Genel Yoğun Bakımda Takip Edilen Hastalarda Kültür Sonuçlarının Araştırılması

Abstract

Amaç: Yoğun bakım ünitelerinde (YBÜ) gelişen hastane kaynaklı enfeksiyonlar, morbidite, mortalite ve sağlık bakım maliyetlerini artıran önemli sorunlardandır. Mikroorganizmaların doğru belirlenmesi, hem erken tanı hem de uygun antibiyotik tedavisi açısından kritik rol oynamaktadır. Bu çalışmanın amacı, genel yoğun bakımda takip edilen hastalarda kültür sonuçlarını incelemektir. Materyal ve metod: Çalışma, 01.01.2021-01.01.2024 tarihleri arasında genel YBÜ’de en az üç gün yatışı bulunan 276 hasta üzerinde retrospektif olarak yürütüldü. Hastaların demografik özellikleri, yatış tanıları, laboratuvar bulguları ve taburculuk sonuçları incelendi. Kan, idrar, derin trakeal aspirat ve kateter kültürlerinde üreyen mikroorganizmalar kaydedildi. Veriler SPSS 25.0 programı ile analiz edildi. Bulgular: Katılımcıların %54’ü erkek (n=149), %46’sı kadın (n=127) olup yaş ortalaması 60,93±19,13 idi. En sık yatış nedeni solunum yetmezliği (%29,7) olarak bulundu. Hastaların %83,3’ü (n=230) kaybedildi. Kültür sonuçlarında en sık izole edilen etkenler kan kültürlerinde Klebsiella pneumoniae (%11,2), Staphylococcus epidermidis (%6,2) ve Pseudomonas aeruginosa (%6,2); trakeal aspiratlarda Klebsiella pneumoniae (%13,4) ve Acinetobacter baumannii (%13,0); idrar kültürlerinde Escherichia coli (%4,3); kateter kültürlerinde Klebsiella pneumoniae (%3,3) idi. Negatiflik oranı özellikle üçüncü kan kültüründe %96,6’ya ulaştı. Sonuç: Yoğun bakım hastalarında mortalite oranı oldukça yüksek bulunmuştur. Gram-negatif bakteriler başlıca etkenlerdir ve ampirik antibiyotik tedavisinde özellikle Klebsiella pneumoniae, Acinetobacter baumannii ve Pseudomonas aeruginosa’ya dikkat edilmelidir. Ayrıca, kültürlerdeki yüksek negatiflik oranı örnekleme zamanı ve laboratuvar süreçlerinin optimizasyonunun önemini göstermektedir.

Keywords

• Yoğun bakım
• Kültür
• Klebsiella pneumoniae
• Hastane enfeksiyonları

Ethical Statement

Çalışmanın yürütülmesi için ilgili kurumdan gerekli kurum izni ve bağlı bulunulan Harran Üniversitesi'nin Klinik Araştırmalar Etik Kurulu’ndan 11.12.2023 tarih ve 2023/23-27 sayılı karar ile etik onayı alınmıştır

Investigation of Culture Results in Patients Followed in General Intensive Care

Abstract

Background: Hospital-acquired infections in intensive care units (ICUs) represent a major cause of morbidity, mortality, and increased healthcare costs. Accurate identification of microorganisms plays a critical role in early diagnosis and guiding appropriate antibiotic therapy. The aim of this study is to examine culture results in patients monitored in the general intensive care unit. Materials and Methods: A retrospective study was conducted on 276 patients aged ≥18 years who were hospitalized in a general ICU for at least three days between January 1, 2021, and January 1, 2024. Demographic data, admission diagnoses, laboratory findings, and discharge outcomes were recorded. Microorganisms isolated from blood, urine, deep tracheal aspirate, and catheter cultures were analyzed. Statistical analyses were performed using SPSS version 25.0. Results: Of the patients, 149 (54%) were male and 127 (46%) female, with a mean age of 60.93±19.13 years. Respiratory failure (29.7%) was the most frequent admission diagnosis. Mortality was observed in 230 patients (83.3%). The most common isolates were Klebsiella pneumoniae (11.2%), Staphylococcus epidermidis (6.2%), and Pseudomonas aeruginosa (6.2%) in blood cultures; Klebsiella pneumoniae (13.4%) and Acinetobacter baumannii (13.0%) in tracheal aspirates; Escherichia coli (4.3%) in urine cultures; and Klebsiella pneumoniae (3.3%) in catheter cultures. Negative results were frequent, reaching 96.6% in the third blood culture. Conclusions: Mortality rates were high among ICU patients. Gram-negative bacteria predominated, highlighting the importance of considering Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa in empirical therapy. The high rate of negative cultures underscores the need for optimized sampling techniques and laboratory procedures.

Keywords

• Intensive care unit
• Culture
• Klebsiella pneumoniae
• Hospital-acquired infections

Ethical Statement

The necessary institutional permission was obtained from the relevant institution for the conduct of the study, and ethical approval was obtained from the Clinical Research Ethics Committee of the affiliated university with decision number 2023/23-27 dated 12/11/2023.

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