicans growth.
Keywords: Candida; Candidemia; Care Unit

References

  • 1. Edwards Jr JE. Candida Species In: Mendel GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases: Elsevier: Churchill Livingstone, 2010.
  • 2. Wey SB, Mori M, Pfaller MA, Robert F, Richard P. Hospital-acquired candidemia: the attributable mortality and excess length of stay. Arch Intern Med. 1988;148(12):2642-5.
  • 3. Wang H, Xu Y-C, Hsueh P-R. Epidemiology of candidemia and antifungal susceptibility in invasive Candida species in the Asia-Pacific region. Future Microbiol. 2016;11:1461-77.
  • 4. Hassan I, Powell G, Sidhu M, Hart WM, Denning DW. Excess mortality, length of stay and cost attributable to candidaemia. J Infect. 2009;59(5):360-5.
  • 5. Zaoutis TE, Argon J, Chu J, Berlin JA, Walsh TJ, Feudtner C. The epidemiology and attributable outcomes of candidemia in adults and children hospitalized in the United States: a propensity analysis. Clin Infect Dis. 2005;41(9):1232-9 . 6. Armstrong-James D. Invasive Candida species infection: the importance of adequate empirical antifungal therapy. J Antimicrob Chemother. 2007;60(3):459-60.
  • 7. Pfaller MA, Castanheira M. Nosocomial candidiasis: antifungal stewardship and the importance of rapid diagnosis. Med Mycol 2015;54(1):1-22.
  • 8. Young E. Brucella species In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases 6Th ed Philadelphia Churchill Livingstone. 2005:2669-74.
  • 9. Agvald-Öhman C, Klingspor L, Hjelmqvist H. Invasive candidiasis in long-term patients at a multidisciplinary intensive care unit: Candida colonization index, risk factors, treatment and outcome. Scand J Infect Dis. 2008;40(2):145-53
  • 10. Gudlaugsson O, Gillespie S, Lee K, Berg VJ, Hu J, Messer S. Attributable mortality of nosocomial candidemia, revisited. Clin Infect Dis. 2003;37(9):1172-7.
Year 2020, Volume: 10 Issue: 4, 55 - 61, 15.12.2020

Abstract

References

  • 1. Edwards Jr JE. Candida Species In: Mendel GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases: Elsevier: Churchill Livingstone, 2010.
  • 2. Wey SB, Mori M, Pfaller MA, Robert F, Richard P. Hospital-acquired candidemia: the attributable mortality and excess length of stay. Arch Intern Med. 1988;148(12):2642-5.
  • 3. Wang H, Xu Y-C, Hsueh P-R. Epidemiology of candidemia and antifungal susceptibility in invasive Candida species in the Asia-Pacific region. Future Microbiol. 2016;11:1461-77.
  • 4. Hassan I, Powell G, Sidhu M, Hart WM, Denning DW. Excess mortality, length of stay and cost attributable to candidaemia. J Infect. 2009;59(5):360-5.
  • 5. Zaoutis TE, Argon J, Chu J, Berlin JA, Walsh TJ, Feudtner C. The epidemiology and attributable outcomes of candidemia in adults and children hospitalized in the United States: a propensity analysis. Clin Infect Dis. 2005;41(9):1232-9 . 6. Armstrong-James D. Invasive Candida species infection: the importance of adequate empirical antifungal therapy. J Antimicrob Chemother. 2007;60(3):459-60.
  • 7. Pfaller MA, Castanheira M. Nosocomial candidiasis: antifungal stewardship and the importance of rapid diagnosis. Med Mycol 2015;54(1):1-22.
  • 8. Young E. Brucella species In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases 6Th ed Philadelphia Churchill Livingstone. 2005:2669-74.
  • 9. Agvald-Öhman C, Klingspor L, Hjelmqvist H. Invasive candidiasis in long-term patients at a multidisciplinary intensive care unit: Candida colonization index, risk factors, treatment and outcome. Scand J Infect Dis. 2008;40(2):145-53
  • 10. Gudlaugsson O, Gillespie S, Lee K, Berg VJ, Hu J, Messer S. Attributable mortality of nosocomial candidemia, revisited. Clin Infect Dis. 2003;37(9):1172-7.
There are 9 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original Research
Authors

Ferhan Kerget This is me

Ömer Karaşahin This is me

Neslihan Çelik This is me

Buğra Kerget This is me

Sibel İba Yılmaz This is me

Publication Date December 15, 2020
Published in Issue Year 2020 Volume: 10 Issue: 4

Cite

APA Kerget, F., Karaşahin, Ö., Çelik, N., Kerget, B., et al. (2020). YOĞUN BAKIM ÜNİTESİNDE HASTA ÖRNEKLERİNDEN İZOLE EDİLEN KANDİDA TÜRLERİNİN VE KANDİDEMİ RİSK FAKTÖRLERİNİN DEĞERLENDİRİLMESİ Evaluation Of Candida Species and Candidemia Risk Factors Isolated From Patient Samples In Intensive Care Unit. Bozok Tıp Dergisi, 10(4), 55-61.
AMA Kerget F, Karaşahin Ö, Çelik N, Kerget B, Yılmaz Sİ. YOĞUN BAKIM ÜNİTESİNDE HASTA ÖRNEKLERİNDEN İZOLE EDİLEN KANDİDA TÜRLERİNİN VE KANDİDEMİ RİSK FAKTÖRLERİNİN DEĞERLENDİRİLMESİ Evaluation Of Candida Species and Candidemia Risk Factors Isolated From Patient Samples In Intensive Care Unit. Bozok Tıp Dergisi. December 2020;10(4):55-61.
Chicago Kerget, Ferhan, Ömer Karaşahin, Neslihan Çelik, Buğra Kerget, and Sibel İba Yılmaz. “YOĞUN BAKIM ÜNİTESİNDE HASTA ÖRNEKLERİNDEN İZOLE EDİLEN KANDİDA TÜRLERİNİN VE KANDİDEMİ RİSK FAKTÖRLERİNİN DEĞERLENDİRİLMESİ Evaluation Of Candida Species and Candidemia Risk Factors Isolated From Patient Samples In Intensive Care Unit”. Bozok Tıp Dergisi 10, no. 4 (December 2020): 55-61.
EndNote Kerget F, Karaşahin Ö, Çelik N, Kerget B, Yılmaz Sİ (December 1, 2020) YOĞUN BAKIM ÜNİTESİNDE HASTA ÖRNEKLERİNDEN İZOLE EDİLEN KANDİDA TÜRLERİNİN VE KANDİDEMİ RİSK FAKTÖRLERİNİN DEĞERLENDİRİLMESİ Evaluation Of Candida Species and Candidemia Risk Factors Isolated From Patient Samples In Intensive Care Unit. Bozok Tıp Dergisi 10 4 55–61.
IEEE F. Kerget, Ö. Karaşahin, N. Çelik, B. Kerget, and S. İ. Yılmaz, “YOĞUN BAKIM ÜNİTESİNDE HASTA ÖRNEKLERİNDEN İZOLE EDİLEN KANDİDA TÜRLERİNİN VE KANDİDEMİ RİSK FAKTÖRLERİNİN DEĞERLENDİRİLMESİ Evaluation Of Candida Species and Candidemia Risk Factors Isolated From Patient Samples In Intensive Care Unit”, Bozok Tıp Dergisi, vol. 10, no. 4, pp. 55–61, 2020.
ISNAD Kerget, Ferhan et al. “YOĞUN BAKIM ÜNİTESİNDE HASTA ÖRNEKLERİNDEN İZOLE EDİLEN KANDİDA TÜRLERİNİN VE KANDİDEMİ RİSK FAKTÖRLERİNİN DEĞERLENDİRİLMESİ Evaluation Of Candida Species and Candidemia Risk Factors Isolated From Patient Samples In Intensive Care Unit”. Bozok Tıp Dergisi 10/4 (December 2020), 55-61.
JAMA Kerget F, Karaşahin Ö, Çelik N, Kerget B, Yılmaz Sİ. YOĞUN BAKIM ÜNİTESİNDE HASTA ÖRNEKLERİNDEN İZOLE EDİLEN KANDİDA TÜRLERİNİN VE KANDİDEMİ RİSK FAKTÖRLERİNİN DEĞERLENDİRİLMESİ Evaluation Of Candida Species and Candidemia Risk Factors Isolated From Patient Samples In Intensive Care Unit. Bozok Tıp Dergisi. 2020;10:55–61.
MLA Kerget, Ferhan et al. “YOĞUN BAKIM ÜNİTESİNDE HASTA ÖRNEKLERİNDEN İZOLE EDİLEN KANDİDA TÜRLERİNİN VE KANDİDEMİ RİSK FAKTÖRLERİNİN DEĞERLENDİRİLMESİ Evaluation Of Candida Species and Candidemia Risk Factors Isolated From Patient Samples In Intensive Care Unit”. Bozok Tıp Dergisi, vol. 10, no. 4, 2020, pp. 55-61.
Vancouver Kerget F, Karaşahin Ö, Çelik N, Kerget B, Yılmaz Sİ. YOĞUN BAKIM ÜNİTESİNDE HASTA ÖRNEKLERİNDEN İZOLE EDİLEN KANDİDA TÜRLERİNİN VE KANDİDEMİ RİSK FAKTÖRLERİNİN DEĞERLENDİRİLMESİ Evaluation Of Candida Species and Candidemia Risk Factors Isolated From Patient Samples In Intensive Care Unit. Bozok Tıp Dergisi. 2020;10(4):55-61.
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