Kandidemi Oolgularında Candida türlerinin Dağılımı ve Sağ kalıma Etki Eden Faktörlerin Belirlenmesi

Öz

Amaç: Bu çalışmada, kandidemide etkenlerin dağılımı, risk faktörleri ve olguların sağ kalımına etki eden faktörlerin incelenmesi amaçlanmıştır. Materyal ve Metot: Ocak 2016-Haziran 2019 tarihleri arasında kan kültüründe Candida türleri üreyen erişkin hastalar çalışmaya alınmıştır. Kan kültür şişeleri BACTEC FX-40 (Becton Dickinson, MD, ABD) tam otomatize kan kültür sisteminde inkübe edilmiştir. Kolonilerin tanımlanmasında Phoenix™ (Becton Dickinson Diagnostics, ABD) otomatize sistem kullanılmıştır. Hastaların klinik özellikleri hastane kayıtlarından geriye dönük olarak incelenmiştir. Bulgular: Candida türleri, 114 hastadan alınan 261 kan kültürü örneğinde saptanmıştır. Bu hastalarda, 122 kandidemi atağı tespit edilmiştir. Klinik özelliklerine ulaşılan 75 hasta incelenmiştir. Olguların %66,6’sı kadın, yaş ortalaması 74,35±14,34 yıl ve mortalite oranı %70,7 idi. Atakların %57’sinde C. albicans üredi. C. albicans ve nonalbicans Candida (NAC) üreyen olgularda, klinik bulgular ve risk faktörleri açısından istatistiksel olarak anlamlı bir fark saptanmadı. Otuz günlük sağ kalım açısından, yoğun bakım biriminde yatış, mekanik ventilasyon, bakteriyemi ve uzun yatış süresi sağ kalan grupta daha yüksek bulunmuştur. Sonuç: Kandidemi olgularının yoğun bakım biriminde izlenmesinin, hastaların sağ kalımına olumlu etki yaptığını düşünmekteyiz .

Anahtar Kelimeler

• İnvazif kandidiyaz
• Kandidemi
• Sağkalım oranı

Distribution of Candida Species and Determination of Factors Affecting Survival in Patients with Candidemia

Abstract

Objective: It is aimed to analyze the distribution of agents, risk factors and factors affecting survival in candidemia. Materials and Methods: We included adult patients who produced Candida spp. in the blood culture between January 2016 and June 2019 to study. Blood culture bottles were incubated in the BACTEC FX-40 (BectonDickinson, MD) fully automated blood culture system. Phoenix ™ (BectonDickinsonDiagnostics) automated system was used to identify the colonies. The clinical features of the patients were retrospectively determined from the hospital records. Results: Candida species were detected in 261 blood culture samples taken from 114 patients. In these patients, 122 attacks of candidemia were detected. 75 patients who were having clinical findings were reached. 66.6% of the cases were female, mean age was 74.35±14.34 and mortality rate was 70.7%. C. albicans growth in 57% of the attacks. There was no statistically significant difference in terms of clinical findings and risk factors in cases which C. albicans and non-albicans candida (NAC) growth. In terms of the 30-day mortality, hospitalization in intensive care unite (ICU), mechanical ventilation, bacteraemia and long hospitalization duration were found higher in the surviving group. Conclusions: We think that monitoring candidemia cases in the ICU has a positive effect on patients' survival.

Keywords

• Candidemia
• Invazive candidiasis
• survival rate

Kaynakça

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