Türkiye’de Üçüncü Basamak Bir Hastanede Kandidemili Hastalarda Epidemiyoloji, Klinik Özellikler ve Mortalite Belirteçleri: Tek Merkezli Retrospektif Bir Çalişma

Öz

Amaç: Bu çalışmada hastanede yatan hastalarda kandidemi epidemiyolojisini değerlendirmeyi ve mortalite ile ilişkili risk faktörlerini belirlemeyi amaçladık. Gereç ve yöntem: Bu çalışmada 1 Mayıs 2015 ile 1 Mayıs 2016 tarihleri arasında hastaneye yatırılan kandidemili 81 yetişkin hastanın tıbbi verileri kullanıldı. Vital bulguları, klinik özellikleri, servis veya yoğun bakım ünitesi (YBÜ) yatışı, komorbiditeleri ve biyokimya bulgularını kaydettik. 30 günlük mortaliteyle bağımsız olarak ilişkili faktörleri tanımlamak için çok değişkenli lojistik regresyonda ileri koşullu dahil etme modeli kullanıldı. Bulgular: Yıllık kandidemi insidansı 10.000 kişi başına 23 vakaydı (%0.23). En sık tespit edilen üç tür ise C. albicans (%46,91), C. parapsilosis (%29,63) ve C. glabrata (%8,64) oldu. 30 günlük mortalite oranı %59,26 (n=48) olarak bulundu. Çok değişkenli lojistik regresyon ile, ileri yaşın (OR: 1.037, 95% CI: 1.006 - 1.070, p=0.018), yoğun bakım ünitesine yatışın (OR: 3.325, 95% CI: 1.132 - 9.766, p=0.029) ve akut böbrek yetmezliğinin (OR: 3.383, 95% CI: 1.024 - 11.173, p=0.046) bağımsız olarak mortaliteyle ilişkili olduğu gösterildi. Sonuç: Merkezimizde yıllık kandidemi insidansının %0,23 olduğunu ve 30 günlük mortalite oranının oldukça yüksek olduğunu ortaya çıkardık. Yaşlı hastalar, yoğun bakım ünitesine kabul edilen kişiler ve böbrek fonksiyon bozukluğu olan kişiler artmış mortalite riskiyle karşı karşıya kalabilir; bu popülasyonlarda yakından izlem önemlidir.

Anahtar Kelimeler

• Kandidemi mortalite
• Kandidemi epidemiyoloji
• Kandidemi klinik bulgu

Epidemiology, Clinical Features and Predictors of Mortality in Patients with Candidemia in a Tertiary Care Hospital in Turkiye: A Single-Center Retrospective Study

Öz

Objective: We aimed to evaluate the epidemiology of candidemia among hospitalized patients and identify risk factors associated with mortality. Materials and methods: The medical data of 81 adult patients with candidemia who were hospitalized between May 1, 2015 and May 1, 2016 constituted the study. We recorded vital signs, clinical characteristics, ward or intensive care unit (ICU) interventions, comorbidities, and biochemistry findings. To identify factors independently associated with 30-day mortality, a forward conditional inclusion model was used in multivariable logistic regression. Results: The annual incidence of candidemia was 23 cases per 10000 individuals (0.23%). The three most frequently detected species were C. albicans (46.91%), C. parapsilosis (29.63%) and C. glabrata (8.64%). The 30-day mortality rate was 59.26% (n=48). Multivariable logistic regression showed that older age (OR: 1.037, 95% CI: 1.006 - 1.070, p=0.018), ICU admission (OR: 3.325, 95% CI: 1.132 - 9.766, p=0.029) and acute renal failure (OR: 3.383, 95% CI: 1.024 - 11.173, p=0.046) were independently associated with mortality. Conclusion: We revealed an annual candidemia incidence of 0.23% and a notably high 30-day mortality rate at our center. Older patients, individuals admitted to the ICU, and those with renal dysfunction may face an elevated risk of mortality, underscoring the importance of close monitoring in these populations.

Anahtar Kelimeler

• Candidemia mortality
• Candidemia epidemiology
• Candidemia clinical feature

Kaynakça

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