İKİ FARKLI YOĞUN BAKIMDA KANDİDEMİ RİSK FAKTÖRLERİNİN DEĞERLENDİRİLMESİ

Öz

Amaç: Bu çalışmada, Anesteziyoloji ve Reanimasyon Yoğun Bakım Ünitesi ve Nöroloji-Nöroşirürji Yoğun Bakım Ünitesinde kandidemi ile ilişkili risk faktörlerinin değişkenlik gösterip göstermediğinin belirlenmesi amaçlandı.

Gereç ve Yöntemler: Çalışmaya Ocak 2014-Kasım 2019 tarihleri arasında Karadeniz Teknik Üniversitesi Sağlık Araştırma ve Uygulama Merkezi’nde kandidemi tanısı alan 110 erişkin hasta dâhil edildi. Hastalara ait demografik, klinik ve laboratuvar özellikleri; hasta dosyaları, enfeksiyon kontrol komite verileri ve enfeksiyon hastalıkları ve klinik mikrobiyoloji konsültasyon formlarından elde edildi. T-testi ve Ki-kare testiyle veriler değerlendirildi. İstatistiksel anlamlılık değeri p<0.05 olarak kabul edildi.

Bulgular: Hastaların yaş ortalaması 62.5±19.5 /yıl idi. Hastaların %52.7 (n=58)’si erkek, %47.3 (n=52)’ü kadındı. Etkenlerin %47.3 (n=52)’ü Candida albicans, %52.7 (n=58)’si non-albicans Candida spp. idi. Yoğun bakım üniteleri arasında steroid kullanımı (p=0.001), total parenteral nütrisyon kullanımı (p=0.021) ve hemodiyaliz (p=0.005) açısından istatistiksel anlamlı farklılık vardı. Çalışmamızdaki kandidemi hastalarında genel mortalite oranı %59.1 (65/110)’di. C. albicans'ın etken olduğu hastalarda mortalite %63.5 (33/52), non-albicans Candida spp.’de %55.2 (32/58) olarak tespit edildi.

Sonuç: Yoğun bakım ünitelerinde kandidemi için risk faktörleri etkenlere ve ünitelere göre değişkenlik gösterebilmekte ve yüksek mortalite ve morbiditeye neden olabilmektedir. Çalışmamızda total paranteral nutrisyon kullanımı, steroid kullanımı, hemodiyaliz, santral venöz kateter ve cerrahi girişim önemli risk faktörleri olarak belirlendi.

Anahtar Kelimeler

• kandida
• kandidemi
• risk faktörleri
• yoğun bakım ünitesi

Evaluation of Candidemia Risk Factors in Two Different Intensive Care

Öz

Objective: In this study, it was aimed to determine whether risk factors related to candidemia in Anesthesiology and Reanimation Intensive Care Unit and Neurology-Neurosurgery Intensive Care Unit show variability.

Material and Methods: One hundred and ten adult patients diagnosed with candidemia at Karadeniz Technical University Health Research and Application Center between January 2014 and November 2019 were included in the study. Demographic, clinical and laboratory features of the patients; patient files, infection control committee data, and infectious diseases and clinical microbiology consultation forms were obtained. The data were evaluated by T-test and Chi-square test. Statistical significance value was accepted as p<0.05.

Results: The mean age of the patients was 62.5±19.5 /year. Of the patients, 52.7% (n=58) were male and 47.3% (n=52) were female. Type of candida was Candida albicans in 47.3% (n=52) and non-albicans Candida spp in 52.7% (n=58). There was a statistically significant difference between the intensive care units in terms of steroid use (p=0.001), total parenteral nutrition use (p=0.021) and hemodialysis (p=0.005). The overall mortality rate in patients with candidemia in our study was 59.1% (65/110). Mortality was found to be 63.5% (33/52) in patients with C. albicans and 55.2% (32/58) in non-albicans Candida spp.

Conclusion: Risk factors for candidemia in intensive care unit can vary according to factors and units and can cause high mortality and morbidity. In our study, total parenteral nutrition use, steroid use, hemodialysis, central venous catheter and surgical intervention were identified as important risk factors.

Anahtar Kelimeler

• candida
• candidemia
• risk factors
• intensive care unit

Kaynakça

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