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Surveillance analysis and microbiological profiles of nosocomial infections in a palliative care center

Year 2021, Volume: 13 Issue: 3, 519 - 523, 18.10.2021
https://doi.org/10.18521/ktd.986150

Abstract

Objective: The growing geriatric population and increasing prevalence rates of chronic diseases increase the need for palliative care globally. Despite the wide availability of palliative care units in several countries, they have been founded in our country recently. This study aimed to contribute to the development of appropriate treatment protocols by determining the causes of hospitalizations, comorbidities, infection rates, and causative microorganisms in a palliative care center.
Material and Method: A total of 457 patients admitted to palliative care were evaluated. Blood cultures were taken from the patients suspected to have developed nosocomial infections. Samples for cultures were taken from the foci that were thought to be the origin of infection. Identification of isolates was performed using automated systems and standard manual methods. The numbers of patients and patient days, and the numbers and rates of nosocomial infections were retrieved from the infection control unit data records and were analyzed. The rates and incidences of nosocomial infections in our hospital and the palliative care unit were calculated.
Results: Of the patients, 51% were men and 49% were women. The mean age was 72±12.6 years. Nosocomial infection rates were 6.3% in 2019, 9.1% in 2020, and 3.3% in the first six months of 2021. Urinary system infections ranked first with a rate of 58.6%. The most common cause of hospital admissions was malignancy with a rate of 25.9%. The most commonly isolated microorganism was Klebsiella spp with a rate of 27.5%.
Conclusion: Palliative care is a multidisciplinary practice requiring strong coordination and collaboration. Palliative care aims to improve symptoms and the quality of life of patients. Our study has contributed to developing practical solutions by documenting prognostic factors, infections, causative microorganisms, and issues experienced in palliative care patients.

References

  • 1.WHO. Palliative Care. [Internet]. [cited 2021 August 15].Available online: https://www.who.int/news-room/fact-sheets/detail/palliative-care5 (accessed on August 2021)
  • 2. Dincer M, Kahveci K, Döğer C, Gökçınar D, Yarıcı AK, Taş H. Factors Affectıng The Duratıon Of Admıssıon And Dıscharge In A Pallıatıve Care Center For Gerıatrıc Patıents. Turkish Journal of Geriatrics 2016;19(2):74-80
  • 3. Macedo F, Bonito N. Current opinion about antimicrobial therapy in palliative care: an update. Current opinion in oncology. 2019;31(4):299-301.
  • 4. Alp E , Leblebicioglu H , Doganay M, Voss A. Infection control practice in countries with limited resources. Annals of clinical microbiology and antimicrobials. 2011;10(1):1-4.
  • 5- Vasudevan A , Mukhopadhyay A, Li J, Yuen EGY, Tambyah P A. A prediction tool for nosocomial multi-drug resistant gram-negative bacilli infections in critically ill patients-prospective observational study. BMC infectious diseases.2014;14(1);1-10.
  • 6-Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care setting. American journal of infection control. 2008;36(5):309-332.
  • 7- Widmer AF. Infection control and prevention strategies in the ICU. Intensive care medicine. 1994;20(4):7–11.
  • 8-Cadircin D, Ayazoz Y, Kocakoglu S. Evaluatıon Of Patıents Followed In A Pallıatıve Care Unıt In Turkey. Turkish Journal of Geriatrics.2021;24(2):227-234.
  • 9-Şentaş S, Kahveci K. Surveillance of hospital infections in longterm intensive care unit and palliative care centre: a 3-year analysis. J Contemp Med. 2018; 8: 55-9.
  • 10-Karahocagil MK, Yaman G, Göktaş U, Sünnetçioğlu M, Çıkman A, Bilici A, et al. Hastane enfeksiyon etkenlerinin ve direnç profillerinin belirlenmesi.Van Tıp Dergisi.2011; 18 (1):27-32.
  • 11-Erdin FS, Yetkin MA, Hatipoglu CA, Yucel M, Karakoc AE, Cevik MA, et al. Five-year surveillance of nosocomial infections in Ankara Training and Research Hospital. Journal of Hospital infection.2006;64(4):391-396.
  • 12.Dincer M, Kahveci K, Doger C. An Examination of Factors Affecting the Length of Stay in a Palliative Care Center. J Palliat Med. 2018;21(1):11-5.
  • 13. Yürüyen M, Tevetoğlu IÖ, Tekmen Y, Polat Ö, Arslan İ, Okuturlar Y. Prognostic Factors and Clinical Features in Palliative Care Patients. Konuralp Medical Journal. 2018;10 (1):74-80.
  • 14.Komaç A, Elyiğit F, Türemiş C, Gram E, Akar H. Retrospective analysis of hospitalized patients in Tepecik Training and Research Hospital Internal Medicine Palliative Care Unit. FNG & Bilim University Journal of Medicine. 2016;2:1-3.
  • 15- Turgut Ö, Pektaş M, Aydinli, B, Sagün A. Mersin Şehir Eğitim ve Araştırma Hastanesi Erişkin Palyatif Bakım Biriminde yatan hastaların retrospektif analizi. Mersin Üniversitesi Sağlık Bilimleri Dergisi. 2019;12(3);407-412.
  • 16-Chun ED, Rodgers PE, Vitale CA, Collins CD, Malani PN. Antimicrobial use among patients receiving palliative care consultation. American Journal of Hospice and Palliative Medicine. 2010;27(4):261-265.
  • 17. Pereira J, Watanabe S, Wolch G. A retrospective review of the frequency of infections and patterns of antibiotic utilization on a palliative care unit. J Pain Symptom Manage.1998;16(6):374-81.
  • 18-Dagli O, Tasdemir E,Ulutasdemir N. Palliative care infections and antibiotic cost: a vicious circle. The Aging Male. 2020;23(2):98-105.
  • 19-Akdoğan D, Kahveci K. Evaluation Of Geriatric Infectiıons In Palliıatiıve Care Center. Turkish Journal of Geriatrics. 2018;21(4):507-514.
  • 20-Vitetta L, Kenner D, Sali A. Bacterial infections in terminally ill hospice patients. J Pain Sympt Manag. 2000;20:326–334.

Palyatif bir bakım merkezinde hastane enfeksiyonlarının sürveyans analizi ve mikrobiyolojik profilleri

Year 2021, Volume: 13 Issue: 3, 519 - 523, 18.10.2021
https://doi.org/10.18521/ktd.986150

Abstract

Amaç: Global olarak yaşlı nüfustaki ve kronik hastalıklardaki artış, palyatif bakım ihtiyacını artırmaktadır. Dünyada Palyatif bakım birimleri yaygın olmakla birlikte ülkemizde birçok hastanede yeni açılmaktadır. Bunun için bu merkezlerde takip edilen hastaların, yatış sebepleri, komorbiditeler, enfeksiyon hızları ve etken mikroorganizmalar belirlenerek uygun tedavi protokollerinin oluşturulmasına katkı sağlanması amaçlandı.
Gereç ve Yöntem: Palyatif bakım ünitesinde yatan 457 hasta değerlendirildi. Hastane enfeksiyonu geliştiği düşünülen hastalardan kan kültürü ile birlikte enfeksiyon olduğu düşünülen odaklardan kültürler alındı. İzolatların tanımlanması otomatize sistemler ve standart manuel yöntemler kullanılarak yapıldı. Enfeksiyon kontrol birimi kayıtlarından hasta sayısı, hasta günü sayıları, HE sayısı, HE hızı verileri incelendi. Hastanemizdeki ve palyatif bakım ünitesindeki hastane enfeksiyon oranları ve insidansları hesaplandı.
Bulgular: Hastaların %51’i erkek, %49’u kadın, yaş ortalaması 72±12,6 olarak bulundu. Hastane enfeksiyonu hızı 2019 yılında % 6,3, 2020 yılında %9,1 ve 2021 yılının ilk altı ayında %3,3 olarak hesaplandı. Üriner sistem enfeksiyonları %58,6 ilk sırayı alırken, en sık görülen yatış tanısı %25.9 oanı ile malignite idi. En çok izole edilen mikroorganizma ise %27.5 oranı ile Klebsiella spp idi.
Sonuç: Palyatif bakım, güçlü koordinasyon ve işbirliği gerektiren multidisipliner uygulamaları içerir. Palyatif bakım, hastaların semptomlarını iyileştirmeyi ve hayat kalitelerini artırmayı amaçlamaktadır. Çalışmamız, palyatif bakım hastalarının problemlerini, prognostik faktörleri, enfeksiyonları ve etken mikroorganizmaları dokümente ederek, bu hastalar için pratik çözümler geliştirilmesine katkı sağlamıştır

References

  • 1.WHO. Palliative Care. [Internet]. [cited 2021 August 15].Available online: https://www.who.int/news-room/fact-sheets/detail/palliative-care5 (accessed on August 2021)
  • 2. Dincer M, Kahveci K, Döğer C, Gökçınar D, Yarıcı AK, Taş H. Factors Affectıng The Duratıon Of Admıssıon And Dıscharge In A Pallıatıve Care Center For Gerıatrıc Patıents. Turkish Journal of Geriatrics 2016;19(2):74-80
  • 3. Macedo F, Bonito N. Current opinion about antimicrobial therapy in palliative care: an update. Current opinion in oncology. 2019;31(4):299-301.
  • 4. Alp E , Leblebicioglu H , Doganay M, Voss A. Infection control practice in countries with limited resources. Annals of clinical microbiology and antimicrobials. 2011;10(1):1-4.
  • 5- Vasudevan A , Mukhopadhyay A, Li J, Yuen EGY, Tambyah P A. A prediction tool for nosocomial multi-drug resistant gram-negative bacilli infections in critically ill patients-prospective observational study. BMC infectious diseases.2014;14(1);1-10.
  • 6-Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care setting. American journal of infection control. 2008;36(5):309-332.
  • 7- Widmer AF. Infection control and prevention strategies in the ICU. Intensive care medicine. 1994;20(4):7–11.
  • 8-Cadircin D, Ayazoz Y, Kocakoglu S. Evaluatıon Of Patıents Followed In A Pallıatıve Care Unıt In Turkey. Turkish Journal of Geriatrics.2021;24(2):227-234.
  • 9-Şentaş S, Kahveci K. Surveillance of hospital infections in longterm intensive care unit and palliative care centre: a 3-year analysis. J Contemp Med. 2018; 8: 55-9.
  • 10-Karahocagil MK, Yaman G, Göktaş U, Sünnetçioğlu M, Çıkman A, Bilici A, et al. Hastane enfeksiyon etkenlerinin ve direnç profillerinin belirlenmesi.Van Tıp Dergisi.2011; 18 (1):27-32.
  • 11-Erdin FS, Yetkin MA, Hatipoglu CA, Yucel M, Karakoc AE, Cevik MA, et al. Five-year surveillance of nosocomial infections in Ankara Training and Research Hospital. Journal of Hospital infection.2006;64(4):391-396.
  • 12.Dincer M, Kahveci K, Doger C. An Examination of Factors Affecting the Length of Stay in a Palliative Care Center. J Palliat Med. 2018;21(1):11-5.
  • 13. Yürüyen M, Tevetoğlu IÖ, Tekmen Y, Polat Ö, Arslan İ, Okuturlar Y. Prognostic Factors and Clinical Features in Palliative Care Patients. Konuralp Medical Journal. 2018;10 (1):74-80.
  • 14.Komaç A, Elyiğit F, Türemiş C, Gram E, Akar H. Retrospective analysis of hospitalized patients in Tepecik Training and Research Hospital Internal Medicine Palliative Care Unit. FNG & Bilim University Journal of Medicine. 2016;2:1-3.
  • 15- Turgut Ö, Pektaş M, Aydinli, B, Sagün A. Mersin Şehir Eğitim ve Araştırma Hastanesi Erişkin Palyatif Bakım Biriminde yatan hastaların retrospektif analizi. Mersin Üniversitesi Sağlık Bilimleri Dergisi. 2019;12(3);407-412.
  • 16-Chun ED, Rodgers PE, Vitale CA, Collins CD, Malani PN. Antimicrobial use among patients receiving palliative care consultation. American Journal of Hospice and Palliative Medicine. 2010;27(4):261-265.
  • 17. Pereira J, Watanabe S, Wolch G. A retrospective review of the frequency of infections and patterns of antibiotic utilization on a palliative care unit. J Pain Symptom Manage.1998;16(6):374-81.
  • 18-Dagli O, Tasdemir E,Ulutasdemir N. Palliative care infections and antibiotic cost: a vicious circle. The Aging Male. 2020;23(2):98-105.
  • 19-Akdoğan D, Kahveci K. Evaluation Of Geriatric Infectiıons In Palliıatiıve Care Center. Turkish Journal of Geriatrics. 2018;21(4):507-514.
  • 20-Vitetta L, Kenner D, Sali A. Bacterial infections in terminally ill hospice patients. J Pain Sympt Manag. 2000;20:326–334.
There are 20 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Doğan Akdoğan 0000-0002-0970-1597

Publication Date October 18, 2021
Acceptance Date September 24, 2021
Published in Issue Year 2021 Volume: 13 Issue: 3

Cite

APA Akdoğan, D. (2021). Surveillance analysis and microbiological profiles of nosocomial infections in a palliative care center. Konuralp Medical Journal, 13(3), 519-523. https://doi.org/10.18521/ktd.986150
AMA Akdoğan D. Surveillance analysis and microbiological profiles of nosocomial infections in a palliative care center. Konuralp Medical Journal. October 2021;13(3):519-523. doi:10.18521/ktd.986150
Chicago Akdoğan, Doğan. “Surveillance Analysis and Microbiological Profiles of Nosocomial Infections in a Palliative Care Center”. Konuralp Medical Journal 13, no. 3 (October 2021): 519-23. https://doi.org/10.18521/ktd.986150.
EndNote Akdoğan D (October 1, 2021) Surveillance analysis and microbiological profiles of nosocomial infections in a palliative care center. Konuralp Medical Journal 13 3 519–523.
IEEE D. Akdoğan, “Surveillance analysis and microbiological profiles of nosocomial infections in a palliative care center”, Konuralp Medical Journal, vol. 13, no. 3, pp. 519–523, 2021, doi: 10.18521/ktd.986150.
ISNAD Akdoğan, Doğan. “Surveillance Analysis and Microbiological Profiles of Nosocomial Infections in a Palliative Care Center”. Konuralp Medical Journal 13/3 (October 2021), 519-523. https://doi.org/10.18521/ktd.986150.
JAMA Akdoğan D. Surveillance analysis and microbiological profiles of nosocomial infections in a palliative care center. Konuralp Medical Journal. 2021;13:519–523.
MLA Akdoğan, Doğan. “Surveillance Analysis and Microbiological Profiles of Nosocomial Infections in a Palliative Care Center”. Konuralp Medical Journal, vol. 13, no. 3, 2021, pp. 519-23, doi:10.18521/ktd.986150.
Vancouver Akdoğan D. Surveillance analysis and microbiological profiles of nosocomial infections in a palliative care center. Konuralp Medical Journal. 2021;13(3):519-23.