COVID-19 Olan ve COVID-19 Olmayan Hastaların Rektal Sürüntü Örneklerinde Kritik Dirençli Bakterilerin Retrospektif Olarak İncelenmesi

Abstract

Amaç: Vankomisine dirençli enterokoklar (VRE) ve karbapenem dirençli Gram negatif Basiller (KRGNB) ciddi hastane enfeksiyonlarına neden olmaktadır. Çalışmamızda COVID-19 olan ve COVID-19 olmayan hastalarda bu etkenlerin prevalansını ve kolonizasyon süresini araştırmayı amaçladık.

Gereç ve Yöntemler: Haziran 2019 ile Aralık 2022 tarihleri arasında Yoğun Bakım Ünitesi'nde (YBÜ) yatan tüm hastaların rektal sürüntü örnekleri retrospektif olarak VRE ve KRGNB varlığı açısından incelendi.

Bulgular: 186 COVID-19 olmayan hastanın 37'sinde (%19,9) VRE, birinde (%0,5) KR Klebsiella pneumoniae saptanmışken, 148 hastada (%79,6) hiçbir etken bulunmamıştır. Ancak 250 COVID-19 hastasının 47'sinde (%18,8) VRE ve KRGNB birlikte saptanırken, 32'sinde (%12,8) VRE, 87'sinde (%34,8) KRGNB pozitif saptandı (p<0,05). COVID-19 olmayan hastalarda VRE ve KRGNB kolonizasyon süreleri sırasıyla 10,5±2,11 ve 7±0 gün olarak belirlendi. COVID-19 hastalarında ise VRE kolonizasyon süresi 17,05±3,50 gün ve KRGNB kolonizasyon süresi 13,72±3,1 gün idi. COVID-19 hastalarında saptanan kolonizasyon süresinin, COVID-19 olmayanlara göre VRE’ler için anlamlı olarak daha fazla olduğu saptandı (p=0,0002).

Sonuç: COVID-19 olan hastalarda VRE ve KRGNB kolonizasyon oranı ve sürelerinin genellikle COVID-19 olmayanlardan fazla olması, bu hasta grubunun olası dirençli enfeksiyonlara karşı yakından takip edilmesi gerektiğini düşündürmüştür.

Keywords

• Vankomisine dirençli enterokoklar
• Karbapenem dirençli gram- negatif basiller
• COVID-19
• yoğun bakım üniteleri
• kolonizasyon süresi

A Retrospective Study of Critical Resistant Bacteria in Rectal Swab Samples of COVID-19 and Non-COVID-19 Patients

Abstract

Aim: Vancomycin-resistant enterococci (VRE) and carbapenem-resistant Gram-negative Bacilli (CRGNB) cause serious hospital-acquired infections. In our study, we aimed to investigate the prevalence and duration of colonization of these agents in patients with and without COVID-19.

Material and Methods: Rectal swabs of all patients hospitalized in the Intensive Care Unit (ICU) between June 2019 and December 2022 were retrospectively examined for the presence of VRE and CRGNB.

Results: Of 186 non-COVID-19 patients, VRE was detected in 37 (19.9%), and CR Klebsiella pneumoniae in one (0.5%), while no agent was found in 148 patients (79.6%). However, of 250 COVID-19 patients, VRE and CRGNB were detected together in 47 (18.8%), while VRE was positive in 32 (12.8%) and CRGNB was positive in 87 (34.8%) (p<0.05). In patients without COVID-19, VRE and CRGNB colonization times were determined as 10.5±2.11 std and 7 ± 0 std days, respectively. In COVID-19 patients, VRE colonization time was 17.05±3.50 std days and CRGNB colonization time was 13.72±3.01 days, and the time to negativity after colonization was determined as 12.26±1.52 days and 14.45±2.57 days, respectively. While the colonization time detected in COVID-19 patients was found to be significantly increased for VRE compared to those without COVID-19 patients (p=0.0002).

Conclusion: The higher rate and longer duration time of VRE and CRGNB colonization generally in patients with COVID-19 compared to those without COVID-19 suggests that this patient group should be closely monitored for possible resistant infections.

Keywords

• Vancomycin-resistant enterococci
• carbapenem-resistant gram-negative bacilli
• COVID-19
• intensive care units
• colonization time

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