Frequency of Resistant Microorganism Colonization and Risk Factors in Patients with Tracheostomy in Palliative Care

Öz

Introduction: Patients who had a tracheostomy for various reasons have an increased risk of infection due to the artificial opening. In this study, we aimed to determine the frequency of resistant microorganism colonization isolated from endotracheal aspirate and the risk factors for colonization in the adult population with tracheostomy in the palliative care inpatient service. Materials and Methods: Patients with tracheostomy who were hospitalized and followed up in the palliative care service between April 2022 and August 2023 were retrospectively examined and the microorganisms in aspirate cultures and antibiotic resistance status were determined. Results: There were 74 tracheal aspirate cultures obtained from a total of 46 patients. There were 36 (78.3%) patients who had extensive drug resistance (XDR) or pan drug resistance (PDR) microorganisms in the culture. While the frequency of resistant colonization was found to be significantly higher in patients hospitalized in intensive care in the last three months (p = 0.04), no significant relationship was found between other clinical conditions and comorbidities. Discussion: We believe that adherence to isolation practices and appropriate antibiotic use can lower mortality rates and healthcare expenses in patients being monitored with tracheostomy, where colonization of resistant microorganisms is common.

Anahtar Kelimeler

• Palliative care
• tracheostomy
• resistant microorganism
• tracheal aspirate culture
• antibiotic resistance

PALYATİF BAKIM SERVİSİNDE TRAKEOSTOMİLİ HASTALARDA DİRENÇLİ MİKROORGANİZMA KOLONİZASYON SIKLIĞI VE RİSK FAKTÖRLERİ

Öz

Giriş: Çeşitli nedenlerle trakeostomi açılmış olan hastalarda yapay açıklık nedeniyle artmış enfeksiyon riski mevcuttur. Bu çalışmamızda, palyatif bakım servisinde trakeostomili erişkin popülasyonda endotrakeal aspirattan izole edilen dirençli mikroorganizma kolonizasyon sıklığının ve kolonizasyon için risk faktörlerinin belirlenmesi amaçlandı. Gereç ve Yöntemler: Palyatif bakım servisinde Nisan 2022–Ağustos 2023 tarihleri arasında yatırılarak takip edilen trakeostomili hastalar retrospektif olarak incelenip aspirat kültürlerinde üreyen mikroorganizmalar ve antibiyotik direnç durumları belirlendi. Sonuç: Toplam 46 hastadan elde edilen 74 trakeal aspirat kültürü mevcuttu. 36(%78,3) hastanın kültüründe extensively drug resistance (XDR) veya pan drug resistance (PDR) üreme vardı. Son üç ay içinde yoğun bakım yatışı olan hastalarda dirençli kolonizasyon sıklığı anlamlı olarak yüksek bulunurken (p=0,04) diğer klinik durumlar ve komorbiditeler arasında anlamlı ilişki bulunmadı. Tartışma: Dirençli mikroorganizma kolonizasyonunun sıklıkla görüldüğü trakeostomi ile takip edilen hastalarda izolasyon kurallarına uymanın ve akılcı antibiyotik kullanımının mortaliteyi ve sağlık masraflarını azaltacağını düşünmekteyiz.

Anahtar Kelimeler

• Palyatif bakım
• trakeostomi
• dirençli mikroorganizma
• trakeal aspirat kültürü
• antibiyotik direnci

Kaynakça

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