Kardiyovasküler Girişimler için Kullanılan Santral Venöz Kateterlerden İzole Edilen Patojenlerin Değerlendirilmesi

Öz

Amaç: Bu çalışmanın amacı kardiyovasküler girişimler nedeniyle santral venöz kateterizasyon uygulanan hastalarda izole edilen patojenleri değerlendirmektir. Materyal ve Metot: Hastalar, kateter ilişkili infeksiyonların gelişimi için günlük olarak izlendi. Nisan 2017 ile Temmuz 2019 tarihleri arasında, kateterizasyondan sonra akıntı, ateş, ağrı, lenfadenopati ve kaşıntı gibi infeksiyon semptomları gösteren hastalar geriye dönük çalışmaya dahil edildi. Hastaların kateter tipleri, kateter yerleştirme bölgeleri, toplam kateterizasyon süreleri, kültür sonuçları, patojenlerin antimikrobiyal ilaçlara karşı duyarlılıkları ve dirençleri kaydedildi ve analiz edildi. Bulgular: Çeşitli endikasyonlar nedeniyle santral venöz kateterizasyon uygulanan 86 hasta çalışmaya alındı. Hastaların ortalama yaşı 52,70±17,82 yıl idi. Hastaların %62,79'unda bakteri üremesi mevcuttu. En sık kateter yerleştirme yerleri sağ subklavyen ven, sağ juguler ven ve sağ femoral venlerdi. En sık izole edilen mikroorganizma %25,58 ile S.aureus idi ve onu E. coli (%6,98), S. haemolyticus (%5,81) ve K. pneumonia (%5,81) izlemekte idi. S. aureus'un vankomisin ve linezolide duyarlı olduğu tespit edildi. Sonuç: Bu infeksiyonların insidansını etkileyen faktörler arasında kateter yerleştirme bölgesi, kateterizasyon süresi, kateter seçimi ve uygulayıcıların becerileri bulunur. Literatürdeki kateterle ilişkili infeksiyonlarda izole edilen patojenler ve bunların antimikrobiyal ajanlara duyarlılığı ve direnci hakkındaki veriler çoğunlukla eskidir. Bu konuda daha kapsamlı, çok merkezli çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• kateterizasyon
• patojenler
• kateterle ilişkili kan dolaşımı infeksiyonları
• S. aureus

Evaluation of Pathogens Isolated from Central Venous Catheters Used for Cardiovascular Interventions

Abstract

Objective: To evaluate the isolated pathogens in patients who underwent central venous catheterization due to cardiovascular procedures. Materials and Methods: Patients were monitored daily for the development of catheter related infections. Between April 2017 and July 2019, patients who exhibited infection symptoms like discharge, fever, pain, lymphadenopathy and itching after the catheterization were included in this retrospective study. Patients’ catheter types, catheter insertion sites, total catheterization durations, culture results, sensitivities and resistances of pathogens against antimicrobial drugs were recorded and analyzed. Results: Eighty-six patients who underwent central venous catheterization due to various indications were included. Mean age of patients was 52.70±17.82 years. Bacterial growth was found in 62.79% of patients. The most common catheter insertion sites were right subclavian vein, right jugular vein and right femoral vein. The most commonly isolated microorganism was S. aureus by 25.58% followed by E.coli (6.98%), S. haemolyticus (5.81%) and K.pneumonia (5.81%). S. aureus was detected to be sensitive to vancomycin and linezolid. Conclusion: Factors affecting incidence of these infections include catheter insertion site, catheterization duration, catheter selection and skills of the practitioners. Data in literature about the pathogens isolated in catheter-related infections and their sensitivity and resistance to antimicrobial agents are mostly old. Further comprehensive, multicenter studies are needed on this issue.

Keywords

• catheterization
• pathogens
• catheter related bloodstream infections
• S.aureus

Kaynakça

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