Çocuk cerrahisi yenidoğan yoğun bakım ünitesinde sağlık bakımı ilişkili enfeksiyonlar ve risk faktörleri

Year 2019, Volume: 44 Issue: Supplement 1, 455 - 468, 29.12.2019

Ahmet Gökhan Güler , Recep Tuncer Hilmi Serdar İskit Murat Alkan Ünal Zorludemir Cemal Parlakgümüş Zerrin Özçelik

Abstract

Amaç: Bu çalışmanın amacı Çocuk Cerrahisi yenidoğan yoğun bakım ünitesinde tedavi edilmiş hastalarda sağlık bakımı ilişkili enfeksiyon (SBİE) sıklığını, enfeksiyon etkenlerini ve risk faktörlerini araştırmaktır.

Gereç ve Yöntem: Hastalar cinsiyet, doğum şekli, doğum kilosu, gestasyonel yaş, başvuru anındaki yaş, hastanede kalış süresi, ameliyat yapılıp yapılmaması, sepsis gelişimi, TPN (Total parenteral nutrisyon) alımı, toraks tüpü uygulaması, endotrakeal entübasyon, idrar sondası kullanımı, nazal veya oral sonda kullanımı, karın dreni uygulaması, santral kateter uygulaması, oral beslenmeme süresi, laboratuar parametreleri, cerrahi stres dereceleri, yara niteliği yönünden incelendi. 

Bulgular: Düşük doğum ağırlığı, yüksek cerrahi stres derecesi, TPN kullanımı ve süresi, toraks tüpü takılması ve süresi, endotrakeal entübasyon ve süresi, idrar sondası ve süresi, santral kateter, ameliyatlarda karın dreni konulması, nazal-oral sonda süresi ve enteral beslenmesiz geçen sürenin uzaması SBİE için risk faktörü olarak bulundu. SBİE olan hastaların 57’sinde sepsis saptandı, bunların 35’i öldü. 

Sonuç: İnvaziv işlemler ve süresinin azaltılması, hastanede kalış süresinin kısaltılması, salgın şeklindeki mikroorganizmalara özel önlemler alınması SBİE ve buna bağlı ölüm oranlarını düşürebilir.

Keywords

Cerrahi yenidoğan, sağlık bakımı ilişkili enfeksiyon, risk faktörleri

Health care related infections and risk factors in neonatal intensive care unit of pediatric surgery

Abstract

Purpose: The purpose of this study is to investigate the infectious agents, risk factors and prevalance of the healthcare-associated infections (HAIs) in patients treated at surgical neonatal intensive care unit. 

Materials and Methods: Patients were examined for application date, sex, mode of delivery, birth weight, gestation age, age at admission, hospital stay, hospitalization at another center, the provinces they come, surgery, developement of sepsis, use of TPN (Total parenteral nutrition), application of chest tube, endotracheal intubation, urinary catheter use, nasal or oral catheter use, application of abdominal drains, central catheter application, oral feeding time, laboratory parameters, degree of surgical stress and the nature of wounds. 

Results: Low birth weight, prior hospitalisation at another center, high degree of surgical stres, TPN use and duration, chest tube application and duration, endotracheal intubation and duration, urinary catheterisation and duration, central cathetery, application of abdominal drains at surgery, duration of nasal-oral catheterisation and the duration of nonenteral feding were found as risk factors of HAIs. Sepsis was detected at 57 of HAIs patients and 35 of them died.

Conclusion: Decreasing the number and duration of invasive procedures, shorten the duration of hospital stay, special measures for the epidemic microorganisms can reduce the HAIs and the related deaths.

Keywords

Surgical newborn, health care-associated infections, risk factors

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