Çocuklarda Yanık Yarası Kültürleri ile Bakteriyemi İlişkisi

Year 2023, , 92 - 99, 31.12.2023

Serap Samut Bülbül , Selim Görgün , Alper Ceylan

https://doi.org/10.58854/jicm.1393465

Abstract

Amaç: Ağır yanık nedeniyle hastanede uzun süre tedavi gören çocuklarda yara yeri bakteri kolonizasyonu ve
bakteriyemi riski artmaktadır. Bu çalışmada ağır yanık nedeniyle hastanede tedavi gören çocuk hastalarda
yanık yeri ve kan kültürleri sonuçlarının irdelenmesi ve yanık yeri kolonizasyonunun bakteriyemi gelişmesine
etkisinin araştırılması amaçlanmıştır.
Yöntem: Çalışmaya Ocak 2019 ile Eylül 2023 arasında ikinci derece ve üzeri yanık nedeniyle hastanemiz
yanık kliniğinde ya da yanık yoğun bakım ünitesinde tedavi gören ve yara kültürü yapılan 84 çocuk hasta
dâhil edildi. Kültür sonuçları hastane kayıtlarından elde edildi.
Bulgular: Hastaların 51’i (%60,7) erkekti. Hastaların ortalama yaşı 10,62±6,21 yıl, ortalama hastanede yatış
süreleri 19,98±17,46 gün idi. Yara kültüründe üreme olanlarda kan kültürü pozitifliği oranı yara kültüründe
üreme görülmeyenlere göre anlamlı düzeyde yüksek bulundu (%20,7 vs. %5,5; p=0,032).
Kültürlerden en çok izole edilen bakteri türleri (Pseudomonas aeruginosa (15 örnek; %17,9) ve Acinetobacter
baumannii (dokuz örnek; %10,7) idi. Sadece bir hastanın yara ve kan kültürlerinden aynı bakteri türü izole
edildi (Acinetobacter baumannii). Kültür pozitif grupta ortalama hastanede yatış süresi kültür negatif gruba
göre anlamlı düzeyde yüksek bulundu (30,66 vs. 13,40; p<0,001). Lojistik regresyon analizinde hastanede
yatış süresi kültür pozitifliği açısından bağımsız risk faktörü olarak saptandı (p<0,001) ve buna göre hastanede
yatış süresinin kültür pozitifliği riski açısından risk katsayısı 1,092 (1,044-1,142) olarak bulundu. Ayrıca yara
kültürü pozitifliği kan kültürü pozitifliği açısından bağımsız risk faktörü olarak saptandı (p=0,044) ve buna
göre yara kültürü pozitif olanlarda kan kültürü pozitifliği riskinin 4,522 (1,033-19,671) kat artmış olduğu
hesaplandı.
Sonuç: Çalışmamızdan elde edilen bulgular ağır yanık nedeniyle hospitalize edilen çocuk hastalarda
hastanede kalış süresinin hastane kaynaklı yanık yeri kolonizasyonu veya enfeksiyonu ve/veya bakteriyemi
gelişmesi açılarından riski belirgin olarak arttırdığını göstermektedir.
Anahtar Kelimeler: Çocuk, yanık, yara kültürü, kan kültürü, Acinetobacter, Pseudomonas

Keywords

Çocuk, yanık, yara kültürü, kan kültürü, Acinetobacter, Pseudomonas

Relationship Between Burn Wound Cultures and Bacteremia in Pediatric Patients

Abstract

Background: The risk of wound bacterial colonization and bacteremia increases in children who are
treated in the hospital for a long time due to severe burns. The aim of this study was to examine the
results of burn site and blood cultures in pediatric patients treated in hospital due to severe burns and to
investigate the effect of burn site colonization on the development of bacteremia.
Material adn Method: The study included 84 pediatric patients who were treated in our hospital’s burn
clinic or burn intensive care unit due to second-degree or higher burns and had wound cultures performed
between January 2019 and September 2023. Culture results were obtained from hospital records.
Results: 51 (60.7%) of the patients were male. The average age of the patients was 10.62±6.21 years and
the average hospital stay was 19.98±17.46 days. The rate of blood culture positivity in those with growth
in the wound culture was found to be significantly higher than in those with no growth in the wound
culture (20.7% vs. 5.5%; p = 0.032). The bacterial species most frequently isolated from cultures were
Pseudomonas aeruginosa (15 samples; 17.9%) and Acinetobacter baumannii (nine samples; 10.7%). The
same bacterial species was isolated from wound and blood cultures of only one patient (Acinetobacter
baumannii). The average hospital stay in the culture-positive group was significantly higher than the
culture-negative group (30.66 vs. 13.40; p<0.001). In logistic regression analysis, hospitalization duration
was determined to be an independent risk factor for culture positivity (p<0.001) and accordingly, the risk
coefficient of hospitalization duration in terms of culture positivity risk was found to be 1.092 (1.044-
1.142). Additionally, wound culture positivity was determined to be an independent risk factor for blood
culture positivity (p=0.044), and accordingly, the risk of blood culture positivity was calculated to be
increased by 4.522 (1.033-19.671) times in those with positive wound cultures.
Conclusion: The findings obtained from our study show that the duration of hospital stay in pediatric
patients hospitalized due to severe burns significantly increases the risk of hospital-acquired burn site
colonization or infection and/or bacteremia development.
Keywords: Child, burn, wound culture, blood culture, Acinetobacter, Pseudomonas

Keywords

Child, burn, wound culture, blood culture, Acinetobacter, Pseudomonas.

Ethical Statement

Bu retrospektif kohort çalışma yerel etik kurul tarafından onaylandı.

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