TY - JOUR T1 - Çocuk Yoğun Bakım Ünitesi'nde Kandida Sepsisi ve Risk Faktörleri TT - Candidemia and Risk Factors in Pediatric Intensive Care Unit AU - Uysal Yazıcı, Mutlu AU - Azapağası, Ebru AU - Özel, Erhan AU - Donbaloğlu, Furkan AU - Kesici, Selman AU - Öz, Fatma Nur PY - 2020 DA - May DO - 10.20515/otd.535313 JF - Osmangazi Tıp Dergisi PB - Eskişehir Osmangazi Üniversitesi WT - DergiPark SN - 1305-4953 SP - 264 EP - 268 VL - 42 IS - 3 LA - tr AB - Fungal infeksiyon sıklığı sonyıllarda artış göstermektedir. Hastane kaynaklı fungal infeksiyonların büyükbir kısmı Candida türleri ileoluşmaktadır. Günümüzde; kronik hastalık, invaziv işlem sıklığındaki artış ve genişspektrumlu antibiyotik tedavi uygulamaları sonucunda kandidemi görülme sıklığı artmaktadır.Çocuk yoğun bakım ünitelerinde en sık görülen invaziv fungal infeksiyonetkenleri Candida ve Aspergillus türleridir. İnvaziv fungal enfeksiyonlarmorbidite ve mortaliteyi artırmaktadır. Bu çalışmada çocuk yoğun bakımünitesinde izlenen Candida albicansve non-albicans Candida türlerinebağlı kandidemi gelişen olguların demografik ve laboratuvar özellikleri ilerisk faktörleri açısından değerlendirilmesi amaçlanmıştır. Çalışmaya Ocak 2014-Şubat 2018 tarihleri arasında çocuk yoğun bakım ünitesinde takip edilen, 1ay-18 yaş arası kandidemi gelişen 20 hasta dahil edildi. Kandidemi tanısıHastalık Kontrol ve Önleme Merkezi tarafından belirlenen sürveyans tanıkriterlerine göre konuldu. Her hasta için demografik veriler, klinik velaboratuvar bulguları ve uygulanan girişimler kaydedildi. Hastaların ortancayaşı 12.5 aydı ve %50 'si (n=10) kız, %50'si (n=10) erkekti. Kandidemi riskfaktörlerinden santral venöz 17 hastada (%85), nötropeni iki hastada,intraabdominal cerrahi öyküsü bir hastada mevcutken, immünsüpresif tedavi alanhasta yoktu. Kandidemi tanısı aldığında hastaların hepsi invaziv mekanikventilasyonda izlenirken, mekanik ventilatörde medyan kalış süresi 33 günolarak bulundu. En sık üreyen kandida türü C.albicans 9 (%45) idi. Non-albicans kandida 11 (%55) hastadasaptandı ve en sık görülen(%40; n=8) C. parapsilosis idi. Tüm tedaviyaklaşımlarına rağmen yedi (%35) hasta kaybedildi. C. albicans üreyen hastaların %44.4 'ü, non-albicans kandidemisiolanların %36.4'ü kaybedildi. Candida türü ile mortalite oranları arasındaistatiksel olarak anlamlı fark bulunmadı ( p>0.05). Kandidemiye yol açanrisk faktörlerinin ortadan kaldırılması, üreme olduktan sonra kateterin hızlıcaçekilmesi kandidemi mortalitesini azaltabilir. KW - Kandida sepsisi KW - çocuk yoğun bakım KW - mortalite N2 - In recent years, the incidenceof fungal infections has increased. The majority of hospital-acquired fungalinfections are caused by Candida species.Recently, with an increase of chronic diseases frequency and invasiveprocedures, the incidence of candidemia increases as a result of administrationof broad-spectrum antibiotic. The most common invasive fungal infections in thepediatric intensive care unit are Candidaand Aspergillus species. Invasivefungal infections increase morbidity and mortality. The aim of this study wasto evaluate the demographic, laboratory and risk factors of pediatric patientswho developed candidemia due to C. albicansand non-albicans Candida species inpediatric intensive care unit. In this study, 20 patients aged between 1 months and 18 years old and who developed candidemia inbetween January 2014 and February 2018 were included. The diagnosis ofcandidemia was done according to the diagnostic criteria of surveillance whichdefined by the Center for Disease Control and Prevention. Demographic data,clinica/laboratory findings, and interventions have been recorded. The medianage of the patients was 12.5 months and50% (n=10) were girls and 50% (n=10) were boys. There were 17 patients withcatheters (85%), two patients with neutropenia and one patient withintraabdominal surger; none of thepatients had history of immunosupression. All patients have invasive mechanicalventilation when they were diagnosed with candidemia. The median duration ofmechanical ventilation was 33 days. The most common isolated candida specie wasC. albicans (n=9; 45%). Non-albicansCandida species were detected in 11 (55%) patients and most common type wasC. parapisilosis (n=8;40%). Despiteappropriate treatment, 7 (%35) patients were died. In whole study group, 44% patientswith C. albicans and 36.4% ofpatients with non-albicans Candida wasdied. No statistically significantdifference was found between the mortality rates and the type of isolated candida species (p>0.05). Eliminationof risk factors leading to candidemia sepsis, rapid removal of the catheterafter candida reproduction may reduce the mortality associated with candidemia. CR - 1. 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UR - https://doi.org/10.20515/otd.535313 L1 - https://dergipark.org.tr/tr/download/article-file/781048 ER -