Üçüncü Basamak Hastanede Sağlık Hizmeti ile İlişkili Kandidemilerin Epidemiyolojisi ve Mikrobiyolojik Özellikleri: Tek Merkez Deneyimi

Year 2020, Volume: 7 Issue: 1, 12 - 17, 28.04.2020

Sevil Alkan Çeviker Özgür Günal Süleyman Sırrı Kılıç Eda Köksal Alper Tahmaz

Abstract

Kandida kaynaklı kan dolaşımı enfeksiyonu veya kandidemi, en sık görülen ve mortalitesi yüksek olan kandidaya bağlı sistemik enfeksiyondur. Bu enfeksiyonunu çoğu sağlık hizmeti ilişkili enfeksiyon (SHİE) olarak karşımıza çıkar. Bu çalışmada, kandideminin yıllar içerisindeki dağılımı ve bu enfeksiyonun gelişimi açısından epidemiyolojik, mikrobiyolojik ve mortalite ile ilişkili faktörlerin incelenmesi planlandı. Bu çalışmada Ocak 2014-Nisan 2019 tarihleri arasında hastanemiz tüm kliniklerinde sağlık hizmeti ilişkili (SHİ) kandidemi saptanan hastalar retrospektif olarak incelendi. Çalışma döneminde, toplam 150 kandidemi tespit edildi. Kandidemi gelişen hastaların yaş ortalaması 56.25±11.8 ve 90 (%60)’ı erkekti. Kan kültürlerinden izole edilen Candida türlerinin 124 (%82.66)’ü C. albicans, 26 (%17.33)’sı non-albicans Candida idi. En sık kandidemi edinilme yeri, yoğun bakım ünitesi (%88) idi. Kandidemiler odak açısından değerlendirildiğinde; laboratuvar tarafından doğrulanmış kan dolaşım enfeksiyonu 63 (%42) hastada, santral venöz kateter ilişkili kan dolaşımı enfeksiyonu 36 (%24) hastada ve sekonder kan dolaşım enfeksiyonu (KDE) 51(%34) hastada tespit edildi. En sık sekonder KDE odağı kateter ilişkili üriner sistem enfeksiyonu (%82.3) idi. Kandidemilerde düzeltilebilen risk faktörlerinden biri olan invazif kateter ve foley sondaların gereksiz kullanımının azaltılmasının, sağlık bakımı ile ilişkili kandidemi gelişimini engelleyebileceği kanaatindeyiz.

Keywords

Kandidemi, Kan Dolaşım Enfeksiyonu, Sağlık Hizmeti İlişkili Enfeksiyon

Supporting Institution

yok

Project Number

yok

Epidemiology and Microbiologic Characterization of Health Care Associated Candidemia In a Tertiary Hospital:Single Center Experience

Abstract

Candida-induced bloodstream infection or candidemia is the most common and high mortality systemic infection due to candida. Most of these infections occur as health care-associated infections (HCAIs). In this study, it was planned to investigate the distribution of candidaemia over the years and the epidemiological, microbiological and mortality related factors for the development of this infection. In this study, patients, who were found to have health care-associated (HCA) candidemia in all clinics of our hospital between January 2014 and April 2019, were analyzed retrospectively. During the study period, a total of 150 candidemia was detected. The mean age of the patients who developed candidemia was 56.25±11.8 and 90 (60%) were male. Of the Candida species isolated from blood cultures, 124 (82,66%) were C. albicans and 26 (17.33%) were non-albicans Candida. The most common site of candidemia was intensive care unit (88%). Candidemias were evaluated in terms of focus; laboratory-confirmed bloodstream infection was detected in 63 (42%) patients, central venous catheter-related bloodstream infection in 36 (24%) patients, and secondary bloodstream infection (BSI) in 51 (34%) patients. The most common secondary BSIfocus was catheter related urinary tract infection (82.3%). We believe that reducing unnecessary use of invasive catheters and foley catheters, which are one of the correctable risk factors in candidemias, may prevent the development of health care-associated candidaemia.

Keywords

Bloodstream İnfection, Candidemia, Health Care-Associated İnfection

Project Number

yok

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